Geriatrician interventions on medication prescribing for frail older people in residential aged care facilities

• DOI: 10.2147/cia.s84402
• Publication Date: 2015-06-25T22:16:21Z
• Authors: Arjun Poudel; Nancye M Peel; Charles A Mitchell; Leonard C Gray; Lisa M Nissen; Ruth E Hubbard
• Keywords: Medication therapy management; Beers Criteria

Objective: In Australian residential aged care facilities (RACFs), the use of certain classes high-risk medication such as antipsychotics, potent analgesics, and sedatives is high. Here, we examined prescribed medications subsequent changes recommended by geriatricians during comprehensive geriatric consultations provided to residents RACFs via videoconference. Design: This a prospective observational study. Setting: Four in Queensland, Australia, are included. Participants: A total 153 referred general practitioners for assessment delivered video-consultation. Results: Residents’ mean (standard deviation, SD) age was 83.0 (8.1) years 64.1% were female. They had multiple comorbidities (mean 6), high levels dependency, (SD) 9.6 (4.2) regular medications. Ninety-one percent patients taking five or more daily. Of (n=1,469), withdrawal 9.8% (n=145) dose alteration 3.5% (n=51). New initiated 47.7% (n=73) patients. 10.3% (n=151) considered risk, 17.2% stopped altered 2.6%. Conclusion: There moderate prevalence potentially inappropriate However, made relatively few changes, suggesting either that, on balance, prescription these appropriate or, because other factors, there reluctance adjust structured review using an algorithm withdrawing disutility might help optimize frail Further research, including broader survey, required understand dynamics. Keywords: older, geriatrician intervention, medications,