Prescribed medicines for elderly frail people with diabetes resident in nursing homes-issues of polypharmacy and medication costs

Aims To describe the numbers and costs of medications prescribed to people living with diabetes resident in nursing homes in one primary care trust in the UK. Methods A retrospective case notes review of 75 people with known diabetes who were resident in the 11 nursing homes in the Coventry teaching primary care trust. Results Sixty-three residents (84%) were being prescribed four or more medications. Forty-four residents (59%) were prescribed anti-platelet drugs for prevention of cardiovascular disease, including aspirin, clopidogrel and dipyridamole, and 31 residents (41%) were on statin therapy. Eighteen (24%) residents had a monthly medication cost that was above £101 per month. On detailed review, these were largely residents who were being prescribed special order liquid preparations, usually for secondary cardiovascular disease prevention. Conclusion Polypharmacy, defined as taking four or more drugs per day per resident, is highly prevalent within this population of care home residents with diabetes. A high proportion of residents are prescribed drugs for cardiovascular disease prevention, which may be entirely inappropriate in this population with limited life expectancy. Regular medication review of care home residents with diabetes should be undertaken as it has the potential to reduce costs, minimize adverse drug reactions and increase health gain.