A major study of 3,000 residents across 23 Sydney aged care homes has found that four in ten were given “potentially inappropriate” psychotropic medicines and that seven in ten of those residents later suffered a fall, often bad enough to require hospital care.
Published in BMJ Open by the Australian Institute of Health Innovation (AIHI) at Macquarie University, the research links antidepressants and antipsychotics routinely used for anxiety, insomnia and depression—to a cascade of injuries and hospital transfers that could be avoided through tighter medication oversight.
“When older people experience a fall, the injuries can be very serious, including fractures and head injuries,” says first author and PhD candidate Narjis Batool.
The authors are urging aged care operators to make full use of the federal government’s Residential Medication Management Review and embedded‑pharmacist programs, arguing that regular audits will flag drugs that have quietly drifted beyond their recommended duration.
“Medication reviews can alert clinicians and other care staff to a resident who may have been on a medication longer than the recommended time,” Batool says.
Senior author Dr Nasir Wabe called falls “one of the leading challenges in aged care.”
“Medications are a common yet modifiable risk factor in falls among aged care residents, highlighting the opportunity to prevent falls through targeted interventions,” he says.
“The Australian government has facilitated access to medication review services through initiatives such as embedded pharmacists and the Residential Medication Management Review programs, and providers are encouraged to make the most of these opportunities.”
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Beyond medication checks, the paper recommends staff training to spot high‑risk residents, better lighting, and exercise programs to improve balance. The researchers also highlight non‑drug therapies—behavioural support, social interaction and group activities as safer first‑line options for many mental health concerns.
With one‑third of psychotropic‑related falls ending in hospitalisation, the authors warn that the financial and human costs will keep climbing unless homes treat medication review as routine preventive care rather than an optional extra.
Ritchelle is a Content Producer for Healthcare Channel, Australia’s premier resource of information for healthcare.
