- Medication is generally not recommended according to the SmPCs by assessing documented diagnosis.
- Consideration of duplicate active drug or duplicate drug class.
- Dose is not recommended (too low, too high) or not adjusted for age, weight or renal failure according to the SmPCs.
- Interaction described by the database used and considered as clinically relevant by using all available clinical parameters (e.g., laboratory data).
Inappropriate administration time
- Administration time is not recommended according to the SmPCs.
Inappropriate drug form
- Drug form is not appropriate for residents’ intake practices (e.g., chewing medication).
Inappropriate treatment duration
- Treatment duration is not recommended (too long, too short) according to the SmPCs.
Inappropriate medication for indication or concomitant condition
- A medication is prescribed that is not the recommended medication choice according to clinical therapy guidelines for the documented diagnosis or concomitant condition.
Insufficient drug treatment
- Additional medication is required according to clinical therapy guidelines by assessing the documented diagnosis.
Potentially inappropriate medication
Unclear indication for drug
- Medication without a clear indication according to the SmPCs is used by assessing documented diagnosis.
Medication use problems
- Missing medication package according to the medication chart; Lack of recommended resident name reference on medication package; Usage of medication after expiration date.
- Comparison of residents medication charts with the current dispensed medication (in cups or dose administration aids prepared for administration in advance) in terms of wrong medication, wrong dose, omission, additional not prescribed medication, wrong time, not recommended division of tablets or not recommended removal from primary packaging according to the SmPCs.
- Not recommended crushing of tablets or opening of capsules according to the SmPCs; Crushing of several tablets at the same time; Mixing of crushed and liquid medications.
- Comparison of residents medication charts with current medication administered to the residents in terms of wrong resident, wrong medication, omission, additional not prescribed medication, wrong time, no attention to individual intake problems (e.g., chewing the medication), which would require a different preparation.
Incomplete or unclear documentation in the medication records
- No clear identification of the medication; No clear identification of dose or drug form when several are available; Wrong or missing information for required drug preparation or administration (e.g., crushing of tablets); Missing information for PRN medication (e.g., no minimal or maximal dose); Discrepant information (e.g., more than one medication chart available with discrepant information for medications).