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National Monitoring of Medication-Related Quality of Care in Residential Aged Care: Is Australia Making Progress?

  • Gillian E. Caughey
    Correspondence
    Address correspondence to Gillian E. Caughey, PhD, Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute, PO Box 11060, Adelaide, South Australia, 5001, Australia.
    Affiliations
    Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
    UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
    Discipline of Pharmacology, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
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  • Janet K. Sluggett
    Affiliations
    Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
    UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
    Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia
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  • Catherine Lang
    Affiliations
    Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
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  • Steve L. Wesselingh
    Affiliations
    Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
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  • Maria C. Inacio
    Affiliations
    Registry of Senior Australians (ROSA), South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
    UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
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Published:August 13, 2022DOI:https://doi.org/10.1016/j.jamda.2022.07.008
National Monitoring of Medication-Related Quality of Care in Residential Aged Care: Is Australia Making Progress?
Previous ArticleProviders’ Perspectives on High-Quality Dementia Care in Long-Term Care
Next ArticleValidating the Centre of Excellence on Longevity Self-AdMinistered (CESAM) Questionnaire: An Online Self-Reported Tool for Frailty Assessment of Older Adults
      In 2018, the Australian Government established a Royal Commission into Aged Care Quality and Safety.
      Royal Commission into Aged Care Quality and Safety
      Final Report: Care, Dignity and Respect. Volume 1 Summary and Recommendations.
      https://agedcare.royalcommission.gov.au/publications/final-report
      Date: 2021
      Recommendations from the final report in 2021 included national monitoring of quality of care in residential aged care facilities (RACFs) and the need to improve medication-related care to reduce medication-related harms and improve resident well-being.
      Royal Commission into Aged Care Quality and Safety
      Final Report: Care, Dignity and Respect. Volume 1 Summary and Recommendations.
      https://agedcare.royalcommission.gov.au/publications/final-report
      Date: 2021
      Over the past decade, the health status of those entering RACFs in Australia has worsened, together with increased frailty and polypharmacy.
      • Inacio M.C.
      • Lang C.
      • Bray S.C.E.
      • et al.
      Health status and healthcare trends of individuals accessing Australian aged care programmes over a decade: the Registry of Senior Australians historical cohort.
      Intern Med J. 2021; 51: 712-724
      Studies have shown that 44% to 73% of RACF residents use 1 or more potentially inappropriate medications, including high-risk medications such as opioids and antipsychotics.
      • Sluggett J.K.
      • Harrison S.L.
      • Ritchie L.A.
      • et al.
      High-risk medication use in older residents of long-term care facilities: prevalence, harms, and strategies to mitigate risks and enhance use.
      Sr Care Pharm. 2020; 35: 419-433
      ,
      • Pharmaceutical Society of Australia
      Medicine Safety: Aged Care.
      Pharmaceutical Society of Australia, Canberra, Australia2020
      Internationally, many countries mandate the monitoring and reporting of medication-related quality of care in residential long-term care with the aim to drive improvements in quality and care outcomes.
      • Caughey G.E.
      • Lang C.E.
      • Bray S.C.
      • et al.
      International and National Quality and Safety Indicators for Aged Care.
      in: Research Paper 8. Report for the Royal Commission into Aged Care Quality and Safety. South Australian Health and Medical Research Institute, Adelaide, Australia2020
      The Registry of Senior Australians (ROSA) has developed quality indicators to examine the quality and safety of aged care using existing data sources, including 4 medication-related indicators (high sedative load, antipsychotic use, chronic opioid use, and antibiotic use) to monitor medication-related care.
      • Inacio M.C.
      • Lang C.
      • Caughey G.E.
      • et al.
      The Registry of Senior Australians outcome monitoring system: quality and safety indicators for residential aged care.
      Int J Qual Health Care. 2020; 32: 502-510
      Using these indicators, we examined if medication-related quality of care in Australia has changed over the past 5 years, using routinely collected data.
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      References

        • Royal Commission into Aged Care Quality and Safety
        Final Report: Care, Dignity and Respect. Volume 1 Summary and Recommendations.
        (Accessed January 12, 2022.)
        https://agedcare.royalcommission.gov.au/publications/final-report
        Date: 2021
        View in Article
        • Inacio M.C.
        • Lang C.
        • Bray S.C.E.
        • et al.
        Health status and healthcare trends of individuals accessing Australian aged care programmes over a decade: the Registry of Senior Australians historical cohort.
        Intern Med J. 2021; 51: 712-724
        View in Article
        • Sluggett J.K.
        • Harrison S.L.
        • Ritchie L.A.
        • et al.
        High-risk medication use in older residents of long-term care facilities: prevalence, harms, and strategies to mitigate risks and enhance use.
        Sr Care Pharm. 2020; 35: 419-433
        View in Article
        • Pharmaceutical Society of Australia
        Medicine Safety: Aged Care.
        Pharmaceutical Society of Australia, Canberra, Australia2020
        View in Article
        • Caughey G.E.
        • Lang C.E.
        • Bray S.C.
        • et al.
        International and National Quality and Safety Indicators for Aged Care.
        in: Research Paper 8. Report for the Royal Commission into Aged Care Quality and Safety. South Australian Health and Medical Research Institute, Adelaide, Australia2020
        View in Article
        • Inacio M.C.
        • Lang C.
        • Caughey G.E.
        • et al.
        The Registry of Senior Australians outcome monitoring system: quality and safety indicators for residential aged care.
        Int J Qual Health Care. 2020; 32: 502-510
        View in Article
        • Gerlach L.B.
        • Fashaw S.
        • Strominger J.
        • et al.
        Trends in antipsychotic prescribing among long-term care residents receiving hospice care.
        J Am Geriatr Soc. 2021; 69: 2152-2162
        View in Article

      Article Info

      Publication History

      Published online: August 13, 2022
      Accepted: July 10, 2022
      Received: July 5, 2022

      Publication stage

      In Press Corrected Proof

      Footnotes

      This work was supported by a Hospital Research Foundation Mid-Career Fellowship (MCF-27-2019) and an NHMRC Investigator Grant (APP119378). J.K.S. is supported by a National Health and Medical Research Council (NHMRC) Early Career Fellowship (APP1156439).

      The authors declare no conflicts of interest.

      Identification

      DOI: https://doi.org/10.1016/j.jamda.2022.07.008

      Copyright

      © 2022 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

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