Seniors over-sedated

Tegan Fleming

The ReDUSe Project (Residential care: decreasing use of sedatives), funded by the government under the Fourth Community Pharmacy Agreement, aims to develop, trial and evaluate, via community pharmacy, a sustainable program to address inappropriate sedative prescribing in aged care.

Studies have consistently shown that the use of sedative medications in many aged care facilities is excessively high.

Greg Peterson, project lead investigator and Professor of Pharmacy at the University of Tasmania, said the problem was particularly bad in his home state, Tasmania, where the project will take place.

"One of their [sedative's] major uses seems to be controlling behavioural symptoms or features of dementia in aged care [but] most of the experts would say they probably don't help a lot.

"In that age group, the major risks would be cognitive impairment, confusion and the risk of falls. You get greater risk of fractures with sedative use in older groups," Prof Peterson said.

The strategies of drug use evaluation (DUE) cycles and nursing staff training are currently promoted in aged care; however, there has been limited training for community pharmacists to effectively deliver these strategies.

The ReDUSe Project will begin with a dedicated measurement of sedative use as part of a DUE cycle. This information will be presented to each home and an educational session on appropriate use of these medications delivered to staff by pharmacists.

The final component of the program will be a case conference for those residents taking sedative medications.

"We've developed a means to pull data out of the dosage administration aid software in pharmacy so we can present local audits or local data on the use of sedatives in the aged care facilities that the pharmacies serve," Prof Peterson said.

"They can compare that data to national or to other data, thus providing local feedback in an automated way," he said.

Following a successful reduction in sedative use, the elderly in aged care facilities should benefit from increased mobility and alertness, decreased fall rate and improved wellbeing.