Quality Use of Medicines in Residential Aged Care

Background: Older people are more likely to be exposed to polypharmacy. People with dementia, especially those living in residential aged care facilities (RACFs), are at particularly high risk of medication harm. We sought to describe medications prescribed for a sample of people with dementia living in RACFs.

Methods: A total of 351 residents with dementia aged over 65 years were recruited from 36 RACFs in Western Australia. Data on all medications prescribed were collected, including conventional medications, herbal medications, vitamins and minerals.

Results: Polypharmacy was identified in 91.2% (average 9.75 medications per person); one-third were prescribed an antipsychotic medication; and 50.4% were found to be taking at least one potentially inappropriate medication. The combination of antipsychotics and antidepressants was the most frequently observed drug-drug interaction, being prescribed to 15.7% of participants.

Discussion: People with dementia living in RACFs are commonly exposed to polypharmacy. Prescription of contraindicated medications, antipsychotics, medications with high anticholinergic burden, and combinations of potentially inappropriate medications is also common. There may be substantial scope to improve prescribing for older people with dementia living in RACFs.