The Impact of Aged Care on the Federal Election: Spotify podcast interview →

Prof Maria Inacio (ROSA Director) was interviewed by the The Swanston Explainer Podcast.

In the third year of the pandemic, and with an election on the horizon, the safety of aged care services has grown increasingly polarising. With both major parties reacting to the findings of the Royal Commission, and the vulnerability of Australia's elderly under COVID-19, the safety of our seniors may decide the future of the state's leadership. We talk with experts and analysts at the center of the crisis for their insight on how the partisan responses to aged care safety has rippled through the latest election period.
By Tiarna Condren, Tom Cutbush and James Dowling. Series Producer India Curtain.

Listen to the full interview here.

Press Release: Majority of aged care residents don’t receive eye health care, study finds. →

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Use of optometrists and other eye health professionals in Australian care homes is low, despite over 40 per cent of residents having one or more eye condition, a new study has found.

The study, published in the Translational Vision Science and Technology Journal, evaluated the prevalence of eye diseases, use of eye health care services and eye medications by almost 410,000 aged care residents, aged 65 years or older, who entered residential care between 2008 and 2015.

The researchers found that 44 per cent of the care home residents had at least one eye condition, 33 per cent had a chronic eye condition and 20 per cent had an acute eye condition.

Adding to these alarming figures, the investigation also found that the majority of residents who required eye care were not having regular appointments with an optometrist. Only 46 per cent of residents with eye conditions accessed an eye health service in the first year of entering residential aged care, despite 71 per cent using at least one ophthalmic medication.

Lead researcher Dr Jyoti Khadka said the findings were worrying. He said: “If you have proper eye health services, simple kinds of treatments and corrections related to eye rehabilitation can help significantly. If you leave them like that, these eye conditions may lead to blindness.”

He also noted that if patients suffering from unnecessary low vision and blindness isn’t bad enough, it can also lead to injuries and hospital admissions from falls.  

Luke Arundel, Optometry Australia’s Chief Clinical Officer, said: “No matter your age or circumstances, if you have an eye condition then it’s vital that you regularly see your optometrist or ophthalmologist. This is to ensure that the condition is being treated properly and that you’re using the right medications, and to reduce the risk of further damage to your eyes.  

“It’s concerning that many home care patients, who are among the most vulnerable in or society, are not being supported enough when it comes to eye health. It’s not acceptable to just accept vision loss in the elderly – around 90 per cent of the time this is avoidable with early detection and proper care.

“There are options available for Australians who can’t make their own way to an eye examination. The Good vision for life website’s Find an Optometrist allows you to search for a nearby mobile optometrists who will provide comprehensive vision checks and eyecare in homes and aged and residential care services” he said.

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Two in five residents found to have an eye condition

The study published in the Translational Vision Science and Technology Journal this month evaluated prevalence of eye diseases, use of eye health care services and ophthalmic medications.

It involved a cross-sectional study using ROSA data on 409,186 individual aged care residents aged 65 years or older who entered residential aged care between 2008 and 2015.

The study found that 44 per cent of these residents had at least eye condition, 33 per cent had a chronic eye condition and 20 per cent had an acute eye condition.

It also found that less than half of residents with eye conditions accessed an eye health service in the first year of entering residential aged care (46 per cent) but more than two-thirds used at least one ophthalmic medication (71 per cent).

Lead researcher Dr Jyoti Khadka said the findings were concerning.

“It’s definitely concerning because the predisposition of having more eye conditions is definitely age, so age is a big risk factor of having eye conditions. It’s also more concerning they are not accessing proper eye health services,” Dr Khadka told Australian Ageing Agenda.

“If you have proper eye health services, eye conditions can be assessed because simple kinds of treatments and corrections related to eye rehabilitation can help significantly. If you leave them like that, these eye conditions may lead to blindness,” said Dr Khadka, a senior research fellow at ROSA.

He said there are also negative impacts associated with blindness, such as falls and fractures, which can lead to hospital admissions.

“All these negative outcomes could be prevented if we identify their eye health problems, provide them appropriate eye health assessment and then provide them with the appropriate treatment that is required. It could be as simple as glasses. It could be a simple surgery like cataract removal or managing glaucoma,” Dr Khadka said.

The study found glaucoma is the most common eye condition among residents (14 per cent), followed by poor vision (10 per cent), cataracts (8 per cent) and blindness (5 per cent).

Dr Khadka said it is an issue that aged care assessment only captures some eye conditions.

“The Aged Care Assessment Team doesn’t capture the other major eye conditions – it only captures cataracts, glaucoma, blindness and visual impairment. But there are other eye conditions like age-related macular degeneration and diabetic retinopathy, which is related to diabetes, that are also very common in this cohort who are 65 years and older,” he said.

The study also identified the prevalence of blindness among residents decreased during the study period.

“Probably one of the reasons for that is people are accessing some kind of eye health services that is basically preventing them from going blind,” he said.

Dr Khadha said aged care assessment needed to be broader to detect all eye conditions.

“There should be a comprehensive eye health assessment along with the ACAT assessment when residents are being assessed for aged care eligibility. That has to happen. Then we can actually identify if they have eye health issues… and then have some kind of follow up assessment,” he said.

He also said the aged care system should support optometrists to make regular visits to aged care facilities to help residents who are unable to leave the home.

Press Release. New quality indicator pilot trial reliant on community input for success. →

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A national consortium including SAHMRI’s Registry of Senior Australians (ROSA), the University of Queensland and PricewaterhouseCoopers (PwC) is now consulting with industry and community stakeholders regarding their new quality indicator pilot trial.

The trial will test the effectiveness of the health department’s existing quality indicators for residential aged care (RAC), as well as inform the development of five similar quality indicators for in-home care services.

Further assessment tools relating to ‘consumer experience’ and ‘quality of life’ will be developed for both RAC and in-home care.

Associate Professor Gillian Caughey, associate director of ROSA, says that community input is a vital part of the consultation process.

“The fact that we’re having the consumer voice as part of this quality indicator program is something that is important moving forward for Australia,” she says.

The community consultation will occur via numerous online seminars across November and December 2021.

Each session will cover a specific area of care, such as:  

• Consumer Experience and Quality of Life

• Functions and Activities of Daily Living

• Depression

• Infection control

• Pain

Regulatory meetings catered to peak industry bodies have been listed, but dates and further details are TBA.

Those interested in attention the sessions can register via this link.

Aged care providers are invited to express interest in participating in a nation-wide pilot trial, which will commence in 2022.

Further background information can be found in PWC’s consultation paper: Development of quality indicators for in-home aged care.

The National Aged Care Mandatory Quality Indicator Program is a health department initiative that began in July 2019.

The program requires Commonwealth-subsidised RAC services to report on the quality indicators every three months.

Aggregate data pertaining to this data is published quarterly and annually on the GEN Aged Care Data website by the Australian Institute of Health and Welfare (AIHW).

The data is deidentified, meaning the public cannot ascertain the status of individual RAC providers and facilities.

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Press Release: New pilot trial to provide 'comprehensive overview of the quality and safety of care being delivered in aged care' →

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Aged care providers nationwide will have the opportunity to volunteer to be involved in a nationwide aged care quality indicators pilot trial, set to commence in January 2022.

A national consortium including SAHMRI’s Registry of Senior Australians (ROSA), the University of Queensland and PricewaterhouseCoopers (PwC), is set to launch a nationwide pilot to trial new quality indicators in aged care.

The pilot, an opportunity for residential aged care services to demonstrate their commitment to quality improvement, will be conducted in January 22, but is inviting expressions of interest from providers now and until November 26.

Associate professor Gillian Caughey, pharmacoepidemiologist and associate director of ROSA, says the six-week-long pilot will support expansion of the National Aged Care Mandatory Quality Indicator Program (QI Program) to include additional quality of care measures and a quality-of-life tool for those living in residential aged care.

“This is a major step forward that’s indicative of the collective recognition that older people in our society need and deserve a higher standard of care and quality of life.”

Existing indicators in residential aged care relate to incidence rates of five indicators: pressure injury, physical restraint, unplanned weight loss, falls/major injury and medication management.

The trial will look at developing quality indicators for home care, as well as a subjective quality of life assessment tool, which will gather survey data from residents themselves.

Caughey tells Aged Care News that the quality-of-life assessment tool will comprise a short series of questions, adaptable even to those living with dementia or other forms of mild-moderate cognitive impairment.

“We can then use that to give a score and then essentially rate people in terms of whether they have good quality of life or a poor quality of life,” Caughey notes.

“The fact that we’re having the consumer voice as part of this quality indicator program is something that is important moving forward for Australia.”

Caughey adds that the new system must not simply measure each indicator in its own right, but note how they interconnect.

An overemphasis on one metric, for example, falls prevention, must not result in deprivation to mobility and independence.

“What we need to move toward is a comprehensive quality indicator program that actually captures all those key domains, and we know that many of those are interrelated,” Caughey says.

In fact, previous research by Flinders University’s Caring Futures Institute found that factors such as staying mobile, maintaining social connections and retention of independence and topped residents’ personal wellbeing priorities.

This pilot will aim to assess whether the current metrics are comprehensive enough and inform the creation of additional measures where necessary.

The evidence review, consultation and trial process are being funded and overseen by the Department of Health.

However, Caughey says that these evaluation tools are not punitive in nature, with results being delivered for the sake of internal benchmarking and quality control as opposed to regulatory compliance.

“The aim of the program isn’t to be punitive, it’s to provide aged care providers with the opportunity and ability to measure and monitor their performance against these key indicators of safety and quality of care,” she says.

“The reports are provided to aged care providers about their rates,and measured against state and national averages so they can see where they fall… and ideally these data can be used for continuous quality improvement.”

The National Aged Care Mandatory Quality Indicator Program (QI Program) started on July 1, 2019. It requires Commonwealth-subsidised residential aged care services to collect data and report on a set of quality indicators every three months.

Reports on the quality indicators are published quarterly and annually on the GEN Aged Care Data website by the Australian Institute of Health and Welfare (AIHW).

The data is ‘deidentified’, meaning that results pertaining to specific facilities are unavailable to the general public.

The full press release is available to read here.

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Press Release: Development of quality indicators for in-home aged care. →

A consortium consisting of PricewaterhouseCoopers, the Centre for Health Services Research at the University of Queensland and the Registry of Senior Australians has been engaged by the Australian Government Department of Health (the Department) to assist in the further expansion of the National Aged Care Mandatory Quality Indicator Program.

This project is designed to gather stakeholder views on potential quality of care domains and indicators. The project will include stakeholder consultations and a six-week quality indicator pilot.

The full press release is available here.

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Press Release: Expansion of quality indicators for residential aged care. →

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A consortium consisting of PricewaterhouseCoopers, the Centre for Health Services Research at the University of Queensland and the Registry of Senior Australians has been engaged by the Australian Government Department of Health (the Department) to assist in the further expansion of the National Aged Care Mandatory Quality Indicator Program.

The full press release is available here.

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Call for better support for people with arthritis in residential aged care →

Musculoskeletal conditions are negatively impacting the quality of life of older people living in residential aged care facilities, Australian research shows.

A study of 490,325 people in the Registry of Senior Australians admitted to residential aged care between 2004 and 2014 found 40.2% of residents had a musculoskeletal condition, with arthritis accounting for 90% of those.

The study also showed the prevalence of musculoskeletal or arthritis conditions increased between 2004 and 2014.

“Activity limitations most strongly associated with having a musculoskeletal condition were those related to domestic tasks (OR 1.44; 95% CI 1.39- 1.49), home maintenance (OR 1.12; 95% CI 1.10-1.13), transport (OR 1.10; 95% CI 1.07-1.13) and social activities (OR 1.16; 95% CI 1.14-1.19).”

The full press release based on this scientific publication is available in the Limbic Rheumatology which can be accessed here.

Hospitalisation predictors common at time of ACAT assessment →

Just over one in five older South Australians had an unplanned hospitalisation or visit to the emergency department within the first three months after their aged care assessment, a University of South Australia study has found.

Important predictors were identified at the time of the assessment meaning this is an actionable period for targeting at-risk individuals to reduce hospitalisations, the study found.

The study, which looked at 22,130 South Australians who had an ACAT assessment between 1 January 2013 and 31 May 2016, examined individual, medication, system and healthcare related predictors of hospitalisation and emergency department presentations within 90 days of their assessment.

It found that 5,028 individuals had an emergency department presentation (23 per cent) and 4,906 individuals were hospitalised (22 per cent) within three months of their assessment.

Lead researcher Professor Maria Inacio said the findings highlighted that the ACAT assessment was an important time to target reducing future hospitalisations and ED presentations.

“The ACAT is a point that we can use as a potential intervention because we know that at that point it’s very likely that these individuals are going to be returning for hospitalisation in the very short term,” Professor Inacio told Australian Ageing Agenda.

The study also identified 25 predictors that point to those who most at risk of being hospitalised.

An individual’s history of hospitalisation is the strongest predictor of rehospitalisation, said Professor Inacio, director of the Registry of Senior Australians at the South Australian Health and Medical Research Institute and adjunct research professor at UniSA.

An individual’s level of frailty at the time of their ACAT, their medication use and the frequency of after-houses services are other key predictors, she said.

“Individuals that are using a lot of urgent after hours care and are repeatedly seeing their general practitioner, especially at urgent after hour attendances, usually means that potentially their health is declining,” Professor Inacio said.  

Other predictors include being male, a user of sulphonamides or trimethoprim antibiotics and unplanned hospitalisations within 30 days or an emergency department visit within one year of assessment.

Optimised medication management is an intervention that could potentially be implemented through existing programs such as home medicine reviews, Professor Inacio said.

“Frailty could be addressable. Given the appropriate strategies to manage frailty like consultation with a geriatric specialist and appropriate allied health professionals, that could be managed and changed,” Professor Inacio said.

She said the findings were not surprising because international studies have identified hospitalisation risk factors of hospitalisations.

“But they are things that are unique to Australia. The fact that we’ve identified these now is really helpful for us,” she said.  

The research, which received funding from the Health Translation SA through the Medical Research Future Fund Rapid Applied Research Translation Program, is published in Journal of the American Geriatrics Society.

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The text above is taken from the Australian Ageing Agenda press release dated 22 September 2021. The full press release is available here.

Study identifies ways to reduce hospitalisations for older Australians →

One in five South Australians will experience an unplanned hospitalisation or emergency department presentation within 90 days of undertaking an aged care assessment, according to new research by the University of South Australia and the South Australian Health and Medical Research Institute.

The large-scale study, which analysed the outcomes of 22,130 people who had an aged care eligibility assessment (ACAT), also found 25 predictors that identify older people most at risk of being hospitalised.

These risk factors include level of frailty, types of medications taken, and frequency of after-hours services use.

Lead researcher Professor Maria Inacio says the findings suggest that the ACAT, which 186,000 Australians undertake every year, is a promising period to implement programs targeted at reducing hospitalisation for older Australians.

“We can identify moderately well those most at risk of being hospitalised, meaning we can determine the older people who need the most follow up after their assessment,” Prof Inacio says.

“If we provide targeted treatment or therapies during this time, we can not only provide better support to older people transitioning to care, but we could reduce overcrowding and ramping in our hospitals as well.

“We found 25 specific predictors of either hospitalisations or emergency department encounters, including recent history of high use of after-hours services, prior hospitalisation, and certain medications.”

In 2018 in Australia, older people accounted for 16 per cent of the population and 42 per cent of the hospitalisations and 49 per cent of the days spent in hospital.

Prof Inacio, who oversees the national database Registry of Senior Australians, says reducing the amount of time older people spend in hospitals is better for everyone, and the study offers practical recommendations to help this happen.  

“Our findings can help ensure older people have the best care, and their families, clinicians, and aged care providers are informed on how to best care for them,” she says.

“Older people are usually on a lot of medication, for example. We found that after a certain number of medications they are at a higher risk of unplanned hospitalisations.

“Optimised medication management is one potential area that could be implemented through existing programs such as home medicine reviews. This is a Medicare-subsidised program for older people living in the community, yet it is not used as often as it should be.

“Frailty is also a significant predictor of hospitalisations, and this is another factor we could address following an ACAT assessment.

“If we invest in services and care that can help reduce frailty – things like encouraging physical exercise if possible, or comprehensive management with geriatric specialists and appropriate allied health professionals – we could improve older people’s quality of life and reduce the impact on our hospitals at the same time.”

The research paper ‘Predictors of short-term hospitalisation and emergency department presentations in aged care’ was published in the Journal of the American Geriatrics Society in June.

The study is part of the wider State Action on Avoidable Rehospitalisations and Unplanned Admissions in South Australia (STAAR-SA) project led by Professor Maria Crotty (Flinders University), Professor Gillian Harvey (Flinders University), and Prof Inacio (SAHMRI/UniSA). The project involves collaboration with SA Health, all state local health networks, and several stakeholders from both the health care and aged care sectors.

This study was funded by the National Health and Medical Research Council accredited Health Translation SA, through the Medical Research Future Fund Rapid Applied Research Translation Program.

The text above is taken from the University of South Australia press release dated 08 September 2021.

The full University of South Australia article is available to read here: https://www.unisa.edu.au/media-centre/Releases/2021/study-identifies-ways-to-reduce-hospitalisations-for-older-australians/

ROSA is delivering research to help older Australians make the best decisions about their health

The Registry of Senior Australians (ROSA) is extending its efforts to deliver research with impact, by working closely with the community of older Australians it serves. 

ROSA has recently teamed up with partner organisation, The Council on the Ageing South Australia (COTA SA) to investigate how older Australians receive and react to news about research findings through a survey of those living inside and outside aged care. 

ROSA Project Manager, Dr Sarah Bray, said it’s crucial that ROSA understands the needs of older Australians in order to effectively communicate the results of the research which is based on information routinely collected as older people navigate the health and aged care sectors.

“It’s essential that this information reaches the people who can benefit from it and that it’s communicated in a way that empowers older people and their carers to seek out the best evidence-based health care available,” Dr Bray said. 

“We made use of COTA SA’s network of older people to ensure the results of this survey can be broadly applied so we get the full picture.” 

COTA SA General Manager and Head of The Plug-in, Miranda Starke said COTA SA and The Plug-in were delighted to work with ROSA on this project.

“The Plug-in works with a wide range of organisations that want to work in partnership with people aged 50 or older and we’ve been thrilled to see the project results put into action so quickly,” Mrs Starke said. 
The Plug-in survey found: 

• 95% of older people living in the community are interested in hearing about health research findings.

• 71% of those living in aged care are eager to engage with it.

• For those living outside of aged care, newspapers were found to be the most popular medium for receiving information, followed by newsletters and emails from individual aged care and health advocacy organisations relevant to them, TV, radio and lastly via friends and family.

• The majority said they actively seek out further details after finding out about research that interests them.

• People living in aged care homes rely on TV news and their GP for information and are much less likely to follow it up.

• Overall, 80% of respondents said the media is their primary source of information, but trusted GPs were the clear second preference.

“This work is reinforcing the importance of GPs as the link between health care and aged care that many older people turn to and trust to keep them up to date on the latest research findings relevant to them” Dr Bray said.

Respondents wanted stories in the media to have clear, positive headlines and content that explains why the findings are important to them and what action they can take next.  

Above all the information needs to be from a reliable source, relevant to the person or their family and easy to understand.

“We already regularly seek input from members of the ROSA Consumer and Community advisory committee on our research and in preparing stories for the media, and this survey undertaken by The Plug-in team has reassured us that we’re on the right track and also provided valuable new tips that will inform how we communicate the results of our studies in future.” Dr Bray said. 

Watch the video for more details about ROSA and the results of The Plug-in survey. 

Text above from SAHMRI’s press release 15 December 2020.

Aged Care medication going unchecked

New research from the Registry of Senior Australians at SAHMRI has shown just one in five older Australians receive a government-funded medication review after entering an aged care facility.

The study’s lead researcher, Dr Janet Sluggett from the University of South Australia said the findings point to potential dangers that demand attention.

“Residents are taking an average of 10 different medicines each day and this often includes medicines that need close monitoring such as antipsychotics, opioids, insulin and blood thinners,” Dr Sluggett said.

“These medicines can have beneficial effects for some people. But we’ve seen a sharp increase in the use of these medicines that when used incorrectly, can cause side effects such as drowsiness, confusion, falls and hospital visits.”

During a medication review, a pharmacist checks through all medicines prescribed and makes recommendations for improvements. 

Guidelines recommend medication schedules are reviewed on entry to an aged care facility. The Royal Commission into Aged Care Quality and Safety has highlighted regular medication reviews as national priority area for people taking high-risk medicines such as antipsychotics. 

Dr Sluggett said some welcome changes have been made to the program since the study was conducted, but more needs to be done.

“People who receive a medication review can now get an extra two follow-up visits from a pharmacist and a variety of doctors can refer a resident for the service, in addition to the GP,” Dr Sluggett said.

“But we still urgently need strategies to address medication safety issues for all of those in aged care who aren’t getting their schedules reviewed.”

Overall the medication review service is under-used. The study revealed just 6% of all facilities in Australia reviewed more than half of all new residents medication programs. 

Older people who may be concerned about their medication are being encouraged to ask their doctor about a review.

“There is no charge for a medication review when your doctor provides a referral letter. If you, or a family member are living in an aged care facility and would like to have your medicines checked, ask your pharmacist, GP or nurse about how to access this free service,” Dr Sluggett said. 

“There is a similar medication review service available for people living in their own home.”

Jane Mussared, Chief Executive of COTA SA, the peak body representing older people, said the findings show an urgent need for medication reviews to occur routinely for all those living in aged care.

“The evidence base for regular medication reviews as we age is well established and compelling. The fact that many residents of aged care are missing out is appalling,” Ms Mussared said. 

The study, published in the Journal of the American Medical Directors Association, analysed data collected from 143,676 residents across all 2799 aged care facilities nationally between 2012 and 2015. 

Text above from SAHMRI’s press release 08 December 2020.

Two ROSA researchers receive prestigious Tall Poppies Awards!

SAHMRI Press Release:

Two researchers from the SAHMRI-based Registry of Senior Australians (ROSA) have been honoured among this year’s Young Tall Poppies of Science.

ROSA Director, Associate Professor Maria Inacio, and NHMRC Early Career Fellow, Dr Janet Sluggett, were recognised for their work to improve medication use and the quality of aged care in Australia.

Associate Professor Inacio has been instrumental in developing ROSA, which analyses data to identify who accesses aged care services and how it affects their health and wellbeing.

“Every year, 1.3 million older Australians use aged care services at a cost of $18 billion to the Federal Government,” she says.

“As our population ages, the need for these services will grow, and it is imperative that we meet this demand with high-quality care. By measuring and evaluating the quality and safety of aged care services with the right tools and systems, we can achieve this.”

Associate Professor Inacio is a joint UniSA and SAHMRI researcher as well as a The Hospital Research Foundation Mid-Career Fellow. Under her leadership ROSA has published 25 studies, delivered three reports to the Royal Commission into Aged Care Quality and Safety and received $5.74 million in additional funding to expand its work on areas affecting vulnerable individuals in aged care.

An interim report handed down by the Royal Commission in October 2019 found that the aged care system was “unkind and uncaring” towards older people and, in many instances, neglected them.

Dr Sluggett has also given expert testimony to the Royal Commission, calling for changes to medication procedures which informed nationwide changes in the medication review program in the aged care sector earlier this year.

The clinical pharmacist and UniSA Senior Research Fellow is credited with developing and testing a new pharmacist service in aged care homes to simplify medication schedules for residents. She was also part of a worldwide collaboration to identify gaps in medication management for frail, older people and draw up new guidelines for health professionals.

“People living in aged care homes are the highest users of medications, taking on average 10 different medications every day,” she says.

“Medications can help us to thrive but can also harm, so it’s really important for us to get the balance right for older people.”

The prestigious annual Young Tall Poppy Science Awards aim to recognise the achievements of Australia’s outstanding young scientific researchers and communicators.

The Award winners - Tall Poppies - participate in education and community outreach programs in which they become role models to inspire school students and the broader community about the possibilities of science.

Press Release: New tool provides comparisons to improve aged care

SAHMRI Press Release:

Australia’s aged care sector will soon have a new tool to improve care by providing accurate quality and safety comparisons between aged care homes.

The tool is an Outcome Monitoring System (OMS) enabled through funding from The Hospital Research Foundation (THRF). It was designed using information from the SAHMRI-based Registry of Senior Australians (ROSA) to measure quality and safety in aged care based on 12 key indicators.

ROSA Director and THRF Mid-Career Fellow, Associate Professor Maria Inacio, says the registry’s OMS will promote transparency and accountability throughout the industry.

“The indicators have been chosen based on what’s being used in other countries and factors found to be associated with poor health and increased risk of harm,” she said.

“Additionally, the indicators can be examined using routinely collected data that’s available from State and Commonwealth Governments, eliminating the burden of collecting new information from aged care residents or service providers.”

ROSA recently used the OMS to assess data of individuals living in permanent residential aged care in Australia in 2016. The research was published in the International Journal for Quality in Health Care. It found:

• 1 in 2 residents experienced a high sedative load

• 1 in 4 were taking antipsychotic medication

• 1 in 4 were exposed to chronic opioid use

• 1 in 5 returned to the emergency department within 30 days of being discharged from

• hospital

• 1 in 10 had at least one fall requiring medical attention

• 2.3% of people living with dementia were hospitalised for dementia and/or delirium related episodes.

“Importantly, our OMS has been designed so that each indicator is risk-adjusted to account for the varying profile of individuals living in permanent residential aged care facilities,” A/Prof Inacio said.

“This allows comparisons of care homes to be made more fairly, taking into account the diverse spectrum of individual situations across the many facilities.”

ROSA’s OMS has been presented to the Royal Commission into Aged Care Quality and Safety in the hope it can inform recommendations for future policy changes regarding quality and safety monitoring within the sector.

“The OMS will also enable the development of strategies to improve the quality and safety of aged care services and reduce variation across the sector, leading to better health and wellbeing of older people living in aged care in Australia,” A/Prof Inacio said.

Currently 2,695 aged care facilities are operating nationally, caring for 242,000 people annually and subsidised by the Australian Government at a cost of $12.2 billion annually.

The 12 Indicators of Quality and Safety in Aged Care measured by the ROSA OMS are:

1. High sedative load

2. Antipsychotic use

3. Chronic opioid use

4. Antibiotic use

5. Premature mortality

6. Delirium and/or dementia hospitalisations

7. Fractures

8. Medication-related adverse events

9. Weight loss and malnutrition

10. Falls

11. Pressure injury

12. Emergency department presentation

For more information:

• The link to the scientific article is available from the ROSA Publications section of our website.

• A summary information sheet is available under the ROSA Reports section of our website.

New PhD Student Project - Mental health service use among older Australians

If you are considering doing a PhD in aged care research, you may be interested in this exciting new project. This project will involve using ‘big data’ to examine mental health service use among older Australians and how these services impact wellbeing and outcomes. The student will be co-supervised by Dr Monica Cations (Flinders) and by Associate Professor Maria Inacio (SAHMRI), working with ROSA data. This project would suit a student with an interest in epidemiology/public health, and who enjoys quantitative data analysis.

Dr Monica Cations is also looking to recruit a PhD student for an applied research project at Flinders looking to adapt trauma-informed care for aged care settings - for more information on either of these two projects, please contact Monica.

To see ideas of other potential PhD projects with the ROSA team, please visit the Student Project section of our website and download the Student Information Booklet.

ROSA Research Team at SAHMRI - Oct2019

ROSA wins award for using Big Data to help the aged care sector.

The Registry of Senior Australians (ROSA) is a unique data platform based at SAHMRI designed to improve the health and wellbeing of older Australians that have entered the aged care sector. This ‘big data’ project is the first large scale resource of its kind in Australia, connecting existing data silos at both the state and federal levels to reveal a more complete picture of how older people navigate the aged care and health care sectors, and how this impacts their overall health outcomes and quality of life.

This week the ROSA Research Team were thrilled to be awarded the “Best application of business intelligence to leverage value from Big Data” at the Information Technology in Aged Care (ITAC) 2020 Conference Awards in Brisbane. The ROSA team dedicated their award to the tireless work of the ACATs and to the older people seeking aged care services that they are working to help.

You can watch the video that accompanied the ROSA application for the award HERE to learn more about what ROSA does.

A/Prof Maria Inacio & Dr Sarah Bray accepting the ITAC2020 Award for “Best application of business intelligence to leverage value from Big Data”.

Press Release: Use of psychotropic medicines before and after entry into Residential Aged Care Facilities in Australia

SAHMRI Press Release:

Residential aged care providers should rethink use of psychotropic medicines according to researchers behind the latest work from the SAHMRI-based Registry of Senior Australians (ROSA).

Dr Stephanie Harrison is the lead author of the study which was published in the Medical Journal of Australia (MJA). She says use of “chemical restraints” for people in residential aged care has been a key focus of the recent Royal Commission into Aged Care Quality and Safety.

“There has been growing concern about the use of psychotropic medicines, especially antipsychotics, but it was previously unknown if people were already being prescribed these medicines before they moved to residential care,” Dr Harrison says.

“Our study showed that although the proportion of individuals receiving psychotropic medicines is generally high for older Australians before entering residential care, that proportion increased markedly after entering residential care.”

The research team examined seven years of national data that included more than 320,000 Australians entering permanent residential aged care. The data reveal 21 per cent of residents received antipsychotic medication within the first three months of their stay. Of these people, 46 per cent had not been prescribed antipsychotics in the 12 months before entering care.

“Antipsychotic medicines are associated with a higher risk of serious adverse events and should only be used in accordance with guidelines, at the lowest possible dose and with appropriate monitoring,” Dr Harrison says.

The study also showed 31 per cent of residents were given benzodiazepines and 38 per cent received antidepressants during the first three months of their stay. Of these people, 39 per cent and 20 per cent respectively had not received those medicines in the year before going to residential care.

The report authors, including geriatrician and Flinders University academic, Professor Craig Whitehead, are calling on aged care providers to find alternatives to the use of psychotropic drugs.

“There are effective non-pharmacological approaches to help people experiencing changes in behaviour which are commonly experienced by people with dementia,” Professor Whitehead says.

“If you have a loved one taking one of these medications, or you’re unsure what medications they’re taking, speaking with their GP or aged care facility nursing staff is a great first step. Regular review of medications is always a good idea and they should be able to suggest whether the medication is still needed.”

Psychotropic medicines affect a person’s behaviour or mood. The psychotropic medicines investigated in the study were antipsychotics, benzodiazepines and antidepressants.

Antipsychotic medicines may help people with severe mental health conditions. In this study, the most common antipsychotic dispensed was risperidone (62 per cent of residents who received antipsychotics). Risperidone is indicated for managing severe, persistent psychological symptoms in people with dementia.

The most common benzodiazepine in this study was temazepam (62 per cent of residents who received benzodiazepines). Temazepam is often used to treat conditions such as sleep disturbance and anxiety.

More information in the media relating to this study includes:

• A 5 minute interview with A/Prof Craig Whitehead on the ABC Radio National “Health Report”.

• A 25 minute interview with A/Prof Craig Whitehead on the MJA Podcast.

• An online editorial in Insight+ on “Psychotropics in aged care: where are the alternatives?”.

New ROSA Video

Our new video is out: Meet the ROSA research team based at SAHMRI and learn a little about how we use the powerful data platform linking the health and aged care sectors to produce evidence that guides policy and practice to improve the health and wellbeing of older people receiving aged care services in Australia.

You can watch our 2 minute video HERE.

This video was prepared by the ROSA Team & SAHMRI’s Media Team as the ROSA team have been named as a finalist for the ITAC2020 awards.

ROSA Wins SAHMRI Awards.

The ROSA research team were honoured and thrilled to have their work recognised at the 2019 SAHMRI annual Awards Night. The ROSA team were awarded the Research Translation award for their contributions to the Royal Commission. The ROSA Director, A/Prof Maria Inacio, was awarded the Diane Ranck Leadership Award (Research Leader) and the Mid Career Researcher Award, and the ROSA Project Manager and Consumer Engagement Officer, Dr Sarah Bray, was awarded the Community Engagement Award for excellence in meaningful consumer and community engagement in health and medical research.

We are looking for a Research Assistant to join the ROSA team!

We are currently advertising for a Research Assistant to join the ROSA team at SAHMRI. This exciting role will support ROSA’s research and research administration activities (0.6  FTE), and the coordination (0.4 FTE) of the establishment of the ROSA Aboriginal governance structure under the guidance of a Senior Research Fellow from the Wardliparingga Aboriginal Health Equity group at SAHMRI. If you know of any suitable candidates for this role, please encourage them to apply.

Aboriginal and Torres Strait Islander people are strongly encouraged to apply.

Applications close 13 January 2020.

For more details, and to apply for this position, please visit the position description on the SAHMRI website.