Medication-related quality of care in residential aged care: an Australian experience

Abstract

Objective

To describe medication-related quality of care (MRQOC) for Australian aged care residents.

Design

Retrospective cohort using an administrative healthcare claims database.

Setting

Australian residential aged care.

Participants

A total of 17 672 aged care residents who were alive at 1 January 2013 and had been a permanent resident for at least 3 months.

Main outcome measures

Overall, 23 evidence-based MRQOC indicators which assessed the use of appropriate medications in chronic disease, exposure to high-risk medications and access to collaborative health services.

Results

Key findings included underuse of recommended cardiovascular medications, such as the use of statins in cardiovascular disease (56.1%). Overuse of high-risk medications was detected for medications associated with falls (73.5%), medications with moderate to strong anticholinergic properties (46.1%), benzodiazepines (41.4%) and antipsychotics (33.2%). Collaborative health services such as medication reviews were underutilised (42.6%).

Conclusion

MRQOC activities in this population should be targeted at monitoring and reducing exposure to antipsychotics and benzodiazepines, improving the use of preventative medications for cardiovascular disease and improving access to collaborative health services. Similarity of suboptimal MRQOC between Australia and other countries (UK, USA, Canada and Belgium) presents an opportunity for an internationally collaborative approach to improving care for aged care residents.

medications, quality of care, aged care, retrospective cohort