Providers urged to use therapy over meds
Researchers are calling for frequent medication reviews and non-medication-based alternatives to psychotropic medication for aged care residents to reduce falls.
New research conducted by by PhD student Narjis Batool under the supervision of Dr Nasir Wabe from the Australian Institute of Health Innovation at Macquarie University found two in five aged care residents were given potentially inappropriate psychotropic medicines over a two-year period.
The research also found that 70 per cent of the people who had received such medicines experienced at least one fall, with a third of them transferred to hospital.
The median age of the residents involved in the study was 86 years old, and two-thirds (66.7 per cent) were female, while over half of the residents had arthritis (55.7%) and dementia (51.3%).
The study drew data from three types of falls and used data from medicine administered rather than prescribed, to capture information relating to the actual use of medicines across 23 residential aged care facilities in Sydney that care for over 3,000 older people.
The research team note the results focus on aged care facilities from one provider and recognise it may not be representative of all aged care facilities nationally.
Psychotropic medicines – which can include antidepressants and antipsychotics – impact the central nervous system and can have a negative effect on balance and cognitive function, increasing the risk of falls.
To reduce these heightened fall risks, the researchers are calling for regular medication reviews in aged care homes. Dr Wabe told Australian Ageing Agenda these reviews involved comprehensive assessments by a pharmacist to identify any potentially inappropriate or high-risk medications, or unnecessary medications, drug interactions or dosing issues.
“Following the review, the pharmacist provides recommendations to the resident’s general practitioner, who is responsible for making any changes to the medication regimen. Evidence shows that medication reviews are effective in improving medication safety, reducing the use of inappropriate medicines, and lowering the risk of preventable harms,” he said.
The researchers said the findings highlighted the need for more awareness on the use of non-medication-based treatments for aged care residents experiencing mental health issues, listing alternatives such as behavioural therapy, social interaction and group activities as pathways to consider.
Dr Wabe told AAA that in recent years, many aged care facilities across Australia have already introduced a range of lifestyle-related activities for residents and while they support general wellbeing, they are typically not tailored to address mental health concerns specifically and tend to follow a one-size-fits-all approach.
“Aged care facilities can build on these existing programs by incorporating evidence-based non-medication alternatives – like behavioural therapies, structured social interaction, and group-based activities – explicitly designed to support residents with mental health conditions. For example, tailored group therapy sessions, reminiscence activities for residents with cognitive decline, or peer support programs could be integrated into daily schedules,” he said.
“While it’s well known that psychotropic medicines are associated with an increased risk of falls in older people, the scale of the issue uncovered in this study is quite surprising. The fact that 40 per cent of aged care residents were prescribed potentially inappropriate psychotropic medications, and that 70 per cent of those experienced at least one fall – with a third requiring hospitalisation – highlights the magnitude of the problem,” he added.
The complete paper was published in BMJ Open and can be found here.
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