Study reveals high-risk medications and safer alternatives in Australia


A groundbreaking study has unveiled a list of 16 potentially dangerous medications used in Australian healthcare, along with their safer alternatives.

Led by Dr Kate Wang from RMIT University’s School of Health and Biomedical Sciences, the research addresses the risks associated with ‘potentially inappropriate medicines’ (PIMs) and aims to enhance medication management and safety practices.

Dr Wang said PIMs lists help clinicians identify medications with higher risks of negative clinical outcomes, including hospitalisation and death, emphasising the importance of having an up-to-date resource tailored to the Australian healthcare setting.

These lists are particularly crucial for older adults, who often require multiple medications to manage their condition. Between 20% to 70% of older individuals are prescribed at least one PIM, contributing significantly to medication-related adverse effects and unplanned hospital admissions.

The study, conducted with input from a multidisciplinary panel of 33 clinicians and researchers, evaluated 130 medications or medication classes commonly associated with PIMs internationally. The research team identified gaps in existing lists and developed Australia’s first comprehensive list of high-risk medications and potential alternatives.

Australia’s existing PIMs list was developed 15 years ago, and there have been many changes to medications available since then.

“We found that the lists in other countries were only partially applicable in Australia due to differences in medication availability, what clinicians tend to prescribe, clinical practice guidelines and the healthcare system,” Dr Wang said.

“Furthermore, no Australian lists to date have made recommendations for potentially safer alternatives.”

The newly developed list offers insights into safer alternatives for commonly prescribed medications such as ibuprofen, lorazepam and codeine. However, Dr. Wang stressed the importance of individualised medication reviews and clinical considerations.

Dr Wang said there was no replacement for regular, individualised medication reviews – particularly for older people who may be taking medications included in the PIMs list.

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