Physicians employed full-time at a nursing home reduced prescriptions significantly, while community community physicians tended to do the opposite, a new study finds.

Investigators followed 101 long-term stay residents at the Los Angeles Jewish Home for the Aging for 12 months, with a goal of learning whether prescriptions were reduced after their first year at the facility. The study is one of the first efforts of the Brandman Research Institute to look at effective models for post-acute care for seniors. Results appeared last month in The Senior Care Pharmacist and were publicized last week by BRI.

“Readmissions rates are a huge stressor, with 30% of readmissions due to medication issues,”  said LAJH Chief Medical Officer and Brandman Executive Director Noah Marco, M.D., to McKnight’s. “We said, ‘Let’s focus on medications first.’ Our hypothesis was that people will be coming in on a large number of medications and at the end of the year, their medications will be reduced.”

But the mean number of scheduled prescriptions increased from 11.1 prior to admission to 13.3 by the end of the year, they found. Marco and team were shocked. When he and researchers dug into the data, they found that physicians employed full-time by the home ordered significantly fewer additional prescriptions. The home has five full-time geriatricians, with about the same number of community physicians also treating residents.

While more research is needed, Marco suspects that the on-staff geriatricians have a different philosophy with regards to medication.

“We’re here full time and get to know the patients. We also get to know the nursing staff and don’t have significant turnover. With that knowledge and alignment, we can create a plan,” he said.

The challenge is to find more avenues to study this patient population, he said. Marco also noted that pharmacists play a critical role in long-term care facilities.

“Just as they are playing a more important role in quality of care in the hospital, it’s incredibly important for more work to demonstrate the value of pharmacists actively involved in the day-to-day future care of this population,” he said. “I’m thankful I have such skilled pharmacists who are actively helping us create knowledge.”