Medicine safety for older Aussies ‘a game of Russian roulette’

The Pharmaceutical Society of Australia believes our most vulnerable are being put at risk.

Medicine risk for older Australians

A new report from the Pharmaceutical Society of Australia (PSA) shows that medicine safety for older Australians is a game of Russian roulette and our most vulnerable are being put at risk every day.

PSA president Associate Professor Chris Freeman says the Medicine Safety: Aged Care report sounds an urgent alarm about the need to tackle medicine safety in aged care.

“The royal commission has shone a light on significant shortcomings in residential aged care,” Assoc. Prof. Freeman said.

“Unfortunately, our report has found we are also neglecting vulnerable older Australians when it comes to protecting them from medicine-related harms.

“One of the most shocking findings of our report is that 20 per cent of unplanned hospital admissions for aged care residents are a result of inappropriate medicines use.”

Half of all aged care residents are taking medicines that cause sedation or confusion, with 20 per cent taking antipsychotics and more than half of these residents taking these medicines for far too long.

“While medicines are meant to help patients, in many instances these types of medicines can make symptoms worse, cause excessive drowsiness and make residents more likely to experience significant injury from a fall,” Assoc. Prof. Freeman said.

“Pharmacists are medicine experts and in collaboration with other health professionals and carers can help identify and diminish the risk of medicine side-effects and harmful interactions. One way pharmacists already do this is through medication reviews.

“Currently, these can generally only be conducted once every two years. When they are, nearly all aged care residents have at least one problem with their medicines and most have three problems.”

The government has gone some way to addressing this by providing $25.5 million to improve medication management programs to reduce the use of medication as a chemical restraint on aged care residents and at home, and new restrictions and education for prescribers on the use of medication as a chemical restraint.

“The commonwealth government has recognised the need to address medicine safety and quality use of medicines and declared medicine safety as the 10th National Health Priority Area,” said Assoc. Prof. Freeman.

“This commitment needs to translate into actions and sustainable funding. When it comes to protecting older Australians, we must support pharmacists to spend more time in aged care and enable them to conduct more frequent medication reviews and follow-ups.

“Pilot programs which have embedded pharmacists in the aged care team have achieved demonstrable improvements in medicine safety and quality use of medicines.”

Jean Fry, a resident of Goodwin David Harper House, said there were many benefits in having a pharmacist in residential aged care homes.

“In my opinion, every nursing home should have its own pharmacist to help residents maintain independence and safety regarding their medications,” Ms Fry said.

Peter Heaume, the son and representative of parents Jane and Ern who are aged care residents, said it was invaluable having a pharmacist take the time to explain each drug and its purpose to him.

“It gave me confidence that I could make an informed decision, and both understand and agree to the changes proposed. I found it very informative and also beneficial,” he said.

Pharmacists in aged care can provide training and advice on medicines to support others involved in the care of residents.

“Aged care staff, trying to do the right thing, often alter medicines,” said Assoc. Prof. Freeman. “For example, if a resident finds it difficult to swallow, they may crush a medicine, not realising this can negatively impact its efficacy.”

PSA has a 10-point plan to protect older Australians from medicine harm and is calling on the commonwealth to implement these recommendations in order to keep aged care residents safe.

“Pharmacists are key to improving the quality and safe use of medicines in aged care. We look forward to working with the government, the aged care sector, other healthcare professionals, residents and families to improve this untenable situation,” Assoc. Prof. Freeman said.

Should there be more access to pharmacists in aged care homes?

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    COMMENTS

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    Laura52
    27th Feb 2020
    11:40am
    I am a clinical hospital and community pharmacist with 30 years of experience, working closely with hospital physicians and general practitioners. I definitely have to say yes to this due to the errors I have discovered, from inappropriate dosing, which includes over and underdosing, drug interactions and incorrect administration of medication. Elderly people in particular metabolise medications differently , especially with renal and liver function, compared to a younger person and require constant monitoring of their medication. Some elderly people may not even need to be on certain medications, 0 when it is no longer needed but still continue to take it, due to lack of communication and medication reviews. I can use my father as an example, who is 86, who had recently had his dosages of two medications reduced, after I consulted with his cardiologist, who stated he really didn't need to be on the previous dosages, and dad feels better.
    KSS
    27th Feb 2020
    12:48pm
    This smacks of the PSA continuing their obsession with empire building and becoming doctors without completing a medical degree.

    Yes they know drugs BUT they do NOT know the health profile of the patient. The PSA are pushing more and more for pharmacists to be involved in prescribing and administering drugs over the counter with little to no medical investigation. It started with the flu vax and has now broadened to travel vacconations, the abortion pill and they want to be able to prescribe antibiotics for things such as UTIs. Basically they want to be doctors without doing the study.

    People in aged care are frequently medicated for inconvenient behaviours with their GP sidelined in favour of a doctor who will just prescribe the sedating medication. Pharmacists, whether on site or not, are not in a position to prevent that.

    Family members such as those in the article, should be having those discussion about the value and purpose of any medication with the doctor at the point of prescription niot waiting until they are dispensed or administered. Yes the pharmacist would be able to answer questions ABOUT THE DRUG but they would be unable to answer anything about the effects of that drug on the individual patient as they do not have the medical history. Nor do they always know what other medications the patient may be on.

    Pharmaists clearly have a role to play but they are no substitute for the doctors no matter what the PSA claim.
    Laura52
    27th Feb 2020
    2:47pm
    irst of all KSS, I am NOT a member of the PSA for many reasons and I DO NOT believe that pharmacists should give injections, prescribe antibiotics...which I refuse to do. I DOUBT that prescribing antibiotics by pharmacists will happen. Not all pharmacists agree with this. As for the health profile of the patient, clinical pharmacists in a hospital setting have access to it and consult with hospital physicians or general practitioners for medication reviews. Also many family members do not understand medication, and prefer health professionals such as pharmacists, nurses or doctors (if they have the time..which they often do not, so doctors ASK patients to consult the pharmacist as this happens to me a lot) to explain it to them...in simple terms. I have a Bachelor of Honours in Science, Pharmacology as well as in Pharmacy, so I am a PHARMACOLOGIST by training and I have the knowledge to explain the medication. Doctors usually ask pharmacists to explain the effects of medication on any patient as clinical pharmacists have access to blood lab, renal and liver function and call the local GP and pharmacy to make sure not other medications are missed on the patients profile. I hope this clarifies the issue on what pharmacists actually do. By the way, for your information, as a clinical pharmacist I PREVENTED A BABY FROM BECOMING DEAF and HAVING KIDNEY FAILURE, after checking the medical history etc, as I prevented a major antibiotic overdose, written by prescribing physician....medication issues happens a lot the hospital and aged care system.
    Laura52
    27th Feb 2020
    1:23pm
    First of all KSS, I am NOT a member of the PSA for many reasons and I DO NOT believe that pharmacists should give injections, prescribe antibiotics...which I refuse to do. I DOUBT that prescribing antibiotics by pharmacists will happen. Not all pharmacists agree with this. As for the health profile of the patient, clinical pharmacists in a hospital setting have access to it and consult with hospital physicians or general practitioners for medication reviews. Also many family members do not understand medication, and prefer health professionals such as pharmacists, nurses or doctors (if they have the time..which they often do not, so doctors ASK patients to consult the pharmacist as this happens to me a lot) to explain it to them...in simple terms. I have a Bachelor of Honours in Science, Pharmacology as well as in Pharmacy, so I am a PHARMACOLOGIST by training and I have the knowledge to explain the medication. Doctors usually ask pharmacists to explain the effects of medication on any patient as clinical pharmacists have access to blood lab, renal and liver function and call the local GP and pharmacy to make sure not other medications are missed on the patients profile. I hope this clarifies the issue on what pharmacists actually do. By the way, for your information, as a clinical pharmacist I PREVENTED A BABY FROM BECOMING DEAF and HAVING KIDNEY FAILURE, after checking the medical history etc, as I prevented a major antibiotic overdose, written by prescribing physician....medication issues happens a lot the hospital and aged care system.
    KB
    27th Feb 2020
    4:31pm
    I agree that there should be a pharmacist on site. Just coming out of hospital the pharmacist explained the effects of the medication. As for my late mother she was given a whole heap of drug prescribed by different doctors. More extensive knowledge of these drugs would have been useful to know when she did come home from respite care
    KB
    27th Feb 2020
    4:31pm
    I agree that there should be a pharmacist on site. Just coming out of hospital the pharmacist explained the effects of the medication. As for my late mother she was given a whole heap of drug prescribed by different doctors. More extensive knowledge of these drugs would have been useful to know when she did come home from respite care
    Laura52
    27th Feb 2020
    4:47pm
    So glad to hear that you were counselled on your medications! Yes, going to different doctors poses a huge problem with drug interactions and side effects, the need for medication...again all due to lack of communication between the different prescribers and aged care provider.
    Eddy
    27th Feb 2020
    9:09pm
    Pharmacists are an invaluable resource. My little story is going to my local pharmacy to get some cough medicine for a nagging dry throat and cough. I selected a nationally advertised brand which I thought would do me good. The pharmacist asked if it was for me which I confirmed. He told me I should not take that particular brand as it would interfere with my blood pressure medication, he recommended another brand. I took his advice but on reaching home queried Google. My pharmacist was right.
    Laura52
    28th Feb 2020
    1:16pm
    Thanks for your supportive comment...shows how patient care is important to pharmacists. You sound like a lovely person that a pharmacist would love to help!
    Laura52
    2nd Mar 2020
    8:23am
    I do not know as I cannot provide an answer for a generalised, superficial question. Are you inquiring about and speaking "critically of pharmacists in general "? You will need to ask the 32,000 registered in Australia according to the Australian Pharmacy Board. The PSA can answer this question for you. I googled their phone number for you :) Here is their phone number: Contact us on 1300 369 772 Monday to Friday, business hours. You can direct your grievance and other issues with the PSA, as stated by you in this comments section to them :)
    Blossom
    4th Mar 2020
    12:04am
    One thing that really annoys me is the fact that if you have to go to the Emergency Dept and are supplied with medication they only prescribe enough for 2 - 3 days. If it is just before or during a weekend you can't always see your GP as soon as you are supposed to. They have to Squeeze you in - especially if it is a small medical centre.


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