Four in five new residents missing out on medication review

Just over one in five aged care residents received a medication review within 90 days of entering an aged care facility, a new study shows.

The research from the Registry of Senior Australians at the South Australian Health and Medical Research Institute analysed the data of 143,676 residents across all 2,799 aged care facilities nationally between 2012 and 2015.

It investigated how many new residents received a federally-funded Residential Medication Management Review, which involves a pharmacist checking all prescribed medicines and making recommendations for improvements.

Current guidelines recommend residents receive a medication review as soon as possible after they move into an aged care facility.

However, lead researcher Dr Janet Sluggett said they found the service underutilised with approximately one in five new residents receiving a medication review in the first three months.

“There was a lot of variation between facilities in the percentage of residents who received an early medication review,” Dr Sluggett told Australian Ageing Agenda.

It ranged from 0 per cent in around 300 facilities to 100 per cent in four facilities.

“There was only 6 per cent of aged care facilities where more than half of all new residents got a medication review,” said Dr Sluggett, a senior research fellow with University of South Australia.

She said the findings highlighted potential dangers for aged care residents, who are often in their 80s, frail and take many medications.

“We know that residents on average are taking 10 different medications regularly every day. And then they have when required medicines and short-term medicines like antibiotics on top of that,” Dr Sluggett said.

“We know that the combination of taking lots of medications, but also age related changes in our bodies can make us a bit more susceptible to problems with medicine.”

It is surprising the government-funded service is not more widely used because RMMRs have been in place for more than 20 years.

“It’s a very well-established service and a government subsidised service. There are no out of pocket costs for residents or family members,” she said.

The study also found that residents with dementia or those whose first language wasn’t English were more likely than other residents to get a medication review within 90 days of entering the facility.

“We think that’s a positive finding because with both of these groups of people, there may sometimes be difficulties communicating about medicines and about side effects,” Dr Sluggett said.

Dr Sluggett recognised there were welcome changes to the RMMR program in April, which now allows other medical professionals including geriatricians, psychiatrists, palliative and pain medicine specialists to refer medication reviews.

However, she said more needs to be done to ensure residents receive medication reviews when they enter aged care.

“Medication safety is everyone’s responsibility. It’s a shared responsibility and so therefore, I think it needs a team approach to tackle this issue,” she said.

She said all stakeholders need to be more aware about the importance of medication reviews.

“Raising awareness among staff is important because they can potentially identify residents who may benefit from a review and flag them for referral,” Dr Sluggett said.

“Raising awareness among family members and residents themselves is important because then they can prompt and ask for medication review when they would like to have their medicines looked at.”

The study is published in the Journal of the American Medical Directors Association

Access the study here.

This story has been updated for accuracy

Comment on the story below. Follow Australian Ageing Agenda on Facebook, Twitter and LinkedIn, sign up to our twice-weekly newsletter and subscribe to AAA magazine for the complete aged care picture.