Significant gaps in medication oversight have been revealed across Australian aged care facilities, with a major national audit showing that many facilities are falling short of recommended safety standards despite government recommendations.
The comprehensive study by Monash University examined 120 Medication Advisory Committees (MACs) overseeing 642 residential care homes, nearly a quarter of all Australian facilities, and found concerning variations in how medication safety is managed nationwide.
While MACs are designed to tackle the critical issue of polypharmacy, the dangerous practice of prescribing nine or more medications simultaneously to elderly residents, the audit revealed that many committees are not fulfilling their complete role in protecting residents.
The findings show that only 28% of MACs were fully engaged in quality improvement initiatives, while just 41% fulfilled all their educational responsibilities. Even in their strongest areas, barely half of the committees performed all recommended functions, with 59% handling policy development and 53% managing risk oversight adequately.
“This audit highlights both the strengths and the areas needing targeted support in how we manage and govern medication safety in aged care,” said Dr Amanda Cross, lead author and research fellow at Monash’s Centre for Medicine Use and Safety. “MACs have the potential to lead transformational change in this sector – if adequately supported and resourced.”
The timing of these findings is particularly significant as Australia prepares to implement strengthened Aged Care Quality Standards on 1 July 2025. These new standards will require facilities to demonstrate safe clinical care delivery to almost 200,000 older Australians currently in residential care.
MACs serve as multidisciplinary committees providing overarching governance of medication management within residential care homes. The Australian Government Department of Health, Disability and Ageing recommends that all residential care facilities have access to a MAC to support safe medication use and reduce risks associated with inappropriate prescribing.
The audit examined how MACs function across four key operational domains: policy development, risk management, education and quality improvement. The research team used the Department of Health and Aged Care’s MAC Audit Tool to assess performance across these critical areas.
Despite the gaps identified, researchers see significant potential for improvement. “MACs are well positioned to support implementation and monitoring of Quality Standard 5 to ensure delivery of safe and quality clinical care to the almost 200,000 older Australians who access residential care,” Dr Cross noted.
The study forms part of a larger research initiative funded by the Medical Research Future Fund. Professor Simon Bell, who leads the Maximising Embedded Pharmacists in aGed cAre Medication Advisory Committees (MEGA-MAC) project, explained that the program includes quality improvement measures designed to address these identified gaps.
“The national quality improvement collaborative implemented as part of the MEGA-MAC project utilises a real-time clinical network designed to deliver, monitor and evaluate quality improvement initiatives,” Professor Bell said.
The findings come amid ongoing concerns about medication safety in aged care, where residents often face complex health conditions requiring multiple medications. Proper oversight through functional MACs is considered essential for preventing adverse drug reactions and ensuring appropriate prescribing practices.
Ritchelle is a Content Producer for Healthcare Channel, Australia’s premier resource of information for healthcare.
