Study shows benefits of on-site pharmacists

New research from the University of South Australia shows an acute need for additional pharmaceutical support within the aged care sector.

Lead researcher Professor Libby Roughead said, currently, residents only receive a medication review every two years, or earlier if required. “Our research highlights the need for personalised and continuing support by pharmacists more frequently.”

Working with 248 aged care residents across 39 aged-care facilities in South Australia and Tasmania, the study – funded by the Australian Government Department of Health – assessed the effectiveness of pharmacist-led interventions. 

Over 12 months, pharmacists met with residents every eight weeks to record any new illnesses or conditions and to monitor any adverse effects or symptoms. They also reviewed residents’ medicines and monitored cognitive and physical health.

At each visit, pharmacists found 60 per cent of residents had problems with their medicines. They made 309 recommendations to change residents’ medications or monitor their medications with a view to change and – for almost two-thirds of the cohort – recommended reduced medicine use.

One-in-five aged care residents were also found to have experienced an adverse effect due to their medicines; over half of which were preventable.

In its May Budget, the former government announced funding for on-site pharmacists to improve medication management in aged care facilities. The scheme is due to commence January 2023.

Professor Roughead welcomed the move and called it “an essential step forward.” However, she said the initiative should encompass holistic pharmaceutical support, with a focus on efforts to reduce harms from medicines.

“It’s important to realise that the new on-site pharmacists will not only need to monitor and review medications, but also be able to recognise the early onset of medicine-induced deterioration, such as changes in a person’s cognition or activity, so as to prevent harms such as injurious falls or delirium,” she said.

The study notes that medicines cause the most frequent harm in the healthcare system – the harm is also the most preventable. “Older people are the most frequent users of medicines and experience the most harm, particularly older persons in aged care,” said the report’s authors.

Harm can occur as a direct result of the pharmacodynamic effects of the medicine or result from the effects of the medicine on cognition, activity, strength or appetite. There is “significant evidence demonstrating that medicine use is associated with frailty,” which contribute to adverse health outcomes, the authors added.

“More comprehensive support will not only avoid the many medicine-induced health issues currently experienced by aged-care residents but may also help in preventing frailty and declining cognition,” said Professor Roughead.

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