Medicines reviews linked to a lower risk of death in care homes

Dr. Janet Sluggett is a Senior Research Fellow at the University of South Australia and the South Australian Health and Medical Research Institute (SAHMRI). She is a pharmacist with interests in medicines management in care homes. She tweets @JanetSluggett

New research published in Age and Ageing has shown that comprehensive medicines reviews are associated with a lower risk of death for residents of care homes.

Funded by the Australian Association of Consultant Pharmacy, the study followed 57,719 residents living in care homes across Australia for up to a year, analysing whether they were hospitalised, went to the emergency department (ED), or died during that period.

The research team found that getting a medicines review in the 6-12 months after entering a care home was linked with a 4.4% lower risk of death over 12 months.

For residents exposed to polypharmacy (defined as taking 9 or more medicines), the risk of death was 6.6% lower among those with a medicines review compared to individuals without reviews.

There was no difference in the risk of hospitalisations for unplanned events or falls among residents with and without medicines reviews.

Only 22% of residents involved in this study received a review despite all of them being eligible to access this Australian Government-funded service.

Also known as a residential medication management review, this service involves a pharmacist visiting the care home to obtain a medicines history for a resident, speak to the resident and staff, and provide education. The pharmacist makes recommendations to the GP about any changes to maximise the benefits and reduce the risk of harms with medicines use. A GP referral is needed to access the service.

This research builds on the findings of another recently published study, focusing on trends in medicines use before and after a review, which found use of some medicines such as proton pump inhibitors decreased after a review.

This project was completed in response to a recommendation from the Royal Commission into Aged Care Quality and Safety (2018-2021), a public inquiry into care provided in Australian care homes, that called for a review of the impact of the medicines review programme.

Read the Age and Ageing paper 'Provision of a comprehensive medicines review is associated with lower mortality risk for residents of aged care facilities: a retrospective cohort study' 

The research team acknowledge Callum Macpherson and Dr. Cyan Sylvester from SAHMRI for their contributions to this post.