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New research has shown medication reviews are linked to a lower risk of death for aged care residents.
The study – from the Registry of Senior Australians at the South Australian Health and Medical Research Institute – followed 57,719 aged care residents in homes across Australia for up to a year.
Researchers – led by Dr Janet Sluggett – then analysed whether the residents were hospitalised, went to the emergency department, or died during that period.
Dr Sluggett and her team found that individuals who had a medication review within a period of a year had a 5 per cent lower risk of death. “That’s a really important finding,” Dr Sluggett told Australian Ageing Agenda. “It’s the first study to show that medication reviews are associated with a lower risk of death.”
The researchers found that – at the 12-month follow-up stage – 22.2 per cent of residents who had undergone a medication review had passed away compared to 23.3 per cent of those who didn’t receive a medication review.
“So it’s not an absolute reduction, but it’s more of a relative reduction,” said Dr Sluggett. “But I was pleasantly surprised by the association in the reduction in mortality.”
There was no difference in the risk of hospitalisation between residents who had a medication review and those who hadn’t, “which is somewhere that I thought we might see a difference,” said Dr Sluggett.
Funded by the Australian Association of Consultant Pharmacy, the study also found that only 22 per cent of residents underwent a medication review, despite every resident being eligible to access the free service.
This is in line with earlier findings, said Dr Sluggett. “We’ve previously shown that only one in five residents receive a medication review in the first three months after entering an aged care facility, so it’s something that we’ve shown consistently across a number of different studies now.”
Another recent ROSA study – also funded by the AACP – focused on the differences in medication use before and after a review.
“What we found was that on average the pharmacists are identifying between three and four medicines-related problems every time they do a medicines review,” said Dr Sluggett.
This may lead to a change of dosage, a tapering off or stopping medicines altogether or starting medicines that might be necessary for untreated or unmanaged conditions.
“There’s a number of changes that can be recommended as part of that medicines review process,” said Dr Sluggett. “Certainly the goal is to improve healthcare outcomes and quality of life for that resident.”
Need for a more streamlined process
Obtaining a medication review involves multiple steps. First, a doctor’s referral is required. A pharmacist then needs to visit a resident in an aged care facility to make recommendations, before the doctor and nursing staff can implement any changes.
Dr Sluggett told AAA that the system needs to be streamlined. “There are some complexities in the process and there can be barriers at each of those stages to make it difficult to provide the review,” she said.
It’s anticipated that once pharmacists begin working onsite in aged care homes from January 2023, there will a substantial increase in the number of medication reviews said Dr Sluggett. “Hopefully that will help to reduce some of those barriers.”
Dr Sluggett is calling for all stakeholders to play a role in identifying residents who could benefit from a medication review. “That can come from the aged care providers, also from the residents and family members themselves, GPs and pharmacists,” she said. “I think everyone has a shared responsibility.”