Use of multiple medications strongly associated with hospitalisations from aged care facilities

January 2017

Researchers are calling for regular medication reviews for residents after a study has found that residents of aged care facilities who take multiple medications and have complex medication regimens are more likely to be hospitalised than those who don’t.

A multidisciplinary team from Monash University led by Associate Professor Simon Bell, working in collaboration with Resthaven Incorporated, tracked a total of 383 residents of six Australian long-term care facilities over a 12-month period.

This study investigated the association between polypharmacy (defined as taking nine or more regular medications), medication regimen complexity and hospital admissions. It concluded that polypharmacy was associated with an increased risk of hospitalisation. Hospitalisation was measured using three different approaches: time to first hospitalisation, number of hospitalisations, and number of hospital days over a 12 month period.

The study discovered that residents with polypharmacy were at 89 per cent higher risk of being hospitalised than those without, even after accounting for residents’ age and medical conditions. Given that international literature suggests that up to 74 per cent of residents of aged care facilities take nine or more medicines on a regular basis the study has far-reaching implications for pharmacists, general practitioners and the aged-care sector.

The findings of this study have led to Resthaven reconsidering its approach to deprescribing. Resthaven intend to explore the potential for medical reviews with GPs and pharmacists to reduce unwanted hospital stays.

Tina Cooper, Resthaven’s Executive Manager of Residential Services, said “We have always advocated for frequent medication reviews, but this takes it to the next level. We now need to look at risk-benefit ratios for prescribing of long-term preventative medications in aged care”.

Associate Professor Bell is careful to note that polypharmacy is not inherently bad. Instead, he advocates for medication regimens to be individually tailored for an individual resident’s goal of care.

“Some residents have medical conditions that are best managed by multiple medicines” said Associate Professor Bell. However, “many older people take medicines that are either unnecessary or no longer appropriate, as the risk-to-benefit ratios for taking specifics medicines changes as people age”

The study was funded by the Alzheimer’s Australia Dementia Research Foundation.