National Audit Highlights Strengths and Areas for Improvement in Australian Aged Care Medication Management

A recent national assessment conducted by Monash University has provided insight into the governance of medication management within Australian residential aged care facilities. This audit reveals considerable variation in the structure and operational effectiveness of Medication Advisory Committees (MACs) across the nation.

MACs play a crucial role in enhancing medication safety in aged care settings, particularly in addressing the serious issue of polypharmacy, defined as the concurrent use of nine or more medications. The Australian Government's Department of Health, Disability and Aging advocates for the establishment of MACs in all residential care homes to facilitate safe medication practices and reduce the risks linked to inappropriate prescribing.

The audit, carried out by the Center for Medicine Use and Safety (CMUS) at the Monash Institute of Pharmaceutical Sciences (MIPS), evaluated the functioning of MACs across four essential operational domains: policy development, risk management, education, and quality improvement. Utilizing the Department of Health and Aged Care's MAC Audit Tool, the study encompassed 120 MACs overseeing 642 residential care facilities, which represents nearly 25% of all residential care homes in Australia. The findings are published in the Australasian Journal on Ageing.

The results indicate that MACs are actively engaged in policy and risk management, with 59% and 53% of committees respectively fulfilling all recommended functions. However, there are notable opportunities for enhancing their capabilities and fostering long-term improvements. Specifically, 41% of the committees met all educational responsibilities, while only 28% were fully involved in quality enhancement initiatives.

The lead researcher from CMUS emphasized that the audit underscores both the strengths and the areas requiring targeted assistance in managing medication safety within aged care. It was noted that MACs possess the potential to drive significant improvements in this sector, provided they receive adequate support and resources.

As the new Aged Care Quality Standards are set to be implemented on July 1, 2025, the researchers advocate that MACs are well-positioned to facilitate the execution and monitoring of Quality Standard 5. This standard aims to ensure the provision of safe and high-quality clinical care to the nearly 200,000 older Australians residing in these facilities.

Furthermore, the project lead of the Maximizing Embedded Pharmacists in Aged Care Medication Advisory Committees (MEGA-MAC) initiative highlighted that a national quality improvement collaborative has been established. This collaborative utilizes a real-time clinical network designed to implement, monitor, and assess quality improvement initiatives effectively.

In conclusion, the findings from this national audit not only shed light on the current landscape of medication oversight in aged care but also point towards pathways for enhancing the effectiveness of MACs to ensure safer medication practices for the elderly population in Australia.