Preventing Adverse Drug Events With a Long-Term Care Pharmacy

April 15, 2026

Adverse drug events remain one of the most significant and preventable threats to resident safety in long-term care settings. These events include any harmful or unintended reaction to a medication, whether caused by incorrect dosing, drug interactions, unnecessary medications, or improper administration.

In facilities where residents often take multiple prescriptions daily, the risk of adverse drug events increases quickly. Age-related changes in metabolism, complex health conditions, and frequent transitions of care all contribute to the challenge. For administrators and clinical leaders, preventing these events is essential for protecting residents, maintaining compliance, and avoiding costly hospitalizations.

A long-term care pharmacy plays a central role in reducing adverse drug events. Through structured oversight, clinical expertise, and ongoing collaboration with facility staff, a consulting pharmacy creates multiple layers of protection that improve safety and strengthen operations.

Why Adverse Drug Events Are So Common in Long-Term Care

Residents in long-term care settings often require complex medication regimens. Chronic conditions such as heart disease, diabetes, cognitive impairment, and chronic pain frequently require multiple therapies that must be carefully balanced.

Several factors increase the likelihood of adverse drug events in these environments:

Polypharmacy, where residents take five or more medications daily
Frequent medication changes following hospital stays
Multiple prescribers who may not have full visibility into a resident’s complete medication list
Age-related changes in drug metabolism and sensitivity
High workloads for nursing staff managing large medication passes

Even when each medication is prescribed appropriately, the combination of therapies can create unintended consequences. Without consistent oversight, small issues can escalate into serious clinical events.

Preventing these outcomes requires a coordinated, proactive approach.

Medication Reviews as a First Line of Defense

Routine medication reviews are one of the most effective tools for preventing adverse drug events. In long-term care, these reviews are typically conducted monthly by a consulting pharmacist and focus on each resident’s full medication profile.

During a medication review, the pharmacist evaluates:

Drug–drug interactions
Duplicate therapies
Appropriate dosing based on age and kidney function
Medications without clear clinical indication
High-risk medications that may require closer monitoring

These reviews are not passive checklists. Pharmacists analyze trends, review lab values when available, and assess whether each medication still aligns with the resident’s current condition and goals of care.

When concerns arise, pharmacists communicate recommendations to prescribers. Adjustments may include dose changes, therapy substitutions, or discontinuation of unnecessary medications.

This ongoing review process ensures that medication regimens evolve with the resident rather than remaining static. Continuous evaluation reduces the likelihood of harmful interactions and inappropriate therapies.

Medication Cart Audits That Catch Issues Early

Medication storage and organization play a critical role in safe administration. Medication cart audits provide another layer of protection by ensuring that medications are stored, labeled, and handled correctly.

During a medication cart audit, pharmacists assess:

Proper labeling of all medications
Accurate resident identification
Correct storage conditions, including temperature requirements
Expiration dates
Organization of medications to reduce confusion during administration

These audits help identify risks before they lead to errors. For example, expired medications or improperly labeled packaging can result in incorrect administration. Disorganized carts increase the likelihood of missed or duplicated doses during busy med passes.

Medication cart audits also reinforce compliance with state and federal regulations. Facilities are required to maintain strict standards for medication storage and handling, and regular audits help ensure readiness for surveys.

By maintaining a clean, organized, and compliant medication system, facilities reduce the risk of preventable errors that can lead to adverse drug events.

Deprescribing as a Strategy for Risk Reduction

As medication lists grow, so does the potential for harm. Deprescribing offers a structured approach to reducing unnecessary medications and minimizing risk.

Deprescribing involves the careful evaluation and discontinuation of medications that no longer provide benefit or may pose unnecessary risk. This process is guided by clinical judgment and carried out in collaboration with prescribers.

Common targets for deprescribing in long-term care include:

Sedatives and sleep aids that increase fall risk
Duplicate therapies within the same drug class
Medications prescribed for short-term conditions that were never discontinued
Therapies that no longer align with a resident’s care goals

Reducing the number of medications simplifies regimens and lowers the chance of interactions. It also decreases the burden on nursing staff responsible for administration.

Deprescribing supports compliance with regulations that require facilities to avoid unnecessary medications. More importantly, it improves resident safety and quality of life by reducing side effects such as sedation, confusion, and dizziness.

Nurse Education That Strengthens Daily Practice

Even the most carefully designed medication regimen depends on accurate administration. Nursing staff play a central role in preventing adverse drug events, and ongoing education is essential for maintaining safe practices.

A long-term care pharmacy provides targeted education that supports nurses in managing medications effectively. Training sessions may focus on:

Recognizing signs of adverse drug reactions
Proper documentation for PRN medications
Best practices for medication administration
Identifying high-risk medications and understanding their potential side effects

Education often extends beyond formal training sessions. Pharmacists provide on-the-floor guidance during visits, answering questions and reinforcing best practices in real time.

This support builds confidence among staff and encourages proactive communication. Nurses who feel comfortable identifying and reporting concerns are more likely to catch potential issues early.

Stronger education leads to greater consistency in medication administration, which directly reduces the likelihood of adverse events.

Coordination Across the Care Team

Adverse drug events often occur when communication gaps exist between providers, pharmacies, and facility staff. A long-term care pharmacy helps close those gaps by serving as a central point of coordination.

Pharmacists collaborate with prescribers to clarify orders, recommend adjustments, and ensure that all parties have accurate, up-to-date information. They also assist with medication reconciliation during transitions of care, such as hospital discharges.

Accurate reconciliation is especially important. Discrepancies in medication lists are a common source of errors, particularly when new medications are added without discontinuing previous therapies.

By maintaining clear communication and accurate records, a consulting pharmacy reduces confusion and ensures that each resident’s medication plan is consistent across all providers.

Technology That Supports Safer Medication Management

Many long-term care pharmacies integrate with electronic health records and e-prescribing systems. These tools improve accuracy and reduce manual errors associated with transcription and documentation.

Technology allows for:

Real-time updates to medication orders
Improved tracking of medication changes
Faster communication between pharmacy and facility
Enhanced visibility into resident medication profiles

These systems support safer medication management by ensuring that staff are working with the most current information. Timely updates reduce the risk of administering outdated or incorrect medications.

The Broader Impact of Preventing Adverse Drug Events

Preventing adverse drug events has far-reaching benefits for both residents and facilities. Residents experience improved safety, fewer complications, and better overall quality of life.

Facilities benefit from:

Reduced hospitalizations and emergency transfers
Lower liability risk
Improved survey outcomes
Greater staff efficiency and confidence

Fewer adverse events also support stronger relationships with families and referral sources. When facilities demonstrate a commitment to medication safety, trust grows and reputation improves.

A Safer Approach to Medication Management

Adverse drug events are not inevitable. With the right systems in place, many of these events can be prevented through careful oversight, collaboration, and education.

A long-term care pharmacy provides the structure needed to manage complex medication regimens safely. Through medication reviews, medication cart audits, deprescribing efforts, and nurse education, a consulting pharmacy reduces risk at every stage of the medication process.

For facilities seeking to improve safety while maintaining efficiency and compliance, partnering with a long-term care pharmacy offers a practical and effective solution.

Support Safer Care With Angus Lake Healthcare

Angus Lake Healthcare partners with long-term care facilities to reduce medication-related risks and support better outcomes for residents and staff. From medication reviews to staff education, our team provides the tools and expertise needed for safer medication management.

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