One-fifth of nursing home residents were receiving at least one prescription drug that was inappropriate for their diagnosis, according to an HHS review of 254 patient records at Texas nursing homes.
The review by HHS' inspector general's office also found that nearly one-sixth of those residents were receiving prescription drugs without a prescription in their patient records, and 21% were receiving drugs that could interact negatively with other drugs they're taking.
The misuse of prescription drugs has led to such adverse events as falls, delirium and depression.
Those findings were in a group of three reports sent to HCFA last week recommending better monitoring of prescription drug utilization in nursing homes. They also urged HCFA to require nursing homes to educate staff on adverse drug reactions.
Federal laws enacted in 1987 and 1990 already require HCFA to regulate the use of prescription drugs in nursing homes.
Two of the three reports focus on Texas, home to one in 10 U.S. nursing homes. A third report gives the results of a national survey of nursing home pharmacists.
Increasing use of prescription drugs by nursing home patients fueled a 21% growth in Medicare and Medicaid expenditures on drugs in Texas between 1992 and 1994. Those expenditures rose to $91.6 million from $75.5 million over that period.
Medicaid programs nationwide spent between $1 billion and $1.7 billion to provide prescription drugs to nursing home residents during fiscal 1995.
The reports note some improvements in nursing home pharmacy operations but generally cast a negative light on many practices.
One long-term-care group played down the reports. They "don't support the sense of crisis that the inspector general gives it," said Tom Burke, spokesman for the American Health Care Association.