National Monitoring of Medication-Related Quality of Care in Residential Aged Care: Is Australia Making Progress?

In 2018, the Australian Government established a Royal Commission into Aged Care Quality and Safety.Recommendations from the final report in 2021 included national monitoring of quality of care in residential aged care facilities (RACFs) and the need to improve medication-related care to reduce medication-related harms and improve resident well-being. Over the past decade, the health status of those entering RACFs in Australia has worsened, together with increased frailty and polypharmacy. Studies have shown that 44% to 73% of RACF residents use 1 or more potentially inappropriate medications, including high-risk medications such as opioids and antipsychotics. Internationally, many countries mandate the monitoring and reporting of medication-related quality of care in residential long-term care with the aim to drive improvements in quality and care outcomes. The Registry of Senior Australians (ROSA) has developed quality indicators to examine the quality and safety of aged care using existing data sources, including 4 medication-related indicators (high sedative load, antipsychotic use, chronic opioid use, and antibiotic use) to monitor medication-related care. Using these indicators, we examined if medication-related quality of care in Australia has changed over the past 5 years, using routinely collected data.