Systematic review of medications in aged care
‘Process, impact and outcomes of medication review in Australian residential aged care facilities: A systematic review’ examined 13 studies of aged care facility medication reviews and argues there is a need for more data on clinical and resident outcomes of medication reviews.
Worldwide it is estimated that more than 43% of people in aged care receive potentially inappropriate medications. This is largely due to the tendency that as people age their medication regimen often gets long and complicated and can result in many medication-related problems (e.g. medication side effects or interactions between medication).
Residents of aged care facilities are often exposed to polypharmacy (the use of multiple medications) and high-risk medications. This review suggests that the Australian government-funded Residential Medication Management Review (RMMR) program is useful to identify and prompt resolution of medication-related problems.
The article argues there is a need for more medication review intervention studies to collect data on clinical and resident outcomes of medication reviews. This evidence on medication-related risk is needed to inform health policy and standards.
Of the 13 studies of aged care facility medication reviews of this systematic review, five reported identifying approximately four medication related problems per resident, and three studies reported that 45-84 percent of GPs rely on pharmacists’ recommendations to resolve medication related problems.
The CDPC Investigating Services Provided In the Residential care Environment for people with Dementia (INSPIRED) study found that over three quarters of residents in 17 of the participating aged care facilities used anticholinergics, sedatives or potentially inappropriate medications and the benefits of GPs and pharmacists working together to resolve these common problems.
This highlights the importance of medication reviews to identify inappropriate medications and stop medication-related problems, shown to result in poor health-related quality of life, poor psychological well-being, higher medication costs, hospitalisations and increased risk of mortality.
(Authors: Esa Y. H. Chen, Kate N. Wang, Janet K. Sluggett, Jenni Ilomaki, Sahar N. Hilmer, Megan Corlis and J. Simon Bell)