This study assessed the frequency of physician contacts for individual nursing home resi
dents (NHRs) and investigated whether the frequency of contacts influences the appropriateness of pain medication in NHRs.
Design
Observational cross-sectional study conducted between March 2009 and April 2010.
Setting
Forty nursing homes in Berlin and Brandenburg, Germany.
Participants
A total of 560 NHRs.
Measurements
The number and type of NHR physician contacts were obtained by face-to-face interviews. To assess the appropriateness of pain medication, the German version of the Pain Medication Appropriateness Scale (PMASD) was used. The influence of physician contacts on the appropriateness of pain medication was calculated with a linear mixed-effect model.
Results
The proportions of NHRs with at least 1 contact with their attending physicians were 61.8% (primary care physicians), 55.2% (general practitioners), 9.6% (neurologists), 9.4% (other), 5.4% (internists), 2.2% (orthopedic surgeons), and 0.7% (psychiatrists). The number of all physician contacts correlated weakly with the appropriateness of pain medication (r = 0.166, P = .039). With every physician contact, the PMASD score rose by about 2 points (P = .056).
Conclusions
Physician care in German nursing homes is mainly provided by primary care physicians. A higher number of physician contacts had a modest impact on more appropriate pain medication use.
