What is the most common medication complaint?

A Tasmanian pharmacist set out to research medication complaints in aged care, finding nearly half related to basic medicine administration

A pharmacist has reviewed consumer feedback on medication use in residential aged care to find out how medicines in these facilities can be managed better.

University of Tasmania Associate Professor Juanita Breen approached the Aged Care Quality and Safety Commission to do the research, she told the National Medicines Symposium 2021 on Tuesday.

Out of over 15,000 complaints received by the Commission in 2019-20, A/Prof Breen found 1,224 individual medication complaints.

Nearly half (n=545 or 45%) of the complaints related to basic medicine administration: right resident, right medicine, right dose, right time, right route, right documentation.

Three categories of medication-related issues accounted for 751 or 61% of all complaint issues.

The first was timing of medication, which accounted for over a quarter (27%) of complaints – for example, the medicine was given late, delayed or even missed completely.

This was followed by inadequate medication management systems, processes or policies in place (22%).  A/Prof Breen explained this could even cover medicines going missing or a trolley being left unlocked.

Finally, the third most common medication-related issue in complaints related to chemical restraint (14%), for example, over sedation.

Pain medicines were commonly implicated in complaint issues, followed by medicines that cause sedation.

Opioids were the most frequently mentioned followed by psychotropics medications.

Despite comprising a seemingly small proportion of all complaints, medicine-related complaints were actually the top-ranked complaint issue of all issues in aged care over the past five years.

This is the first time aged care medication related complaints data has been analysed, said A/Prof Breen.

“This research is vitally important as it reports what matters to consumers, mostly relatives who advocate for those living in aged care,” she told AJP.

We are supposed to have consumer-directed aged care but this is often lost sight of.

“Instead, as pharmacists and researchers, we tend to focus on complexity and aspects such as cholinergic burden,” said A/Prof Breen.

“The reality is it’s the basic things like having pain medication or palliative treatment given on time or getting a trained staff member to give an insulin shot that means more.”

The high number of complaints speaks to a lack of training of staff in aged care homes, she added.

“This stresses the need for pharmacists performing QUM services to upskill staff on basic rights of administration such as medication timing and processes.

“Staff tell me they receive training infrequently and when they do it’s on topics like anticoagulants or digoxin – while important basic medication management topics need coverage first and foremost.”

A/Prof Breen has also looked into complaints specifically related to antimicrobials and is now investigating complaints relevant to restraint.

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1 Comment

  1. a gt

    Hi All,
    My brother has Parkinson’s and is in an Aged Care facility. He has multiple doses of Madopar during the day but was still coming unstuck at times. On a closer examination of the prescribed dosage regime timing with the actual timing that was happening the issue became obvious. I came up with a revised dosage regime that altered the amount of Madopar at each dosage time BUT using the dosing times that the facility used rather than trying to force the facility to match the prescribed times. Same amount of total Madopar each day but lower fluctuations in blood levels. I presented the suggestion to the GP and his specialist along with the rational and it was taken up with great results.
    An important lesson learnt that large facilities have work practices that have to be considered when setting dosage regimes for patients.

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