Dementia is the second leading cause of death in Australia and the single cause of disability burden overall.
As Australia’s population continues to age, and the number of Australians living with dementia increases, medication safety for people living with the disease remains an Australian national health priority area.
This is particularly important as a new study has found that people with dementia may often be prescribed medications incorrectly.
Led by Monash University’s Centre for Medicine Use and Safety (CMUS), a new study has shown that up to two thirds of people with dementia are prescribed potentially inappropriate medications.
Investigating the obstacles and complexities in medication management for people living with dementia through qualitative research that involved four key stakeholders (carers, GPs, nurses and pharmacists), the study found that the barriers to effective medication management include:
- Poor communication and relationships between stakeholders.
- Infrequent medication reviews.
- Lack if practitioner training, evidence and guidelines to navigate prescribing and deprescribing decisions.
According to lead author, Dr Amanda Cross, medication management for those with dementia becomes particularly complicated in the context of polypharmacy, increasing cognitive decline, changing goals of care, multiple stakeholders and multimorbidity.
“Most people with dementia live with multiple chronic diseases, which often require medications to manage symptoms and disease progressions,” says Dr Cross.
“It’s a complex and challenging process, which requires many competing considerations when optimising medication use.”
Dr Cross adds that what makes this process even more challenging is the limited evidence available to guide the process of prescribing and deprescribing for people with dementia.
“We know that up to 90% of people with dementia are exposed to polypharmacy and for each additional medication used, the risk of emergency department presentation and mortality increases.”
Dr Cross advises that collaboration and communication between health professionals is crucial in the optimisation of medication use and that “future interventions should focus on training and evidence-based guidelines”.
The release of the study coincides with the signing of the Seventh Community Pharmacy Agreement (7PCA) between the Australian Government and the Pharmacy Guild of Australia.
The 7CPA includes a commitment to maintaining investment in medication management programs, vital to the care of older people – particularly those with dementia.