Medicine problems behind 250,000 hospital admissions annually
A new report has revealed 250,000 Australians are hospitalised each year, with another 400,000 presenting to emergency departments, as a result of medication errors, inappropriate use, misadventure and interactions.
At least half of the medication incidents could have been prevented.
The Medicine Safety: Take Care Report, developed for the Pharmaceutical Society of Australia by the Quality Use of Medicines and Pharmacy Research Centre at the University of South Australia, calculates the annual cost of medication-related problems in Australia at nearly $1.4 billion – equivalent to 15 per cent of total PBS expenditure.
Speaking at the report’s launch in Melbourne on 31 January 2019, PSA National President Dr Chris Freeman said the report revealed the sobering extent of the issue and demonstrated the need for medicine harm to become a national health priority.
“Each year, approximately 250,000 Australians are admitted to hospital as a result of medicine-related problems. This is almost four times the annual number of people who are hospitalised as a result of motor vehicle accidents,” he said.
“And there is an additional 400,000 presentations annually to emergency departments due to medicine-related problems.
“At least 50 per cent of medicine-related problems are preventable, but only if we remove the siloed approach to medicines management.
“If medicine harm was a chronic disease it would already be a national health priority. This report highlights that governments, pharmacists and other health professionals need to work together to reduce the alarming incidence of medication errors, misadventure, misuse and interactions,” he said.
Report author, Professor Libby Roughead from the Quality Use of Medicines and Pharmacy Research Centre said, “As the use of pharmaceuticals increases so too do rates of medication error, management problems and interactions with other medicines.”
The report highlighted that in 2016-17 two thirds of patients visiting GPs took at least one continual medication, with 11 per cent experiencing adverse medication events in the previous six months. “This equates to almost 1.2 million Australian experiencing an adverse medication event in the past six months,” she said.
“Four-in-ten older Australians have been prescribed at least one potentially inappropriate medicine, confirming the need for greater checks and balances in the way medicines are prescribed, dispensed and monitored,” she said.
PSA argues that increasing the role of pharmacists in medicines management and wherever medicines are used – in residential aged care homes, hospital discharge and in the community – has the potential to significantly reduce the number of adverse events and medication-related hospital admissions.
Dr Freeman added, “There is a clear need for pharmacists to lead medication reconciliation and review activities as they are experts in medicines. They are uniquely placed within the healthcare system and the frequency with which they interact with patients means they are equipped to identify a medicine-related issue and resolve it immediately.”
“Regular and thorough reviews of medicines are one of the ways to reduce this significant health risk and cost to the community. On average, four medication-related problems are detected for each person who has a home medicines review,” he said.
“The report also shows the need for pharmacists to be embedded within residential aged care facilities to tackle the prevalence of medication-related problems that occur in this setting. This could include medication review, clinical governance and educating staff in the quality of use of medicines.”
The report findings focus on four areas where medication-related problems are rife:
Inappropriate medicine use in residential aged care
- 98 per cent of people living in aged care facilities have at least one medication-related problem identified at review, and up to 80 per cent are prescribed potentially inappropriate medicine.
- 17 per cent of unplanned hospital admissions by people living in aged-care facilities are caused by an inappropriate medicine.
Impaired kidney function is increasingly common in older people
- One-in-four older people treated with medicines that rely on the kidneys to clear the body are prescribed doses considered excessive.
- Among people with poor kidney function, at the time of their admission to hospital 16 per cent were receiving a medicine that should not have been prescribed and 21 per cent had been prescribed an inappropriate dose.
Hospital discharge is a missed opportunity
- More than 90 per cent of people have at least one medication-related problem post-discharge from hospital.
- At least one medication error was identified in 60 per cent of hospital discharge summaries where a pharmacist was not involved in its preparation.
- Only one-in-five changes made to the medication regimen during hospital admission were explained in the discharge summary.
Multiple medicine use spells danger
- The use of multiple medicines was responsible for 70 per cent of cases where people are admitted to hospital for adverse drug reactions.
1 February 2019.