The startling extent of Australia’s medication overuse

A new report has found that Australians continue to overuse certain medicines. Pharmacist intervention is necessary to keep this issue in check, said the Pharmaceutical Society of Australia (PSA).

The Australian Commission on Safety and Quality in Health Care has released a report – The Third Australian Atlas of Healthcare Variation – which shows patterns in healthcare via an interactive map. The report revealed that Australians in some areas, particularly older demographics, are at higher risk of harm from medicines overuse.

PSA Vice President and Chair of Policy and Advocacy, Dr Shane Jackson, said the overuse of medicines such as antipsychotics, antibiotics and opioids demonstrates how the system needs to change so healthcare professionals such as pharmacists can deliver the right care to the people who need it most.

The overuse of antipsychotics to manage behaviour and psychological symptoms associated with dementia in elderly patients was found to be disproportionate and of ‘grave concern’.

The prescription rate of antibiotics to younger patients under nine years of age is alarmingly high, with more than three million prescriptions dispensed from 2016–2017 alone.

Amongst this age group, proton pump inhibitors (PPI) continue to be overused for conditions such as gastro-oesophageal reflux, which can have long-term implications.

Opioid use has also increased, with the dispensation rate per 100,000 people increasing by 5% nationally. This is despite Australian deaths involving opioids more than doubling in the past decade.

What pharmacists can do

In terms of overmedication in the elderly Dr Jackson said, ‘Pharmacists are the medicines experts who can make sure medicines are used safely and effectively in residential aged care facilities.’

He welcomed the recommendation in the report for pharmacists to conduct a medicines review after six months. The outcomes of the review should be provided to the treating general practitioner as well as placed on the medication record for people aged 65 years and over who are prescribed antipsychotic medication.

‘PSA has called for pharmacists to be embedded in residential care facilities to reduce inappropriate medicine use and help address the overuse of opioids and antipsychotics,’ said Dr Jackson.

In order to protect young Australians from medication overuse, the report urged healthcare professionals to educate customers about both the risks and benefits of antibiotics use in children, which could lead to marked improvements in their treatment.

Dr Jackson said that the expertise of pharmacists enables them to best ‘support rational use of medicines including PPIs to protect people from serious adverse outcomes’.

Improving medication safety and quality to reduce the potential harms of opioids is also an initiative that pharmacists are well-placed to lead, he said.

‘The Chronic Pain MedsCheck Trial funded by the Australian Department of Health is an important step towards improving opioid use.’