Pharmacy Daily | Act mandates better med use

AGED care advocates have welcomed the start of the new rights-based Aged Care Act, which came into effect on 01 Nov, providing older Australians with greater independence, autonomy, choice and control regarding their care.

With demand for aged care projected to grow dramatically due to Australia's ageing population, a new Act, framed in rights of the older person, was the number one recommendation of the Royal Commission into Quality and Safety in Aged Care's final report almost five years ago, with the Act passing into legislation late last year (PD 25 Nov 2024).

The Act reinforces that older people have the right to make their own decisions, with appropriate support if they need it.

It also provides strengthened quality standards and greater protections for those receiving aged care.

For Dr Isabelle Meyer, Executive Director of Dementia Training Australia, one of the key reforms was around medication prescribing, in particular the inappropriate use of medicines as "chemical restraints" in aged care facilities.

"It is now an offence to over-prescribe inappropriate medication for someone, particularly in residential aged care," Dr Meyer told Pharmacy Daily.

"The Act sets out what is regarded as appropriate in terms of prescribing medication in the first place, and then managing and monitoring the effect of that medication," she explained.

"One of the things that the Royal Commission made very clear was that there is evidence of a very significant amount of overuse of antipsychotic medication for people living with dementia - that it was being used to sedate people to the point of non-responsiveness."

For nursing staff and GPs who are involved in prescribing medication inappropriately and not managing that, it is now an offence under the Act.

Dr Meyer explained that medication can be appropriately prescribed for the purposes of managing symptoms in relation to a specific episode, but it was often the case that people were prescribed the medication and were on it permanently, without review.

"It's still the case that if it is appropriate to prescribe medication, that absolutely should be part of how we improve the quality of life for these people," she clarified.

Within the context of the quality framework that applies to aged care, Dr Meyer said there are also far clearer directions on use of pharmacy as part of a palliative care or chronic care management plan, with a lot more emphasis on using lifestyle changes or changes to the living environment that can assist in improving someone's quality of life, rather than relying on pharmacy.

While there have been many positive signs, particularly around the uptake of training for dementia care, the next year will be critical for the Act, Dr Meyer said, particularly around costs and resourcing for its implementation.

"I think there will be some challenges around whether or not we can actually deliver the system that we want," she concluded. KB