Aug 16, 2018

Overuse of medications in aged care a “major concern”: study

Aged care facilities in Australia have “high rates and inappropriate use” of psychotropic medications, according to a new study by the University of Tasmania.

The study ‘More Action Needed: Psychotropic prescribing in Australian residential aged care’, says its findings reveal “major concerns” and change is “urgently required”.

The nation-wide study of 11,300 residents in 150 aged care facilities found that nearly two-thirds (61 per cent) of aged care residents were taking psychotropic medications regularly.

More than 30 per cent were charted for benzodiazepines as required, and 11 per cent for as required antipsychotics. More than 16 per cent were taking sedating antidepressants, mainly mirtazapine.

The report noted the high rate of medications prescribed ‘PRN’, or ‘as required’, despite research has shown that occasional ‘prn’ prescribing of psychotropic agents is associated with a significantly higher risk of falls in older people.

“This means, in effect, that the practice of prescribing benzodiazepines ‘prn’, with the intention of reducing adverse effects, may inadvertently increase the risk of harm,” the report states.

“Horrifying” findings reveal “elder abuse: article

The Australian reported that the Royal College of GPs said the findings of the research are “horrifying” and warned that aged-care homes can no longer be thought of as safe places. The article also said University of NSW conjoint professor of psychiatry Carmelle Peisah condemned the medication practices as “elder abuse”.

Use of medication in aged care must meet community standards: LASA

Leading Age Services Australia (LASA) CEO Sean Rooney said the inappropriate or unsafe use of medication in residential aged care is something that all Australians should be concerned about.

He said that medication is an important component of caring for the aged, in particular in caring for people with dementia and mental illness.

“Older people with dementia and mental illness can have challenging behaviours that may put themselves or others at risk,” Mr Rooney said.

But he said use of medication must meet community standards.

“We support a multi-disciplined approach to ensuring there is safe and appropriate medication management within residential aged care, with any use of medications also meeting community expectations about the rights of older people.”

Changes to medication management will be introduced in Australia over the next 12 months. The new Aged Care Quality and Safety Commission begins on 1 January 2019 and the new quality standards come in on 1 July 2019. Both will cover medication and chemical restraint issues, and will include recommendations on restraints made in the Carnell Paterson review, in particular decision-making tools to limit the use of restrictive practices.

“We all want safe and high quality aged care. Our older Australians need and deserve it,” Mr Rooney said.

Protecting the rights of residents

Joe Hijazi, Chief Pharmacist of Best Health Solutions, told HelloCare, “Ensuring residents of aged care facilities are not being prescribed and administered inappropriate medication, is an important aspect in meeting the rights of residents under the aged care standards.

Mr Hijazi said digital medication management systems can help aged care facilities make better medication decisions and identify where inappropriate use might be occurring.

“Powerful reporting tools from electronic medication management systems, such as BESTdose, allow the entire healthcare team to make better clinical decisions thus, resulting in better resident care,” he said.

“Identifying cases of inappropriate medication use is the first step to facilitating change.

“Visibility over the use, types and instances of medications within an aged care facility allow for identification of cases like chemical restraint.”

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