Medication reviews linked to lower death risk in aged care

Matt Woodley

11/07/2022 5:06:34 PM

But fewer than one in four residents in aged care facilities are accessing the free service, new research has revealed.

Medication review.
Residents tracked in a recent study who had a medication review within a 12-month period had a 5% lower risk of death.

A new Australian study has linked medication reviews to a lower risk of death for aged care residents.
The Registry of Senior Australians study, led by Dr Janet Sluggett, followed 57,719 residents living in aged care homes across Australia for up to a year, analysing whether they were hospitalised, went to the emergency department (ED), or died.
It found that residents who had a medication review within that 12-month period had a 5% lower risk of death.
‘There was no difference in the risk of hospitalisation between residents who had a medication review and those who hadn’t, the impact was solely based on mortality rates,’ Dr Sluggett said.
The study was completed in response to the recommendation from the Royal Commission into Aged Care Quality and Safety, which called for the evaluation of the medication review system.
But despite the apparent benefit of the medication reviews, only 22% of residents involved in this study access the free service, despite all of them being eligible.
Previous research has shown that the number of older people taking five or more medicines increased by 52% between 2006 and 2017, despite evidence that it places patients at risk of harm and is associated with poor clinical outcomes.
In aged care the issue is even more prevalent, as residents take an average of 10 medications each day, yet only one in five receive a medication review from a pharmacist, which typically identifies up to four problems per person.
Meanwhile, another recent ROSA study, focusing on the differences in medication use before and after a review, found use of some medications tends to decrease following a review.
‘Reviews often show which medicines can be adjusted or stopped, reducing the burden on the resident and boosting the quality of care,’ Dr Sluggett said.
‘There’s a clear link between getting a review and a reduction in the use of some medicines, such as those for reducing reflux, which are often taken for longer than needed.’
Dr Sluggett says a lack of awareness among GPs and aged care providers about the utility of medication reviews for residents is a barrier that needs to be addressed.
‘A key component of this is building strong relationships between pharmacists, GPs and providers, together with residents and their families, so that all parties are on the same page, resulting in the highest possible level of care,’ she said.
‘We hope this will be facilitated by the [Federal] Government’s recent announcement of $345.7 million in new funding for pharmacists to work onsite in aged care homes from January 2023.’
The research team is calling for medical practitioners to be more diligent in making referrals for medication reviews and encouraging aged care residents to be proactive in asking their GP for a review.
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Dr Roberto Celada   12/07/2022 4:36:38 PM

Absolutely agree. I have two fantastic pharmacist and both are very proactive in encouraging me to refer and take action on these medication reviews. I have learnt so much from their feedback. The process is very well remunerated. Item 903. Of course, to make it useful for the resident you have to be diligent in understanding the review and making positive pharmacological changes.

Dr Andrew Robert Jackson   12/07/2022 4:45:58 PM

So pharmacists get $345M in "new" funding for this work.
And all the researchers can do is criticise GPs for not being "diligent" enough. It might have been more helpful had they called for more funding for GPs in this poorly-remunerated area of residential aged care work.