Introduction
confusion
Older people living in residential aged care facilities (RACFs) (also known as “long-term care homes” or “nursing homes”) are often on trajectories of physiological and cognitive decline characterised by co-morbidities and the use of multiple medicationsAntipsychotics, sedatives, and medications with high anticholinergic properties are of particular concern amongst the elderly, often causing increased risk of confusion and falls. The use of psychotropics in RACFs was highlighted as a concern in the Australian Royal Commission into Aged Care Quality and Safety reportIssues such as the inappropriate use of psychotropics medications in RACFs are often complex with many contextual factors. A recent overview of reviews suggested that multi-disciplinary collaboration, along with education and training, may be an effective approach in tacking the issueIn Australia, pharmacists perform two government-funded clinical services in aged care facilities, the residential medication management review (RMMR) and QUM services. The RMMR has been a useful tool in identifying and resolving medication-related problemsIn view of high rates of inappropriate medicine use despite the existing limited pharmacy services, the Pharmacist in Residential Aged Care Facilities (PiRACF) cluster randomised trial aimed to evaluate a new model in which on-site pharmacists perform medication management activities to improve QUM. On-site pharmacists worked in collaboration with the interdisciplinary care team in RACF to conduct day-to-day medication management tasks, both at the resident level such as medication reviews and at the RACF level to improve policies and practice. This trial assessed the impact of the model on medication appropriateness in RACFs