National plan aims to halve unnecessary medicine use by seniors

A newly-released national strategy aims to cut the amount of harmful or unnecessary medicines taken by older Australians in half within five years.

A newly-released national strategy aims to cut the amount of harmful or unnecessary medicines taken by older Australians in half within five years.

Professor Sarah Hilmer

The Quality Use of Medicines to Optimise Ageing in Older Australians report was released by the University of Sydney’s Cognitive Decline Partnership Centre and NPS MedicineWise on Tuesday.

It makes seven recommendations to meet this target, including an overhaul of existing national medicine guidelines and the provision of incentives for health care professionals to encourage quality use of medicines by older patients.

The report says falls, confusion, loss of independence, hospital admissions and death are often attributed to ageing when in fact they could be caused the use of too many medications.

It says two out of three Australians aged 75 or over take five or more medications, and about half of all older adults are taking a medicine that is harmful or unnecessary.

However, nine out of ten are willing to stop their medicines if their doctor said this was possible.

The report’s lead author and professor of geriatric pharmacology Sarah Hilmer called for “top down as well as bottom up strategies” to meet the target.

“This can only be widely achieved with a coordinated approach that integrates action by government, doctors, pharmacists and relevant stakeholders,” she said.

Guidelines warn against providing homeophathy products

Meanwhile, health professionals have been advised not promote or provide homeopathic products in a new set of recommendations on the prescribing of multiple medicines developed by the Pharmaceutical Society of Australia.

PSA National President Chris Freeman says pharmacists and medical practitioners should present clear information to consumers about the safety and evidence for complementary and alternative medicines and only recommend them when known benefits outweigh potential risks.

“In regards to homeopathic products there is no reliable evidence of efficacy,” he said.

“All health professionals should take the time to discuss with health consumers, who are taking or considering taking these products, the lack of efficacy and the risks in rejecting or delaying other treatments known to be safe and effective.”

The guidelines also propose a three-month limit on prescribing benzodiazepines, antipsychotics and other sedative hypnotics for insomnia, agitation or delirium in older people. Prescriptions beyond that time frame should be subject to review.

The guidelines were released on Thursday by Choosing Wisely Australia, an initiative of NPS MedicineWise. They come amid figures showing that some 230,000 Australians are admitted to hospital as a result of medication misadventure each year.

PSA guidelines

  • Don’t medicate to treat side effects and adverse effects without investigating to see if current treatment is being properly used
  • Don’t promote or provide homeopathic products
  • Don’t dispense a repeat antibiotic prescription without clarifying clinical appropriateness
  • Don’t prescribe for patients on five or more medications without a review of existing medications
  • Don’t continue benzodiazepines or antipsychotics in older adults for insomnia, agitation or delirium for more than three months without review
  • Don’t recommend complementary medicines or therapies without credible evidence of efficacy

Read more: High level of inappropriate prescribing for home nursing patients

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