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Improving antipsychotic outcomes in aged care

A project which has driven significant improvements in the quality use of antipsychotics, leading to patient and staff benefits, has been recognised with a High Commendation Award at the recent 2014 Information Technology in Aged Care (ITAC) Awards.
Webstercare pharmacist, Christine Veal, Southern Cross Care dementia care consultant, Sonali Pinto, and Webstercare director, Matthew Stevens, accepted the 2014 ITAC High Commendation Award.
Webstercare pharmacist, Christine Veal, Southern Cross Care dementia care consultant, Sonali Pinto, and Webstercare director, Matthew Stevens, accepted the 2014 ITAC High Commendation Award.

The joint project between medication management company, Webstercare, and not for profit quality aged care service provider, Southern Cross Care (SCC) NSW & ACT, demonstrates that a partnership approach to electronic reporting resources can deliver a range of benefits, not just in patient improvements across a range of measures, but also in driving positive staff cultural change in residential aged care facility care staff.

SCC has 30 aged care homes across New South Wales and the Australian Capital Territory, with a residential population of 1,800 across home and residential care services.

For these resident patients, the project effectively managed deprescribing, evidenced by: increased function; decreased falls and disorientation/confusion; improved communication and appetite in individual residents; increased participation in assisted daily life; decreased extrapyramidal side effects; and insomnia and the promotion of natural sleep patterns.

These outcomes help decrease the risk associated with frequent hospitalisations, directly improve quality of life for residents and have immediate cost benefits to the health care system as a whole.

The project also drives cultural improvements within SCC, with staff reporting higher levels of empowerment in their roles, increased knowledge about the use of antipsychotics, increased confidence and an ability to manage behavioural and psychological symptoms of dementia with non pharmacological intervention. This all facilitated an organisational culture change that has improved the quality use of psychotropic medicines in residential aged care.

“It is fantastic we have received this High Commendation Award for the second year in a row,” says Gerard Stevens AM, managing director and founder of Webstercare.

“It has been a collaborative effort, recognising our IT solutions and how our customers are implementing them. Most importantly, the results from the collaboration are improving the lives of residents in aged care facilities,” Mr Stevens says.

Webstercare's submission focuses on implementing a formal framework to support and encourage the regular review and use of psychotropic medicines in their aged care homes. This includes organisational and operational procedures, governance, quality principles and policy that prompt regular review and use of these drugs.

“SCC, for example, identified the weak evidence for psychotropic medicines, unnecessary polypharmacy and morbidity particularly in people with dementia as an area of concern,” Mr Stevens says.

“So, an expert partnership group was established to provide governance for the program. Their challenge was how to collect relevant data on psychotropic drug use across all residents in 30 residential aged care facilities and to connect this data with effective evaluation in local deprescribing teams," he adds.

To ensure access to quality data, the team has implemented the NPS MedicineWise Quality Use of Medicine (QUM) report, Antipsychotics for behavioural and psychological symptoms of dementia.

This electronic report is reportedly the first in a series of reports which aims to provide fast electronic access to stored ‘big data’ across organisations. The report uses historical prescribing data to provide comprehensive reporting on antipsychotic medicines.

The electronic QUM report was selected as the most appropriate method of gathering and collating data, specifically highlighting residents who are prescribed psychotropic medicines for more than 12 weeks, prompting medication review and thus promoting compliance with quality guidelines.

The report uses routinely entered information at the pharmacy and collates historical data into a readily accessible and easy to produce report.

It includes the exact start date of a medicine and calculates the number of days a resident has been taking a psychotropic medicine; taking into account hospital admissions of up to three days duration. Changes in dose and strength are clearly documented as is the recorded indication for each psychotropic medicine.

The report has the capability to be generated from the Webstercare Medication Management Software within minutes.

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