Home' Australian Ageing Agenda : AAA Jul-Aug 2017 Contents M
anagers of aged care facilities would
be very fit if they had to run for cover
following every media report highlighting
errors within residential care that caused
harm to someone’s loved one, or worse, death.
Don’t get me wrong; this is not a criticism.
As a pharmacist with more than 30 years’
experience ser vicing residential aged care, I
fully understand and share the difficulties and
complexities surrounding the care requirements
of older people.
I also understand the challenges of employing
and training a workforce operating in a high-risk
environment where failure to follow workflow
systems can be catastrophic.
I view myself and pharmacists in general as
being in lock-step with residential aged care in
the quest to provide excellent care.
In recent years, developments in technology –
including an increasing focus on the use of data-
capture systems that can identify trends, risks and
point to prevention strategies – offer enormous
benefits. What’s more, governments expect them
to be employed.
Residential aged care accreditation assessments
require objective evidence that such systems
are in place, understood and being employed
effectively and consistently.
From our end, we focus on how we use
objective evidence to demonstrate that the
facilities we support with our systems, services and
products have a safe medication system in place.
We do that by demonstrating the impact of a
range of functional features common to our systems.
For instance, we can point to a digital
photograph of the resident on ever y Webster-
pak to reduce the risk of medication being
administered to the wrong resident.
By applying predictive analysis
tools to data, residential aged
care facilities can offer residents
enhanced patient management,
writes GERARD STEVENS.
Big data and predictive analysis
We can also use the data we retain within our
medication management software to demonstrate
coordination of the end-to-end medication
system by providing an accountable audit trail.
The data the system retains can be grouped
and analysed in a range of different ways to
identify medication management prescribing,
dispensing and administration trends.
By applying predictive analysis tools to
medication profile data held by the pharmacy,
aged care facilities can offer enhanced patient
management and care by better identifying
the impact of medications on residents and
improving clinical outcomes.
For instance, our most recent analytical tool,
the Drug Burden Report, enables aged care facilities
to predictively analyse the risk of falls and/or
confusion associated with the common prescribing
of medications known as anticholinergics, such as
sedatives, to aged care residents.
The report looks at patients’ current
medication profiles and uses a scientifically
proven mechanism to identify those with a high
anticholinergic burden index.
This tool can then help facilities to better assess
the risk of adverse effects, with falls and confusion
at the top of the list, among their residents.
Using the Drug Burden Report, preliminary
analysis of 26,000 aged care residents found that:
• One third of aged care residents are prescribed
medicines with an anticholinergic impact
score of 3 or higher. A score of 3 or higher is
• Medicines with a low score can have a high
impact as the scores are cumulative.
• One-sixth of all residents had a score of 5
The recent study, Nature and extent of
external-cause deaths of nursing home residents
in Victoria, found that 80 per cent of unnecessar y
deaths were due to falls.
Undoubtedly, some of these unnecessar y
deaths would have been avoided if all facilities
employed such a predictive analysis to prioritise
residents at high risk for a review of their
Data can be analysed to identify medication management issues and trends.
48 | JULY – AUGUST 2017
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