National estimates of medication use in nursing homes: findings from the 1997 medicare current beneficiary survey and the 1996 medical expenditure survey

OBJECTIVES: To provide the first nationwide estimates of medication use in nursing homes (NHs) and to introduce a new data set for examining drug use in long-term care facilities. DESIGN: Cross-sectional comparison. SETTING: NH medication files from two nationally representative data sets, the 1997 Medicare Current Beneficiary Survey (MCBS) and the 1996 Medical Expenditure Panel Survey-Nursing Home Component (MEPS-NHC). PARTICIPANTS: NH residents in the MCBS (n=929, weighted n=2.0 million) and MEPS-NHC (n=5,899, weighted n=3.1 million). MEASUREMENTS: Estimates include characteristics of facilities and residents, average number of drugs used per person per month, and the prevalence and duration of use by select therapeutic drug classes. RESULTS: NH residents received, on average, seven to eight medications each month (7.6 MCBS, 7.2 MEPS-NHC). About one-third of residents had monthly drug regimens of nine or more medications (31.8% MCBS, 32.4% MEPS-NHC). The most commonly used medications in NHs, in descending order, were analgesics and antipyretics, gastrointestinal agents, electrolytic and caloric preparations, central nervous system agents, anti-infective agents, and cardiovascular agents. CONCLUSION: These estimates serve as examples of the first national benchmarks of prescribing patterns in NHs. This study highlights the usefulness of the MCBS as an important new resource for examining medication use in NHs.