Pharmacy Daily | Aged care options needed for COVID

THERAPEUTIC substitution and deprescribing could be key tools in mitigating against the spread of COVID-19 in aged care facilities, US researchers believe.

A guide for optimising medication management during the COVID-19 pandemic in aged care facilities, published in the Journal of the American Geriatrics Society, has outlined a series of potential measures that can be taken to protect both staff and patients, by reducing interaction times, as the crisis continues.

The guide recommends "reducing the use of medication which are often unnecessary or inappropriate", including "certain vitamins and herbal medications which are commonly used but rarely have a compelling indication, as well as medications inappropriate for a person's circumstances such as long-term preventative medications of a person with limited life expectancy".

"Because of the imperative to reduce resident-staff contact in high-risk situations of potential infection transmission, it may also be advisable to temporarily discontinue medications such as bisphosphonates and vitamin B12," the authors said.

"These medications often have appropriate therapeutic uses, but may be able to be held for a period of weeks to a few months without compromising goals of care."

The authors noted that "very frequent monitoring related to medications is often unnecessary, burdensome to residents and staff, and associated with more harm than good", adding that "major gains may also be achieved by reducing the number of medication passes required per resident", through therapeutic substitution.

The authors recommended that changes to medication management should be implemented in stages, and should be reviewed by an interdisciplinary care team.