What is Quality Use of Medicines (QUM)?
Safe, effective, and appropriate use of medicines to achieve optimal health outcomes (part of Australia’s National Medicines Policy).
What are the “Right” principles of QUM?
Right medicine, right dose, right person, right time, right route.
What are the key principles of QUM?
Judicious use (only when needed), appropriate use (safest/effective choice), safe use (storage, admin, monitoring), effective use (monitor outcomes).
What are the benefits of QUM?
Prevents adverse drug events, hospitalisations; improves outcomes, adherence, independence, safety; reduces costs and medication waste.
How is QUM applied in aged care practice?
Regular medication reviews, client/carer education, monitor adverse effects/interactions, accurate documentation.
How does ageing affect drug absorption?
Slower gastric emptying → delayed onset of drugs.
How does ageing affect drug distribution?
↓ body water, ↑ fat, ↓ plasma proteins → altered drug levels.
How does ageing affect drug excretion?
↓ kidney function → increased risk of toxicity.
How does ageing affect drug metabolism?
↓ liver size and blood flow → slower clearance.
What is the nursing role in pharmacological management of older adults?
Monitor side effects/behavioural changes, encourage medication reviews, support simplified regimens, educate on purpose/timing/storage, document/report adverse reactions.
What pharmacodynamic changes occur in older adults?
↑ sensitivity to sedatives, anticoagulants, opioids; ↓ responsiveness to some drugs (e.g., beta-blockers); ↑ risk of dizziness, confusion, constipation, hypotension.
What other pharmacological issues are common in older adults?
Polypharmacy, drug interactions, ADRs, impaired adherence, swallowing difficulties.
What are common causes of polypharmacy?
Multiple chronic conditions, multiple prescribers, prescribing cascades, OTC/herbal additions, lack of regular review.
What is polypharmacy?
Use of ≥5 medications regularly; problematic when unnecessary or harmful.
What are the impacts of polypharmacy?
ADRs (drowsiness, confusion, falls), drug interactions (bleeding risk), medication errors, hospitalisations, functional decline, cognitive effects (delirium, memory issues), financial stress.
How can polypharmacy be prevented or managed?
Regular medication review, deprescribing unnecessary medicines, monitor for side effects/new symptoms, use management tools (Webster packs, charts, apps), educate clients/carers on each medication.
