Differences in Medicare Quality Measures among Nursing Homes after Pharmacogenetic Testing

The number of medications prescribed to nursing home residents exceeds that taken by patients in any other medical setting largely because of the wide variety and severity of chronic comorbid conditions [1]. On average, nursing home residents take 8.8 medications and about a third take >9 medications per day, which increases the chances of drug interactions and medication-related problems (MRPs). A MRP is as an event or circumstance involving treatment that actually or potentially interferes with optimal medical care [2]. Nursing home residents are often frail and vulnerable, and hence are more susceptible to MRPs [3]. In a study of more than 13,000 nursing home residents in the U.S., the prevalence of polypharmacy (n ≥ 9 medications) was estimated to be 40% [4]. However, in a geriatric patient with multiple co-morbidities, polypharmacy may be unavoidable. Hence, an area of emphasis now is to try to minimize the use of potentially inappropriate medications (PIMs) in older adults [5-9]. Routinely prescribed psychiatric medications that are a common cause of adverse drug event (ADE)-driven emergency room visits, are also a substantial financial burden for the patient, the health care system, and the society as a whole [10-12].