The Prevalence and Impact of Polypharmacy and Potentially Inappropriate Medications in Australian Residential Aged Care Facilities: A Narrative Review

Background: Polypharmacy is the simultaneous use of five or more regular daily medications. The older population may be more susceptible and vulnerable to the negative impacts of polypharmacy. The number of older patients living in residential aged care facilities (RACFs) across Australia is increasing, which proportionally increases their risk of being prescribed a Potentially Inappropriate Medication (PIM). The prevalence of PIMS is increased in conjunction with polypharmacy. They increase the risk of patient hospitalisation and harm, which therefore increases the burden on the healthcare system. Aim: To identify the prevalence and impact of polypharmacy and PIMs in RACF patients, to examine the risks and suggest possible solutions to decrease patient harm across Australia. Method: A critical analysis and synthesis of pre-existing literature from academic library databases was utilised to develop themes and acknowledge gaps in the literature. The databases used were Ovid MEDLINE, Emcare Ovis, Scopus, Web of Science, Clinical Key and DynaMed. Results: The studies identified a significantly high rate of inappropriate prescribing causing potential patient harm, especially in the older population of Australia. Psychotropic medications were of particular concern. Conclusion: Older patients in Australian RACFs are at higher risk of harm from medication misadventures due to polypharmacy and the use of PIMs. However, this risk can be decreased through the implementation of future workplace policies that include a standard for thorough and detailed patient medication reviews.