Furniss et al (Reference Furniss, Burns and Craig2000) report the findings from a promising trial which addresses the inappropriate use of medication in nursing homes. They conclude that a pharmacist's review followed by a reduction in medication does not necessarily increase rates of morbidity or mortality. However, one commonly used drug that was not included in their review was alcohol.
Significant rates of alcohol misuse have been recorded in nursing home settings (Reference JohnsonJohnson, 2000), and interactions between prescribed (as well as over-the-counter) medication and alcohol pose significant risks for older people drinking unregulated amounts of alcohol. Alcohol interacts with many of the commonly prescribed medications cited in the study, especially anti-depressants and sedatives. Therefore, residents in the study who drink alcohol will have benefited from the intervention of stopping medication by removing the risk of a potentially dangerous drug reaction.
As part of a survey in Bristol, I approached the managers of several residential homes to find out whether they held a policy regarding alcohol use in the home. None of the seven homes surveyed had such a policy in place, despite some residents having alcohol problems, and it was not unusual for homes to sell alcohol on the premises, either across a bar or in a shop.
Pharmacists have a key role in advising patients of potential interactions with alcohol (Reference WardWard, 1997). The provision of clear and up-to-date information about these interactions could form part of an alcohol policy in nursing and residential homes.
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