Lisa G Pont1,2, Magda Z Raban1, Mikaela L Jorgensen1, Andrew Georgiou1, Johanna I Westbrook1. 1. Faculty of Medicine and Health Science, Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW Australia. 2. Graduate School of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia.
Abstract
OBJECTIVE: The aim of this study was to use routinely collected electronic medicines administration (eMAR) data in residential aged care (RAC) to investigate the quality use of medicines. DESIGN: A cross-sectional analysis of eMAR data. SETTING: 71 RAC facilities in New South Wales and the Australian Capital Territory, Australia. PARTICIPANTS: Permanent residents living in a participating facility on 1 October 2015. INTERVENTION: None. MAIN OUTCOME MEASURES: Variation in polypharmacy (≥5 medications), hyper-polypharmacy (≥10 medications) and antipsychotic use across facilities was examined using funnel plot analysis. RESULTS: The study dataset included 4775 long-term residents. The mean resident age was 85.3 years and 70.6% of residents were female. The median facility size was 60 residents and 74.3% were in metropolitan locations. 84.3% of residents had polypharmacy, 41.2% hyper-polypharmacy and 21.0% were using an antipsychotic. The extent of polypharmacy (69.75-100% of residents), hyper-polypharmacy (38.81-76.19%) and use of antipsychotic medicines (0-75.6%) varied considerably across the 71 facilities. CONCLUSIONS: Using eMAR data we found substantial variation in polypharmacy, hyper-polypharmacy and antipsychotic medicine use across 71 RAC facilities. Further investigation into the policies and practices of facilities performing above or below expected levels is warranted to understand variation and drive quality improvement.
OBJECTIVE: The aim of this study was to use routinely collected electronic medicines administration (eMAR) data in residential aged care (RAC) to investigate the quality use of medicines. DESIGN: A cross-sectional analysis of eMAR data. SETTING: 71 RAC facilities in New South Wales and the Australian Capital Territory, Australia. PARTICIPANTS: Permanent residents living in a participating facility on 1 October 2015. INTERVENTION: None. MAIN OUTCOME MEASURES: Variation in polypharmacy (≥5 medications), hyper-polypharmacy (≥10 medications) and antipsychotic use across facilities was examined using funnel plot analysis. RESULTS: The study dataset included 4775 long-term residents. The mean resident age was 85.3 years and 70.6% of residents were female. The median facility size was 60 residents and 74.3% were in metropolitan locations. 84.3% of residents had polypharmacy, 41.2% hyper-polypharmacy and 21.0% were using an antipsychotic. The extent of polypharmacy (69.75-100% of residents), hyper-polypharmacy (38.81-76.19%) and use of antipsychotic medicines (0-75.6%) varied considerably across the 71 facilities. CONCLUSIONS: Using eMAR data we found substantial variation in polypharmacy, hyper-polypharmacy and antipsychotic medicine use across 71 RAC facilities. Further investigation into the policies and practices of facilities performing above or below expected levels is warranted to understand variation and drive quality improvement.
Authors: Magdalena Z Raban; Melissa T Baysari; Mikaela L Jorgensen; Amina Tariq; Andrew Georgiou; Johanna I Westbrook Journal: Appl Clin Inform Date: 2020-12-09 Impact factor: 2.342
Authors: Sam Kosari; Jane Koerner; Mark Naunton; Gregory M Peterson; Ibrahim Haider; Emily Lancsar; David Wright; Theo Niyonsenga; Rachel Davey Journal: Trials Date: 2021-06-11 Impact factor: 2.279