Retirement and nursing homes Another key aspect of drug safety is the adequate handling of psychotropic medication. Without question, treatment with psychotropic medication is one of the most important pillars of modern psychiatric therapy. Having said that, in the interest of those affected a clear indication and careful application of therapeutic standards are a must in this context. In the year under review, the commissions observed several cases in which the use of psychotropic medication was questionable: Use of psychotropic medication In a Tyrolean facility, a remarkably high number of prescriptions for longterm medication (13 to 16) and additional individual medication was observed for almost all of those in need. One resident was prescribed Psychopax and Temesta at the same time. Both drugs are benzodiazepines (tranquilisers that can cause adiction). Besides, Psychopax is on the Austrian list of potentially inappropriate medication (PIM) (see also NPM Report 2014, pp. 32 et seq. and NPM Report 2015, pp. 38 et seq.) and is thus potentially inappropriate medication for elderly persons. Commission 1 was also critical of psychotropic medication being prescribed for persons who had not been diagnosed with mental illnesses in the nursing home. Even more so, as only the following indications were found: “hiccups”, “for nausea/shortness of breath”, “before showering”; for “agitation, when worried, headache, pressure in the head”. Due to the lack of availability of data on the safety and efficacy of some medication in elderly persons and the lack of evidence of the safe use of medicine in old age, the list of potentially inappropriate medication (PIM list), which is based on expert knowledge, was created for the Austrian pharmaceuticals market. 73 substances are classified as being “potentially inappropriate” for patients over 65 on the PIM list. It is assumed that avoiding this medication contributes to improving the safety of medicine-based therapy in old age. Ultimately, thanks to the many practical tips, the PIM list can also be used as a decision-making tool to support doctors when selecting a therapy. XX  Residents must be protected against polypharmacy by constantly assessing existing medication and discontinuing medicine-based therapy if it is not (no longer) necessary. XX  In particular, prescribing benzodiazepines and antipsychotics without corresponding indication or without regular evaluation of whether another prescription is necessary should stop. XX  A changed morbidity spectrum requires the interlocking of primary medical and nursing care. The collaboration between general practitioner’s surgery and nursing specialists should comprise joint case planning, effective communication and mutual understanding. 37