Background
Hospital-based Residential Aged-care Support Service (RaSS) teams typically consist of doctors and nurses who provide emergency and hospital substitutive care to residents of residential aged care facilities (RACF). While evidence supports the role of community pharmacist-led medication reviews in RACFs, there is limited literature evaluating the role of pharmacists integrated into aged care support teams. The purpose of this study was to analyse the effect of RaSS pharmacist-led medication reviews on polypharmacy, drug burden index, potentially inappropriate medications and potential prescribing omissions for residents living in RACFs.
Methods
Residents were referred to a Residential Aged-care Support Service pharmacist for medication review over a 12-month period. Medication-related problems and recommendations identified by the pharmacist were communicated to the resident’s general practitioner and RaSS medical practitioner for review. Residents’ medication histories were obtained at baseline and at one-month post-intervention. The number of medications prescribed to RACF residents, their associated drug burden indices, potentially inappropriate medications, and potential prescribing omissions identified at baseline and post-intervention were compared to evaluate the effects of RaSS pharmacist-led medication reviews.
Results
175 residents with a mean age of 84 years were referred to a hospital-based Residential Aged-care Support Service pharmacist for medication review. Median time to post-intervention evaluation was 29 days. The mean total number of medications prescribed were reduced from 18 medications at baseline to 17 medications post-intervention (p<0.001). The mean drug burden index score was reduced from 1.53 (at baseline) to 1.35 post-intervention (p<0.001). There were more residents that experienced a decrease in inappropriate medications (p<0.001) and prescribing omissions (p=0.008) compared to those that had an increase.
Conclusions
This study suggests that medication reviews performed by pharmacists embedded in hospital-based residential aged care support services may improve medication use and prescribing practices in aged care. Future research needs to be prioritised to corroborate this.