AUSTRALIAN pharmacists have sounded an urgent alarm over the excessive use of psychotropic drugs by aged care residents.
A recent report commissioned by the Pharmaceutical Society of Australia looks at the extent of medicine harms in aged care. It describes the situation as a "game of Russian routlette with older Australians paying the price with either their life or their quality of life".
Prepared by the Use of Medicines and Pharmacy Research Centre at the University of South Australia, the Medicine Safety: Take Care report paints a damning picture of drug administration in aged care homes with one in five residents taking antipsychotics and more than half of these taking the medications for too long.
The report said that on average residents of age care homes take nine to 11 different medications and half of all residents are taking medicines that cause sedation or confusion.
"Twenty per cent of unplanned hospital admissions for aged care residents are a result of inappropriate medicine use," it added.
According to the report nearly all aged care residents in Australia had at least one medicine-related problem with most having three or more problems, including dangerous and life-threatening drug interactions, and medicine dosage problems including overdosing.
In the report's foreword PSA national president Associate Professor Chris Freeman said "We need to do more for our older Australians living in residential aged care and those supported at home.
"Medicines are developed, prescribed and dispensed for supporting good health and to keep people well. In a large number of circumstances for older Australians, the opposite is happening.
"Now is the time to do more for residents of aged care in Australia. To provide a safe environment that minimises medicine harm and maximises the role of pharmacists as the stewards of medicine safety to prevent this harm from occurring."
The report revealed more than 95% of people living in aged care facilities have at least one problem with their medicines detected at the time of a medicines review; most have three problems. One in six medicine-related problems are due to adverse medicine reactions. Six per cent of people living in aged care were administered at least one potentially hazardous medicine combination.
In addition half of all people living in aged care facilities were prescribed medicines that are considered potentially inappropriate in older people and one in five unplanned hospital admissions among people living in aged care facilities was the result of taking medicines generally considered potentially inappropriate for older people.
Almost half of all of people living in aged care are on medicines that have the potential to cause sedation or confusion and 50 per cent of people with dementia are taking medicines with anticholinergic properties, which can worsen confusion and other symptoms of dementia.
Up to one-third of people living in aged care are taking benzodiazepines; more than half use the medicine for too long and half to three-quarters of people on proton pump inhibitors use the medicine for too long.
The stories from patients and their families are distressing. Chemical restraint should only be used as a last resort.
Speaking at the launch of the report Minister for Regional Health Mark Coulton stressed the importance of improving aged care medicine safety.
"The stories from patients and their families are distressing," he said. "Chemical restraint should only be used as a last resort."
Professor Freeman said pharmacists were the key to improving the quality and safe use of medications in aged care settings.
The report's recommendations include embedding pharmacists into aged care teams and removing the caps on the number of medicines reviews that pharmacists can perform.
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