Long-Term Care Drug
 Database System (LTCDDS)

The Long-Term Care Drug Database System (LTCDDS) is an automated query system that will allow data users to search for drugs taken by nursing home residents sampled in the 2004 National Nursing Home Survey (NNHS). Currently, this system is under development and is not yet available to the public. In the meantime, the data user can obtain useful drug information in the PDF files described below.

The first file, the technical notes, contains information on how the medication data were collected and processed. The data dictionary gives the layout of the 531 variables in this public-use file.  The last two files provide key information to help data users 1) search for medications by brand, generic, and ingredient names and 2) analyze the medication data in the public-use file. These two files, in particular, serve as a substitute for the information that will be available through the LTCDDS later this year. All four documents can be accessed by clicking on their appropriate titles below.

Technical Notes for the 2004 NNHS Prescribed Medications (PM) Public-Use File
The technical notes provide general information on how the medication data were collected, how one can download the PM Public-use File, and how to link the PM Public-Use File with the resident file. The appendix provides the 1995 National Drug Code (NDC) Directory of the therapeutic drug class(es) and codes assigned to medications reported in the 2004 NNHS.

2004 NNHS Data Dictionary: Prescribed Medications Public-Use File
The data dictionary provides the variable name and type, length, file position, field description, and variable values for each field in the PM Public-Use File. The frequencies of select variables are also given to assist in verifying the integrity of the data file and layout.

Drug Estimates and Characteristics
This file gives important information on medications taken by nursing home residents sampled in the 2004 NNHS. The first two fields show the drug name and drug name code.  The next two fields, Drug Estimates and Drug Rate per 10,000 residents, reveal if the medication was taken by any sampled residents and if the medication(s) of interest has enough cases to perform meaningful analyses. The remaining fields provide the drug characteristics for the medications: generic name, generic name code, prescription (Rx) status, Drug Enforcement Agency (DEA) status, composition (Comp) status, drug ingredients, ingredient codes, and drug class codes.

There are a few things to note when using the Drug Estimates and Characteristics file. The true estimate of use of a medication by nursing home residents is based on the multiple forms in which a drug name may appear in the public-use file:

As the drug name (i.e., what is actually recorded in the CAPI instrument based on the information provided to the interviewer by the facility respondents, whether a trade name, generic name, or desired therapeutic effect such as “allergy relief”);

As generic name (for single-ingredient generic substances); and

As ingredient name (for combination products).

If, for example, a data user searches for the drug name, Lasix, he or she will automatically scroll to the record that provides the number of nursing home residents who took Lasix in 2004. However, some facility respondents may have called the drug Furosemide, which is the generic name for Lasix. In this case, the user must type in the name Furosemide. He or she will be taken to the record where Furosemide appears as the drug name (because the drug name reflects what is entered in the CAPI system by the field interviewer). On the other hand, some data users might start their query for this medication by searching for Furosemide as the drug name (for cases where it was entered this way in the CAPI system), but this record will not reflect those cases where the drug name was entered as Lasix in the CAPI. Searching on a single term, therefore, will not give him or her a complete picture of the utilization of this substance.

The user should keep in mind that the generic codes and drug codes are independent of each other. For example, the generic code for Furosemide (52385) is different than the drug name code for Furosemide (13118).

If a data user wishes to check all occurrences of the generic substance Furosemide, he or she should search for it as a generic name. The record for Furosemide will include all occurrences of the substance whether they were entered by the interviewer using the drug name of Lasix or Furosemide. However, if the substance of interest can also occur as an ingredient in a combination product, the user should also search for the substance in the ingredient list to get a more complete picture. Searching for drugs by ingredient name is more labor-intensive but provides another useful way to determine drug estimates.

Drugs by NDC Class
This file lists each therapeutic class in the NDC directory and the medications in the LTCDDS that fall within each class. This is a quick and easy reference to learn which medications are assigned to each therapeutic class.

Guidance on Search Criteria in the Drug Estimates and Characteristics PDF file:

Drug Name: The specific medication name entered by the field interviewer, as told to him or her by the nursing home respondent. It corresponds with information provided in the resident’s medication administration record (MAR). It may be either a trade, brand, proprietary, or generic name, but not a drug class.

Drug Name Code: A unique NCHS-assigned, five-digit code applied to each drug name recorded in the 2004 NNHS. Drugs taken include pharmaceutical agents (by any route of administration-for prevention, diagnosis, or treatment), over-the-counter medications, and vitamin, mineral, herbal or nutritional supplements. Generic as well as brand name drugs are included.

Drug Estimate: The 2004 estimate of the number of nursing home residents who took a pharmaceutical agent-by any route of administration-for prevention, diagnosis, or treatment. Generic as well as brand name drugs are included, as are nonprescription and prescription drugs. If this field is blank, then no residents were recorded to have taken that drug.

Drug Rate per 10,000 Residents: The number of nursing home residents per 10,000 who took a particular drug, as identified by its drug name code.

Generic Name: The official name assigned to every drug entity by the United States Pharmacopeia/United States Adopted Names or other responsible authorities. If the drug listed is a combination medication, this entry will read "Combination Product" and will contain up to five active ingredients.

Generic Name Code: A unique NCHS-assigned, five-digit code applied to each generic, nonproprietary, or active ingredient name.

Prescription (Rx) Status: A single-digit code that identifies the federal legal status (prescription or nonprescription) of the drug entered. Prescription drugs are also referred to as legend drugs.

DEA Status: The Department of Justice, Drug Enforcement Agency (DEA), by federal law, regulates controlled medications because of their significant potential for dependence of abuse and their possible diversion into illicit channels. The Controlled Substance Act of 1970 identifies each controlled drug according to one of five schedules. Schedule I drugs, like heroin and LSD, have a higher potential for abuse and no current accepted medical usefulness for treatment in the United States. Each successive schedule, II through V, reflects a decreasing degree of dependence and potential for abuse.

Composition (Comp) Status: A single-digit code that distinguishes between drug products made of a single active ingredient versus a fixed active ingredient combination (i.e., Combination Product). From this point on, a fixed active ingredient combination drug product will be referred to as a combination drug or combination product.

Drug Ingredients: Active ingredients that compose a combination product.

Ingredient Codes: A unique NCHS-assigned, five-digit code used to identify the active ingredients of combination drugs. A maximum of five active ingredients can be identified for each combination drug.

Drug Class Codes: Codes used to identify each of 21 major therapeutic classes (and 139 subclasses) to which a drug may belong (adapted from Standard Drug Classifications in the National Drug Code (NDC) Directory, 1995). The two-digit categories are the major class and comprise subcategories (e.g., antimicrobial agents). The specific four-digit categories represent the subclasses of the major or general class (e.g., penicillin). The general two-digit codes will also include medications that do not fit into any of the corresponding subclasses (four-digit codes).

Additional Information:
Consumer information about specific drugs (including prescription uses, side effects, special precautions, etc.) is available from the American Society of Health-System Pharmacists’ searchable drug database.

For additional assistance about the Prescribed Medications Public-Use file and the PDF files containing medication estimates and drug characteristics for drugs in the public-use file, please contact the Long-term Care Statistics Branch at (301) 458-4747.

This page last reviewed October 15, 2008