Medication management in older Australians

A national pharmacy-led working group dedicated to improving the quality use of medicines for older Australians has issued 10 recommendations for better integrating healthcare to provide consumer-centred medication management in the aged population.

The working group was one of several to emerge from the National Stakeholders’ Meeting for the Quality Use of Medicines to Optimise Ageing in Older Australians in 2015, which set a target to halve harmful or unnecessary medication use by older Australians by 2020.

The multidisciplinary working group, led by Dr Christopher D. Etherton-Beer, of University of Western Australia’s Centre for Health and Ageing, was tasked with developing recommendations to integrate the health care of older Australians across settings and practitioners to provide multidisciplinary consumer-centred care.

In findings published in the Journal of Pharmacy Practice and Research, the working group spells out its key recommendations. Among the chief aims are bridging communication gaps between healthcare professionals, providing comprehensive medication reviews at every transition of care and creating accessible colocated multidisciplinary teams.

The recommendations are:

1. Every health professional should ask the consumer (or their advocate) if they are carrying a list of any medications they take.
2. Consumers (or their advocate) should be encouraged to bring their medications to facilitate medications review at all healthcare assessments.
3. All older people taking medications should be offered an opportunity to review their medications through a consumer-centred prism (i.e. focusing on their own goals) at least annually.
4. Facilitate consumers’ control, and sharing between health professionals, of medication information by encouraging shared electronic health records.
5. All older people should identify a primary community pharmacist and general practitioner.
6. Improve access to community multidisciplinary teams (e.g. multidisciplinary medical homes) as a policy priority.
7. The Australian Policy framework requires urgent updating to add contemporary steps for comprehensive medication review, medication reconciliation and communication of medication information at every transition of care.
8. Novel solutions using available technologies (e.g. matrix ‘quick response’ (QR) codes on medication labels) need to be explored. A QR code could be incorporated into the manufacturer’s packaging on the front of boxes (distinct from the pharmacy dispensing label). This QR code could link the consumer (or health worker) to information at the reading level they require in the language they prefer and as a voice recording for those with low functional literacy.
9. Alternative versions of CMI leaflets should be available for older consumers, particularly those with a low level of health literacy.
10. There should be renewed consideration of a single funding mechanism for medications and medication management in Australia.

Read the full study here (paywall).