Current projects
Clinical Practice Guidelines for the Appropriate Use of Psychotropic Medications
The Centre for Medicine Use and Safety, Monash University has led a multidisciplinary project to develop Clinical Practice Guideline for the Appropriate Use of Psychotropic Medications in People Living with dementia and in Residential Aged Care (the Guidelines).
The Guidelines have been developed for prescribers and senior clinical staff including registered nurses and pharmacists. The Guidelines include 15 recommendations and 49 good practice statements about the appropriate initiation, monitoring and discontinuation of antipsychotics, benzodiazepines and antidepressants. The Guidelines focused on these medications because they are among the three most common psychotropics in residential aged care facilities. The Guidelines have been developed to be relevant to people living with dementia and in residential aged care or who have high-level home care packages.
The development of the Guidelines was funded by the Dementia Centre for Research Collaboration (DCRC). Additional funding support was provided by the National Health and Medical Research Council (NHMRC) Boosting Dementia Research Leadership Fellowship awarded to Professor Simon Bell.
To read more about the Guidelines click here
Evidence-based Medication knowledge Brokers in Residential Aged CarE (EMBRACE)
Psychotropic medications (antipsychotics, benzodiazepines and antidepressants) are widely used in Australian residential aged care facilities, despite limited evidence of benefit and well-established risks—especially for people living with dementia. National and international guidelines recommend avoiding these medicines where possible, yet over 60% of residents are prescribed them regularly.
To address this, our team is leading an innovative trial to evaluate the role of knowledge brokers—specialists who support translation of evidence into practice—to improve uptake of the new Australian Clinical Practice Guidelines for the Appropriate Use of Psychotropic Medications in Residential Aged Care Facilities.
This program of work is funded by the Australian Government Medical Research Future Fund Dementia, Ageing and Aged Care Grant Opportunity (Chief investigators Professor Simon Bell and Dr Amanda Cross).
To read more about the EMBRACE trial click here
To read more about knowledge brokers click here
Maximising Embedded Pharmacists in AGed CAre Medication Advisory Committees (MEGA-MAC)
Medication safety in older people remains a global public health challenge. The World Health Organization (WHO) has recognized the importance of medication safety through its Medication without Harm Global Patient Safety Challenge. However, poor implementation of clinical guidelines and evidence-based guideline recommendations remains a key barrier. In 2021 the Australian Commission on Safety and Quality in Health Care identified 10 priority action areas for residential aged care, including a need to improve the governance, composition and operation of Medication Advisory Committees (MACs) (priority 4) and a recommendation to trial the role and impact of onsite aged care pharmacists (priority 10).
The Maximising Embedded Pharmacists in AGed CAre Medication Advisory Committees (MEGA-MAC) project will evaluate the effectiveness and relative net benefit of using knowledge brokers, supported by a national quality improvement collaborative, to implement Australia’s new Guiding Principles for Medication Management in Residential Aged Care Facilities (Guiding Principles).
This project is funded by the Commonwealth of Australia represented by the Department of Health and Aged Care Medical Research Future Fund (MRFF) Quality, Safety and Effectiveness of Medicine Use by Pharmacists, 2022 grant (Chief investigators Professor Simon Bell and Dr Amanda Cross).
To read more about medication advisory committees (MACs) click here
To read more about the MEGA-MAC trial click here
To read more about the MEGA-MAC indicators, click here
To read more about quality improvement collaboratives, click here
Reducing medication-related harm in people living with dementia in residential aged care
Ninety-five percent of aged care residents have at least one problem with their medications. Residents living with dementia are at increased risk of medication-related problems and half of all aged care residents are living with dementia. Medicine safety has now been recognised as Australia’s newest national health priority area. There is an urgent need for optimisation of existing clinical processes and implementation of novel approaches to reduce medication-related harm.
This program of research is focused on reducing medication-related harm at all stages of the medication-management cycle for aged care residents, particularly those living with dementia. It explores appropriateness and outcomes associated with high-risk medications to inform prescribing decisions, identifies and addresses missed opportunities for improving resident safety at both a resident and system level, and facilitates the expansion of allied-health involvement in multidisciplinary care teams to improve medicine safety in aged care facilities.
This program of work is funded by an NHMRC Emerging Leadership Investigator Grant (Chief investigator Dr Amanda Cross).
To read one of the most recent outputs from this project, click here
Empowering consumers and healthcare professionals to make evidence-based, informed decisions regarding the pharmacological management of urinary incontinence for people living with dementia
Urinary incontinence, the accidental leakage of urine from the bladder, is extremely common among people with dementia. Urinary incontinence can cause distress and impact well-being. Many people with dementia use medications to manage their urinary incontinence. Unfortunately, many of the medications used for urinary incontinence can be associated with medication-related harm and newer medications have not been evaluated in people living with dementia. This project will involve co-designing targeted resources to help people living with dementia, their families and healthcare professionals decide when to use and when to stop medications for urinary incontinence for people with dementia.
This project was supported by the Dr Stuart and Bonnie Bartle Project Grant from Dementia Australia.
To read more about the resources developed in this project, click here.