A nurse practitioner led protocol to address polypharmacy in long-term care.

The study was descriptive and used secondary analysis of preserved medication management data. Only nine residents were seen at four-month intervals for 13 visits, and 29% were seen only once. The high percentage of residents seen one or two times may have reduced the impact of the intervention. The nurse practitioners worked in a consultation role rather than as primary providers, which the authors say may have limited deprescribing. The medication count did not account for dose reductions without discontinuation. Multiple providers and medications added by emergent on-call providers could have affected the results. Facility exit, end of Medicare Part A stay, and moves to home or other facilities reduced follow-up.

The work was supported by a Centers for Medicare & Medicaid Services grant, the Enhanced Care and Coordination Project under the Initiative to Reduce Avoidable Hospitalization among Nursing Facility Residents. The supplied text does not report author conflicts of interest.

Do not read the 0.47 reduction in administration times as proof that the protocol reduced polypharmacy or improved clinical outcomes. The average number of scheduled medications did not change, and the study was descriptive.