clinical focus
Checks and balances
Research suggests medication goes unchecked in aged care .
By Conor Burke
New research shows that only
one in five Australians receive a government-funded medication review after entering an aged care facility .
Lead researcher Dr Janet Sluggett from the University of South Australia said the findings point to potential dangers for aged care residents , and she believes medication management demands greater attention .
“ Residents are taking an average of 10 different medicines each day and this often includes medicines that need close monitoring such as antipsychotics , opioids , insulin and blood thinners ,” Sluggett said .
“ These medicines can have beneficial effects for some people . But we ’ ve seen a sharp increase in the use of medicines that , when used incorrectly , can cause side effects such as drowsiness , confusion , falls and hospital visits .”
The safe prescription and management of medication in residential aged care has been an issue highlighted by the royal commission time and again , and they have advised that regular medication reviews should be a national priority area for people taking high-risk medicines such as antipsychotics .
It has been estimated that about 80 per cent of people in residential care with dementia are on one form of psychotropic – be that antipsychotics ,
antidepressants or sedatives – but experts believe that only around 10 per cent of those might benefit .
It has also been found that aged care residents are often prescribed antipsychotics for longer than two years on average . This was equivalent to more than 80 per cent of the time they had been living in care and without a single adjustment to the dose in over a year .
Government guidelines limit the use of these medications to 12 weeks , and only for people with severe behaviours of a certain type .
Sluggett said some welcome changes have been made to the program since the study was conducted , but more needs to be done .
“ People who receive a medication review can now get an extra two follow-up visits from a pharmacist and a variety of doctors can refer a resident for the service , in addition to the GP ,” she said .
“ But we still urgently need strategies to address medication safety issues for all of those in aged care who aren ’ t getting their schedules reviewed .”
The study , published by the Registry of Senior Australians at SAHMRI in the Journal of the American Medical Directors Association , reveals that the medication review service is chronically under-used ; just 6 per cent of all facilities in Australia reviewed more than half of all new residents ’ medication programs .
COTA SA chief executive Jane Mussared said the findings show that medication
“
Residents are taking an average of 10 different medicines each day and this often includes medicines that need close monitoring .
reviews need to happen regularly in aged care homes .
“ The evidence base for regular medication reviews as we age is well established and compelling . That many residents of aged care miss out is appalling ,” Mussared said .
Meanwhile , Sluggett said that aged care residents who may be concerned about their medications should ask their GP for a review .
“ There is no charge for a medication review when your doctor provides a referral letter . If you , or a family member are living in an aged care facility and would like to have your medicines checked , ask your pharmacist , GP or nurse about how to access this free service ,” Sluggett said .
“ There is a similar medication review service available for people living in their own home .” ■ agedcareinsite . com . au 19