The role of medication advisory committees in residential aged care services

Leonie Picton; Samanta Lalic; Taliesin E Ryan-Atwood; Kay Stewart; Carl M Kirkpatrick; Michael J Dooley; Justin P Turner; J Simon Bell

doi:10.1016/j.sapharm.2020.01.008

The role of medication advisory committees in residential aged care services

Res Social Adm Pharm. 2020 Oct;16(10):1401-1408. doi: 10.1016/j.sapharm.2020.01.008. Epub 2020 Jan 28.

Authors

Leonie Picton¹, Samanta Lalic¹, Taliesin E Ryan-Atwood¹, Kay Stewart¹, Carl M Kirkpatrick¹, Michael J Dooley², Justin P Turner³, J Simon Bell⁴

Affiliations

¹ Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.
² Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia; Pharmacy Department, Alfred Health, Melbourne, Australia.
³ Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia; Centre de recherche, Institut universitaire de gériatrie de Montréal, University of Montreal, Montreal, Canada.
⁴ Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia. Electronic address: Simon.Bell2@monash.edu.

PMID: 32085949
DOI: 10.1016/j.sapharm.2020.01.008

Abstract

Background: There 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.

Objectives: To explore the current structures and functioning of MACs, and identify opportunities for MACs to better promote safe and effective medication use.

Methods: Semi-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.

Results: Deductively 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.

Conclusion: Despite 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.

Keywords: Drug therapy; Focus groups; Quality improvement; Residential facilities.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Advisory Committees*
Aged
Delivery of Health Care*
Humans
Pharmacists
Polypharmacy
Victoria