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

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Journal Article
International Journal for Quality in Health Care, 2018, 30 (10), pp. 810 - 816
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© The Author(s) 2018. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. 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, hyperpolypharmacy 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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