Effect of comprehensive pharmaceutical services on drug use in long-term care facilities.

The effect of comprehensive pharmaceutical services on drug consumption and cost in long-term care facilities was studied over an eight-year period. Medication administration records for 1970-1977 were obtained for all patients in three long-term care facilities served by a centralized pharmaceutical service. Services included unit dose drug delivery, drug use and chart review, and medical staff consultation. Data from a 10% sample of 4,004 patient records were analyzed. A significant (p less than 0.05) decline in the number of prescription drugs (42.8%) and the number of prescription doses (34.6%) consumed occurred over the eight-year period. The number of nonprescription drugs decreased significantly by 34.4%, but consumption of nonprescription drug doses was not changed significantly. When adjusted for inflation, the average monthly medication bill per patient decreased 28.9%, with the average for Medicaid patients being significantly (p less than 0.001) greater than that for private-pay patients. No significant changes occurred in the therapeutic categories of drug use. Centralized pharmaceutical services, pharmacist consultation and drug use review significantly reduced drug use and medication costs in the facilities studied.