Hillen JB, Vitry A, Caughey GE. Medication-related quality of care in residential aged care: an Australian experience.
Int J Qual Health Care 2019;
31:298-306. [PMID:
30113692 DOI:
10.1093/intqhc/mzy164]
[Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 05/16/2018] [Accepted: 07/17/2018] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE
To describe medication-related quality of care (MRQOC) for Australian aged care residents.
DESIGN
Retrospective cohort using an administrative healthcare claims database.
SETTING
Australian residential aged care.
PARTICIPANTS
A total of 17 672 aged care residents who were alive at 1 January 2013 and had been a permanent resident for at least 3 months.
MAIN OUTCOME MEASURES
Overall, 23 evidence-based MRQOC indicators which assessed the use of appropriate medications in chronic disease, exposure to high-risk medications and access to collaborative health services.
RESULTS
Key findings included underuse of recommended cardiovascular medications, such as the use of statins in cardiovascular disease (56.1%). Overuse of high-risk medications was detected for medications associated with falls (73.5%), medications with moderate to strong anticholinergic properties (46.1%), benzodiazepines (41.4%) and antipsychotics (33.2%). Collaborative health services such as medication reviews were underutilised (42.6%).
CONCLUSION
MRQOC activities in this population should be targeted at monitoring and reducing exposure to antipsychotics and benzodiazepines, improving the use of preventative medications for cardiovascular disease and improving access to collaborative health services. Similarity of suboptimal MRQOC between Australia and other countries (UK, USA, Canada and Belgium) presents an opportunity for an internationally collaborative approach to improving care for aged care residents.
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