The role of medication advisory committees in residential aged care services |
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| Institution: | 1. Unit of Primary Health Care, Department of General Practice, and Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland;2. Health Services, Porvoo, Finland;3. Tapiola Health Centre, Home Care, Espoo, Finland;4. Social Services and Health Care Department, Helsinki, Finland;5. Elderly care, Espoo, Finland;6. Faculty of Pharmacy and Pharmaceutical Sciences, Centre for Medicine Use and Safety, Monash University, Melbourne, Australia;7. School of Pharmacy and Medical Sciences, Sansom Institute, University of South Australia, Adelaide, Australia;8. Faculty of Health Sciences, Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland;1. The University of Sydney, Faculty of Medicine and Health, Australia;2. Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, NSW, Australia;3. Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia;4. Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Macquarie Park, NSW, Australia;5. Department of Clinical Pharmacy & Toxicology, Leiden University Medical Centre, Leiden, the Netherlands;6. Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Macquarie Park, NSW, Australia;7. Australian Digital Health Agency, Sydney, NSW, Australia;8. South Western Sydney Local Health District, Liverpool, NSW, Australia |
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| Abstract: | BackgroundThere is increasing international interest in initiatives to reduce medication-related harm and preventable hospitalizations in residential aged care services (RACS). The Australian Government recommends that RACS establish multidisciplinary Medication Advisory Committees (MACs). No previous research has specifically investigated the structures and functioning of MACs.ObjectivesTo explore the current structures and functioning of MACs, and identify opportunities for MACs to better promote safe and effective medication use.MethodsSemi-structured interviews and focus groups were conducted with a maximum variation sample of health professionals (n = 44) across four health services operating across 27 RACS in rural and regional Victoria, Australia. Qualitative data were analyzed using deductive and inductive content analyses. Results were presented to a multidisciplinary expert panel (n = 13) to identify opportunities for improvement.ResultsDeductively coded themes included composition and functioning of the MAC, education and information needs and support to better manage polypharmacy. Emergent inductively coded themes included general medical practitioner (GP) and pharmacist engagement, collaboration and effectiveness. Participation by GPs and pharmacists was variable, while no MACs involved residents or family carers. Aged care specific and multidisciplinary MACs were generally more proactive in addressing potential medication-related harm. Education to identify and report adverse drug events with high risk medications was identified as a priority. The multidisciplinary panel made 12 recommendations to promote safe and effective medication use.ConclusionDespite all MACs having a strong commitment to medication safety, opportunities exist to improve the composition and structure, proactive identification and response to emerging issues, and systems for staff, resident and family carer training. |
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| Keywords: | Residential facilities Drug therapy Quality improvement Focus groups |
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