New tools to curb medication-related harm in aged care

Two new initiatives aimed at improving medication safety in residential aged care are being launched this week by research-led institutions.

Monash University and Flinders University are releasing a microlearning video series on psychotropic medicines, while Australia’s first national consensus list of high‑risk medications tailored specifically for aged care has been developed.

The developments come amid ongoing reform efforts to reduce preventable medication‑related harm, particularly for people living with dementia and older residents managing multiple chronic conditions.

The new microlearning series comprises 12 short videos covering the initiation, monitoring and discontinuation of antipsychotics, benzodiazepines and antidepressants. The modules translate key recommendations from the Clinical Practice Guidelines for the Appropriate Use of Psychotropic Medications in People Living with Dementia and in Residential Aged Care.

Professor Simon Bell, director of Monash University's Centre for Medicine Use and Safety (CMUS), said the videos were created in direct response to the sector's needs.

“The strong feedback that we got from the aged care sector was that short videos that support micro learning in the workplace are more likely to be effective, than the larger, more traditionally didactic style of education,” he said.

Feedback was collected during a CMUS-led project design to identify the most effective method for the dissemination of medication-related education in residential aged care.

The ongoing EMBRACE project has shown that on-site aged care pharmacists are potentially well placed to act as knowledge brokers in support of the implementation of the Clinical Practice Guidelines.

“A knowledge broker is a person who helps to translate the research evidence into clinical practice and embed the recommendations and good practice statements in the guideline into each aged care provider's organisational policies and procedures,” Prof Bell said.

“Having an NHMRC [National Health and Medical Research Council] approved clinical practice guideline was an important first step. But we need to generate an evidence base for how we implement guidelines into clinical practice, because evidence to practice gaps still remain a barrier to achieving safe and effective medication use.”

The microlearning video series complements a broader suite of resources, including nine one‑page medication fact sheets, a companion guide for people living with dementia and their carers, and an adverse event monitoring tool.

OZ‑ABCD for aged care

In a separate study published in the Australasian Journal on Ageing, researchers and a multidisciplinary panel of experts have developed Australia’s first high‑risk medication list specifically tailored to residential aged care.

The list identifies 15 high‑risk medicines or classes, and uses the mnemonic ‘OZ‑ABCD’ to highlight the top categories: Opioids, Z‑drugs and benzodiazepines, Antipsychotics and lithium, Blood thinners, Chemotherapeutic agents and methotrexate, and Diabetes agents with high hypoglycaemia risk.

Dr Amanda Cross, senior research fellow at Monash University and the study’s lead author, said aged care providers have long been required to identify and mitigate risks associated with high‑risk medicines, but existing tools were designed for hospitals, not aged care.

“The OZ‑ABCD tool gives busy clinicians and aged care staff a simple, memorable way to identify high‑risk medications and ensure systems and monitoring are in place to keep residents safe,” she said.

Critically, the tool also aligns with strengthened the Aged Care Quality Standards introduced last year, which require providers to have clear policies and processes for managing high‑risk medicines.

Supporting safer care

Both initiatives emphasise practical, scalable solutions that fit the realities of aged care workforces, including shift rotations, time pressures and the need for repeated, bite‑sized learning.

Dr Cross said the next step for the ‘OZ‑ABCD’ tool is national implementation support, including template policies, quick‑reference cards and other resources to help aged care services embed the list into practice.

“Bite‑sized education is most effective when paired with repetition and someone on the ground who can help staff apply the knowledge,” she said.

“The next step is really to raise awareness about these medications and build the capacity and empower staff that are working in aged care, whether they're nurses or care workers or GPs or pharmacists, to be able to identify these medications and to make sure that they are being used safely.”

Researchers from Monash and Flinders have also released a Practical Guide to Establishing and Leading a Quality Improvement Collaborative, designed to help aged care organisations and Primary Health Networks support teams working on shared safety and quality goals.

With psychotropic medication use and medication‑related harm remaining key concerns identified by the Royal Commission into Aged Care Quality and Safety, researchers say these tools offer timely, evidence‑based support for a workforce under pressure.

Professor Bell said the challenge now is ensuring the resources are widely adopted.

“We need to continue generating evidence about what strategies are most effective for optimising medication use,” he said.

“These microlearning videos are an important part of translating recommendations into practice so they can benefit residents.”