Leveraging new information technology to monitor medicine use in 71 residential aged care facilities: variation in polypharmacy and antipsychotic use

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: The aim of this study was to use routinely collected electronic medicines administration (eMAR) data in residential aged care (RAC) to investigate the quality use of medicines.

Design: A cross-sectional analysis of eMAR data.

Setting: 71 RAC facilities in New South Wales and the Australian Capital Territory, Australia.

Participants: Permanent residents living in a participating facility on 1 October 2015.

Intervention: None.

Main Outcome Measures: Variation in polypharmacy (≥5 medications), hyper-polypharmacy (≥10 medications) and antipsychotic use across facilities was examined using funnel plot analysis.

Results: The study dataset included 4775 long-term residents. The mean resident age was 85.3 years and 70.6% of residents were female. The median facility size was 60 residents and 74.3% were in metropolitan locations. 84.3% of residents had polypharmacy, 41.2% hyper-polypharmacy and 21.0% were using an antipsychotic. The extent of polypharmacy (69.75–100% of residents), hyper-polypharmacy (38.81–76.19%) and use of antipsychotic medicines (0–75.6%) varied considerably across the 71 facilities.

Conclusions: Using eMAR data we found substantial variation in polypharmacy, hyper-polypharmacy and antipsychotic medicine use across 71 RAC facilities. Further investigation into the policies and practices of facilities performing above or below expected levels is warranted to understand variation and drive quality improvement.
LanguageEnglish
Pages810-816
Number of pages7
JournalInternational journal for quality in health care : journal of the International Society for Quality in Health Care / ISQua
Volume30
Issue number10
Early online date2018
DOIs
Publication statusPublished - 1 Dec 2018

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Polypharmacy
Antipsychotic Agents
Medicine
Technology
Australian Capital Territory
New South Wales
Quality Improvement
Cross-Sectional Studies
Outcome Assessment (Health Care)

Keywords

  • medicines
  • drug utilisation
  • residential aged care
  • quality improvement

Cite this

@article{24bb7a8667654b439628ac5390aaa2b0,
title = "Leveraging new information technology to monitor medicine use in 71 residential aged care facilities: variation in polypharmacy and antipsychotic use",
abstract = "Objective: The aim of this study was to use routinely collected electronic medicines administration (eMAR) data in residential aged care (RAC) to investigate the quality use of medicines.Design: A cross-sectional analysis of eMAR data.Setting: 71 RAC facilities in New South Wales and the Australian Capital Territory, Australia.Participants: Permanent residents living in a participating facility on 1 October 2015.Intervention: None.Main Outcome Measures: Variation in polypharmacy (≥5 medications), hyper-polypharmacy (≥10 medications) and antipsychotic use across facilities was examined using funnel plot analysis.Results: The study dataset included 4775 long-term residents. The mean resident age was 85.3 years and 70.6{\%} of residents were female. The median facility size was 60 residents and 74.3{\%} were in metropolitan locations. 84.3{\%} of residents had polypharmacy, 41.2{\%} hyper-polypharmacy and 21.0{\%} were using an antipsychotic. The extent of polypharmacy (69.75–100{\%} of residents), hyper-polypharmacy (38.81–76.19{\%}) and use of antipsychotic medicines (0–75.6{\%}) varied considerably across the 71 facilities.Conclusions: Using eMAR data we found substantial variation in polypharmacy, hyper-polypharmacy and antipsychotic medicine use across 71 RAC facilities. Further investigation into the policies and practices of facilities performing above or below expected levels is warranted to understand variation and drive quality improvement.",
keywords = "medicines, drug utilisation, residential aged care, quality improvement",
author = "Pont, {Lisa G.} and Raban, {Magda Z.} and Jorgensen, {Mikaela L.} and Andrew Georgiou and Westbrook, {Johanna I.}",
year = "2018",
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doi = "10.1093/intqhc/mzy098",
language = "English",
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T2 - International journal for quality in health care : journal of the International Society for Quality in Health Care / ISQua

AU - Pont, Lisa G.

AU - Raban, Magda Z.

AU - Jorgensen, Mikaela L.

AU - Georgiou, Andrew

AU - Westbrook, Johanna I.

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N2 - Objective: The aim of this study was to use routinely collected electronic medicines administration (eMAR) data in residential aged care (RAC) to investigate the quality use of medicines.Design: A cross-sectional analysis of eMAR data.Setting: 71 RAC facilities in New South Wales and the Australian Capital Territory, Australia.Participants: Permanent residents living in a participating facility on 1 October 2015.Intervention: None.Main Outcome Measures: Variation in polypharmacy (≥5 medications), hyper-polypharmacy (≥10 medications) and antipsychotic use across facilities was examined using funnel plot analysis.Results: The study dataset included 4775 long-term residents. The mean resident age was 85.3 years and 70.6% of residents were female. The median facility size was 60 residents and 74.3% were in metropolitan locations. 84.3% of residents had polypharmacy, 41.2% hyper-polypharmacy and 21.0% were using an antipsychotic. The extent of polypharmacy (69.75–100% of residents), hyper-polypharmacy (38.81–76.19%) and use of antipsychotic medicines (0–75.6%) varied considerably across the 71 facilities.Conclusions: Using eMAR data we found substantial variation in polypharmacy, hyper-polypharmacy and antipsychotic medicine use across 71 RAC facilities. Further investigation into the policies and practices of facilities performing above or below expected levels is warranted to understand variation and drive quality improvement.

AB - Objective: The aim of this study was to use routinely collected electronic medicines administration (eMAR) data in residential aged care (RAC) to investigate the quality use of medicines.Design: A cross-sectional analysis of eMAR data.Setting: 71 RAC facilities in New South Wales and the Australian Capital Territory, Australia.Participants: Permanent residents living in a participating facility on 1 October 2015.Intervention: None.Main Outcome Measures: Variation in polypharmacy (≥5 medications), hyper-polypharmacy (≥10 medications) and antipsychotic use across facilities was examined using funnel plot analysis.Results: The study dataset included 4775 long-term residents. The mean resident age was 85.3 years and 70.6% of residents were female. The median facility size was 60 residents and 74.3% were in metropolitan locations. 84.3% of residents had polypharmacy, 41.2% hyper-polypharmacy and 21.0% were using an antipsychotic. The extent of polypharmacy (69.75–100% of residents), hyper-polypharmacy (38.81–76.19%) and use of antipsychotic medicines (0–75.6%) varied considerably across the 71 facilities.Conclusions: Using eMAR data we found substantial variation in polypharmacy, hyper-polypharmacy and antipsychotic medicine use across 71 RAC facilities. Further investigation into the policies and practices of facilities performing above or below expected levels is warranted to understand variation and drive quality improvement.

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