Quality indicators for safe and effective use of medications in long-term care settings: A systematic review

Daria S. Gutteridge; Annabel H. Calder; Jacquelina Stasinopoulos; Sara Javanparast; Gillian E. Caughey; Jodie B. Hillen; Andrew C. Stafford; Gregory M. Peterson; Maria C. Inacio; Jyoti Khadka; Lisa M. Kalisch Ellett; Shane L. Jackson; Peter D. Hibbert; Monica L. Cations; Megan E. Corlis; Solomon C. Yu; Malcom J. Clark; Natalie R. Soulsby; Elizabeth Manias; Grace H.Y. Yoo; Janet K. Sluggett

doi:10.1002/bcp.70242

Quality indicators for safe and effective use of medications in long-term care settings: A systematic review

Daria S. Gutteridge, Annabel H. Calder, Jacquelina Stasinopoulos, Sara Javanparast, Gillian E. Caughey, Jodie B. Hillen, Andrew C. Stafford, Gregory M. Peterson, Maria C. Inacio, Jyoti Khadka, Lisa M. Kalisch Ellett, Shane L. Jackson, Peter D. Hibbert, Monica L. Cations, Megan E. Corlis, Solomon C. Yu, Malcom J. Clark, Natalie R. Soulsby, Elizabeth Manias, Grace H.Y. YooJanet K. Sluggett

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Abstract

People accessing aged care services are increasingly older and often experience multimorbidity and polypharmacy, which puts them at risk of medication-related harm. Quality indicators (QIs) can assist with monitoring, benchmarking and informing initiatives to reduce medication-related harm. This systematic review aimed to identify and summarize QIs that assess the safe and effective use of medications in long-term care services.

Bibliographic databases and grey literature were searched to identify relevant QIs. Eligible publications were in English and described the development, application and/or validation of QIs in long-term care facilities or in-home aged care services. QI information, including their development and settings, were extracted. All QIs were classified according to 3 validated classification systems and grouped by themes constructed from the review.

From the 62 academic articles and 16 grey literature documents included, 53 QI sets were extracted, which comprised 442 individual QIs and 18 potentially inappropriate medication lists were identified. Most (80%, n = 354) QIs were process indicators. About 1/4 (26%, n = 115) were medication-specific QIs focusing mainly on prevalence of use and dosing, with similar numbers for infection prevention and control (25%, n = 112). A smaller proportion (7%, n = 32) of QIs encompassed person-centred measures such as resident involvement in medication-related decisions.

This comprehensive overview of contemporary QIs to monitor medication safety and effectiveness across long-term care services can help clinicians, aged care providers and policy makers to identify important measures to employ in aged care settings to monitor and influence care improvements.

Original language	English
Number of pages	16
Journal	British Journal of Clinical Pharmacology
DOIs	https://doi.org/10.1002/bcp.70242
Publication status	E-pub ahead of print - 18 Aug 2025

Keywords

health care
health services for the aged
home care
medicines
monitoring
nursing homes
patient safety

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Gutteridge, D. S., Calder, A. H., Stasinopoulos, J., Javanparast, S., Caughey, G. E., Hillen, J. B., Stafford, A. C., Peterson, G. M., Inacio, M. C., Khadka, J., Kalisch Ellett, L. M., Jackson, S. L., Hibbert, P. D., Cations, M. L., Corlis, M. E., Yu, S. C., Clark, M. J., Soulsby, N. R., Manias, E., ... Sluggett, J. K. (2025). Quality indicators for safe and effective use of medications in long-term care settings: A systematic review. British Journal of Clinical Pharmacology. Advance online publication. https://doi.org/10.1002/bcp.70242

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title = "Quality indicators for safe and effective use of medications in long-term care settings: A systematic review",

abstract = "People accessing aged care services are increasingly older and often experience multimorbidity and polypharmacy, which puts them at risk of medication-related harm. Quality indicators (QIs) can assist with monitoring, benchmarking and informing initiatives to reduce medication-related harm. This systematic review aimed to identify and summarize QIs that assess the safe and effective use of medications in long-term care services. Bibliographic databases and grey literature were searched to identify relevant QIs. Eligible publications were in English and described the development, application and/or validation of QIs in long-term care facilities or in-home aged care services. QI information, including their development and settings, were extracted. All QIs were classified according to 3 validated classification systems and grouped by themes constructed from the review. From the 62 academic articles and 16 grey literature documents included, 53 QI sets were extracted, which comprised 442 individual QIs and 18 potentially inappropriate medication lists were identified. Most (80%, n = 354) QIs were process indicators. About 1/4 (26%, n = 115) were medication-specific QIs focusing mainly on prevalence of use and dosing, with similar numbers for infection prevention and control (25%, n = 112). A smaller proportion (7%, n = 32) of QIs encompassed person-centred measures such as resident involvement in medication-related decisions. This comprehensive overview of contemporary QIs to monitor medication safety and effectiveness across long-term care services can help clinicians, aged care providers and policy makers to identify important measures to employ in aged care settings to monitor and influence care improvements.",

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author = "Gutteridge, {Daria S.} and Calder, {Annabel H.} and Jacquelina Stasinopoulos and Sara Javanparast and Caughey, {Gillian E.} and Hillen, {Jodie B.} and Stafford, {Andrew C.} and Peterson, {Gregory M.} and Inacio, {Maria C.} and Jyoti Khadka and {Kalisch Ellett}, {Lisa M.} and Jackson, {Shane L.} and Hibbert, {Peter D.} and Cations, {Monica L.} and Corlis, {Megan E.} and Yu, {Solomon C.} and Clark, {Malcom J.} and Soulsby, {Natalie R.} and Elizabeth Manias and Yoo, {Grace H.Y.} and Sluggett, {Janet K.}",

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Gutteridge, DS, Calder, AH, Stasinopoulos, J, Javanparast, S , Caughey, GE, Hillen, JB, Stafford, AC, Peterson, GM, Inacio, MC , Khadka, J, Kalisch Ellett, LM, Jackson, SL, Hibbert, PD, Cations, ML, Corlis, ME, Yu, SC, Clark, MJ, Soulsby, NR, Manias, E, Yoo, GHY & Sluggett, JK 2025, 'Quality indicators for safe and effective use of medications in long-term care settings: A systematic review', British Journal of Clinical Pharmacology. https://doi.org/10.1002/bcp.70242

TY - JOUR

T1 - Quality indicators for safe and effective use of medications in long-term care settings

T2 - A systematic review

AU - Gutteridge, Daria S.

AU - Calder, Annabel H.

AU - Stasinopoulos, Jacquelina

AU - Javanparast, Sara

AU - Caughey, Gillian E.

AU - Hillen, Jodie B.

AU - Stafford, Andrew C.

AU - Peterson, Gregory M.

AU - Inacio, Maria C.

AU - Khadka, Jyoti

AU - Kalisch Ellett, Lisa M.

AU - Jackson, Shane L.

AU - Hibbert, Peter D.

AU - Cations, Monica L.

AU - Corlis, Megan E.

AU - Yu, Solomon C.

AU - Clark, Malcom J.

AU - Soulsby, Natalie R.

AU - Manias, Elizabeth

AU - Yoo, Grace H.Y.

AU - Sluggett, Janet K.

PY - 2025/8/18

Y1 - 2025/8/18

N2 - People accessing aged care services are increasingly older and often experience multimorbidity and polypharmacy, which puts them at risk of medication-related harm. Quality indicators (QIs) can assist with monitoring, benchmarking and informing initiatives to reduce medication-related harm. This systematic review aimed to identify and summarize QIs that assess the safe and effective use of medications in long-term care services. Bibliographic databases and grey literature were searched to identify relevant QIs. Eligible publications were in English and described the development, application and/or validation of QIs in long-term care facilities or in-home aged care services. QI information, including their development and settings, were extracted. All QIs were classified according to 3 validated classification systems and grouped by themes constructed from the review. From the 62 academic articles and 16 grey literature documents included, 53 QI sets were extracted, which comprised 442 individual QIs and 18 potentially inappropriate medication lists were identified. Most (80%, n = 354) QIs were process indicators. About 1/4 (26%, n = 115) were medication-specific QIs focusing mainly on prevalence of use and dosing, with similar numbers for infection prevention and control (25%, n = 112). A smaller proportion (7%, n = 32) of QIs encompassed person-centred measures such as resident involvement in medication-related decisions. This comprehensive overview of contemporary QIs to monitor medication safety and effectiveness across long-term care services can help clinicians, aged care providers and policy makers to identify important measures to employ in aged care settings to monitor and influence care improvements.

AB - People accessing aged care services are increasingly older and often experience multimorbidity and polypharmacy, which puts them at risk of medication-related harm. Quality indicators (QIs) can assist with monitoring, benchmarking and informing initiatives to reduce medication-related harm. This systematic review aimed to identify and summarize QIs that assess the safe and effective use of medications in long-term care services. Bibliographic databases and grey literature were searched to identify relevant QIs. Eligible publications were in English and described the development, application and/or validation of QIs in long-term care facilities or in-home aged care services. QI information, including their development and settings, were extracted. All QIs were classified according to 3 validated classification systems and grouped by themes constructed from the review. From the 62 academic articles and 16 grey literature documents included, 53 QI sets were extracted, which comprised 442 individual QIs and 18 potentially inappropriate medication lists were identified. Most (80%, n = 354) QIs were process indicators. About 1/4 (26%, n = 115) were medication-specific QIs focusing mainly on prevalence of use and dosing, with similar numbers for infection prevention and control (25%, n = 112). A smaller proportion (7%, n = 32) of QIs encompassed person-centred measures such as resident involvement in medication-related decisions. This comprehensive overview of contemporary QIs to monitor medication safety and effectiveness across long-term care services can help clinicians, aged care providers and policy makers to identify important measures to employ in aged care settings to monitor and influence care improvements.

KW - health care

KW - health services for the aged

KW - home care

KW - medicines

KW - monitoring

KW - nursing homes

KW - patient safety

UR - http://www.scopus.com/inward/record.url?scp=105013567757&partnerID=8YFLogxK

UR - http://purl.org/au-research/grants/NHMRC/2016277

UR - http://purl.org/au-research/grants/NHMRC/2026400

UR - http://purl.org/au-research/grants/NHMRC/119378

U2 - 10.1002/bcp.70242

DO - 10.1002/bcp.70242

M3 - Review article

AN - SCOPUS:105013567757

SN - 0306-5251

JO - British Journal of Clinical Pharmacology

JF - British Journal of Clinical Pharmacology

ER -

Quality indicators for safe and effective use of medications in long-term care settings: A systematic review

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Keywords

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