Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, UniSA, Frome Rd Adelaide, Australia.
School of Pharmacy and Medical Sciences, UniSA, Frome Rd Adelaide, Australia.
Int J Qual Health Care. 2019 May 1;31(4):298-306. doi: 10.1093/intqhc/mzy164.
To describe medication-related quality of care (MRQOC) for Australian aged care residents.
Retrospective cohort using an administrative healthcare claims database.
Australian residential aged care.
A total of 17 672 aged care residents who were alive at 1 January 2013 and had been a permanent resident for at least 3 months.
Overall, 23 evidence-based MRQOC indicators which assessed the use of appropriate medications in chronic disease, exposure to high-risk medications and access to collaborative health services.
Key findings included underuse of recommended cardiovascular medications, such as the use of statins in cardiovascular disease (56.1%). Overuse of high-risk medications was detected for medications associated with falls (73.5%), medications with moderate to strong anticholinergic properties (46.1%), benzodiazepines (41.4%) and antipsychotics (33.2%). Collaborative health services such as medication reviews were underutilised (42.6%).
MRQOC activities in this population should be targeted at monitoring and reducing exposure to antipsychotics and benzodiazepines, improving the use of preventative medications for cardiovascular disease and improving access to collaborative health services. Similarity of suboptimal MRQOC between Australia and other countries (UK, USA, Canada and Belgium) presents an opportunity for an internationally collaborative approach to improving care for aged care residents.
描述澳大利亚老年护理居民的药物相关医疗质量（MRQOC）。
使用医疗保健管理索赔数据库进行回顾性队列研究。
澳大利亚养老院。
共有 17672 名在 2013 年 1 月 1 日仍然存活且居住满 3 个月的养老院居民。
共 23 项基于证据的 MRQOC 指标，评估了慢性病中适当药物的使用、高危药物的暴露和获得协作性医疗服务的情况。
主要发现包括推荐的心血管药物（如他汀类药物在心血管疾病中的使用）的使用不足，占 56.1%。还发现了一些高危药物的过度使用，如与跌倒相关的药物（73.5%）、具有中度至强抗胆碱能特性的药物（46.1%）、苯二氮䓬类药物（41.4%）和抗精神病药物（33.2%）。协作性医疗服务（如药物审查）的利用率较低，占 42.6%。
针对该人群的 MRQOC 活动应针对监测和减少抗精神病药物和苯二氮䓬类药物的暴露、改善心血管疾病预防药物的使用以及增加协作性医疗服务的机会。澳大利亚与其他国家（英国、美国、加拿大和比利时）之间存在类似的次优 MRQOC，为改善养老院居民的护理提供了一个国际合作的机会。
