Poster Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2026

The feasibility and reliability of a psychotropic adverse drug event monitoring tool in the residential aged care setting (#296)

Amelia Crabtree 1 , Jeanette Pham 1 , Helena Ng 1 , Brigid McInerney 1
  1. Monash Health, Melbourne, VIC, Australia

Aims Despite potential harm, psychotropic medications are frequently prescribed in residential aged care facilities. Care standards have highlighted the need for regular review of psychotropic medications, including adverse drug events (ADEs), in this vulnerable population (1, 2). The aim of this study was to assess the feasibility and reliability of a psychotropic ADE monitoring tool in the residential aged care setting.

 

Methods After the provision of education, the tool was implemented by nurses in a residential aged care facility. Inter-rater (IRR), intra-rater (ICC) and test-rest reliabilities of the tool were evaluated to determine agreement between assessors. A staff survey was conducted to further assess feasibility.

 

Results Across 34 residents assessed at two time points, the IRR demonstrated high agreement, with Cohen’s kappa 0.91 – 0.94 for two of the side effects, and complete agreement for the remaining items. At four-weeks, all ten side effects showed complete agreement between the two assessors. Intra-rater reliability demonstrated strong agreement in assessments over time, with variability only observed for the falls item, with Cohen’s kappa ranging from 0.33-0.74. Test-retest reliability between baseline and four weeks showed zero variance for most side effects, with moderate agreement for two of the side effects (average Cohen’s kappa 0.5 – 0.58). The staff survey indicated that the tool was feasible for routine clinical use.

 

Conclusions In this small feasibility study, a psychotropic ADE monitoring tool demonstrated high reliability and feasibility in a residential aged care setting. Robust research is further required to determine its impact on clinical outcomes.

  1. Healthcare ACoSaQi. Psychotropic Medicines in Cognitive Disability or Impairment Clinical Care Standard. Sydney2024.
  2. Simon Bell RB, Sue Brennan, Malcolm Clark, Megan Corlis, Christopher EthertonBeer, Susan Field, Julia Gilmartin-Thomas, Terrence Haines, Sarah Hilmer, Leanne Jack, Alison Kitson, Constance Kourbelis, Sue Kurrle, Dina Logiudice, Steve Macfarlane, Tuan Nguyen, Amy Page, Dimity Pond, Davina Porock, Tara Quirke, Velandai Srikanth, Andrew Stafford, Jane Thompson, Edwin Tan, Jacqueline Wesson (Guideline Development Group). Clinical Practice Guidelines for the Appropriate Use of Psychotropic Medications in People Living with Dementia and in Residential Aged Care: Summary of Recommendations and Good Practice Statements. Parkville: Monash University; 2022.