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Medication goes unchecked in aged care: research

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 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,” Dr Sluggett 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 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.”

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