On-site pharmacists halved medicine harm in aged care: report

On-site pharmacists conducting regular reviews in aged care could lower medication-related harm by 50 per cent, a new study has found.

It’s estimated that one in five older people living in aged care homes has an adverse response to medication each month despite over half of those being preventable. 

Studies suggest that frequent medication reviews by a pharmacist can significantly reduce medicine-related harm.

During the study, researchers from Canberra University and the Pharmaceutical Society of Australia (PSA) followed on-site pharmacists for 12 months across 15 ACT-based aged care facilities.

Canberra University’s associate professor of pharmacy, Sam Kosari, said periodic medication reviews could significantly reduce unplanned hospital admissions.

“Having an on-site pharmacist lowered the number of residents taking potentially inappropriate medicines,” professor Kosari said.

“We also saw that on-site pharmacists assisted in upskilling staff in medication knowledge and improved communication within the care team.”

Medication-related harm in aged care has been linked to nearly 20 per cent of unplanned hospital admissions.

Overall, up to 95 per cent of people in residential care could have medication-related issues, professor Kosari said.

Research suggests that mistakes in medication management are mainly due to human error, such as organisational mistakes and challenging working conditions.

Over 50 per cent of people in residential aged care could consistently be prescribed the wrong medication due to factors such as miscommunication.

Professor Kosari said we needed to provide more training for aged care staff and family members around medication use and management to minimise medication-related harm.

One family member who participated in the study said he felt ‘more confident talking about medication use with doctors and knew better what questions to ask.’

A residential facility manager said the number of complaints had gone from six or seven in a month to zero after more frequent pharmacist reviews were introduced.

Professor Kosari also found that fewer incidents related to anticholinergic drug use occurred.

“We also saw a reduction in the dose of antipsychotic medicines prescribed for residents,” he said.

Anticholinergic drugs are frequently prescribed in aged care to treat health conditions such as overactive bladder, gastrointestinal disorders, and asthma.

They are also used to reduce symptoms of Parkinson’s disease, depression, anxiety and other psychiatric conditions.

Yet, common side effects of anticholinergic drugs are drowsiness, dizziness, blurred vision and confusion – and are linked to increased risk of falls, fractures and injury in aged care.

The 2021 Royal Commission report emphasised the need for more allied health professionals, including pharmacists, to downsize medication-related harm into aged care. 

Professor Kosari said there is a growing recognition that a more integrated approach to pharmacists’ involvement in residential aged care is required.

“Optimising medication management is crucial to reduce the likelihood of adverse health outcomes resulting from medications,” he said.

In December 2022, the federal health department announced it would invest $345.7m to implement a program to install more on-site pharmacists in aged care.

From July 2023, aged care providers can receive funding to employ more pharmacists in their facilities. 

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