Aged care QUM ‘long overdue’ says SHPA

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Embed pharmacists in all healthcare settings providing care for older Australians, says the SHPA

The Society of Hospital Pharmacists has reiterated the need for dedicated, embedded Geriatric Medicine Pharmacist roles to improve the safe, quality care of older Australians.

It has issued what it calls a landmark statement in response to the Royal Commission into Aged Care Quality and Safety’s Final Report: Care, Dignity and Respect.

SHPA’s Geriatric Medicine and Aged Care Clinical Pharmacy Services Position Statement outlines five priorities to mitigate the risks of medication-related harm in older Australians, including the employment of Geriatric Medicines Pharmacists in all healthcare services and settings in which medicines are provided to older people; their utilisation in broader outreach services, Aged Care Assessment Teams and Psychotropic Stewardship programs; and the universal use of Interim Medication Administration Charts.

SHPA Geriatric Medicine Chair Gauri Godbole says studies indicate 20% of all medications used in older Australians are potentially inappropriate.

“Older people constitute a growing proportion of Australians, and currently account for 42% of hospital admissions, and 22% of emergency department presentations,” she says.

“Crucially, up to 30% of hospital admissions of older people are medication-related, and approximately half are preventable.

“Medications are essential in treating chronic health conditions in older people and, when used safely, are effective and improve quality of life.

“However, if overprescribed, poorly monitored, or otherwise mismanaged, medications have the potential to cause adverse effects and may cause or worsen geriatric syndromes and symptoms such as dementia, delirium and incontinence and increase the risk of falls.”

Ms Godbole says concerted hospital pharmacist intervention will support older people at risk of harms associated with the inappropriate use of antipsychotics identified by the Royal Commission.

“We know pharmacist-led Psychotropic Stewardship programs can ensure coordinated interventions improve, monitor and evaluate the use of antipsychotics in older patients, as a safeguard against inappropriate chemical restraint.

“Similarly, research overwhelmingly supports the value of including pharmacists in Aged Care Assessment Teams to identify and mitigate medication-related issues before harm and hospitalisation, as well as the use of interim charting to reduce medication administration delays and errors when patients transition between healthcare services.”

SHPA Chief Executive Kristin Michaels says that with decision-makers now equipped with overwhelming evidence, now is the time to act.

“The shocking testimony of the Aged Care Royal Commission has highlighted the importance of Quality Use of Medicines and Medicines Safety as Australia’s tenth National Health Priority Area,” she says.

“The five measures identified by the SHPA Geriatric Medicine Leadership Committee will ensure specialised, targeted care is readily available to improve the health and wellbeing of these vulnerable populations, while aligning with recommendations 38, 58 and 65 in the Royal Commission’s Final Report.

“This is more than good policy – it is the right thing to do, and it is long overdue.”

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