National audit of the structure and function of Australian residential care medication advisory committees

Abstract

Objective: All Australian residential care facilities are recommended to have access to a medication advisory committee (MAC) to provide governance of medication management. The objective was to explore the structure and function of Australian MACs. Methods: A national 43-item survey of MACs was conducted from November 2023 to January 2024. The survey was adapted from the Australian Government Department of Health and Aged Care Audit Tool and Checklist for a Medication Advisory Committee (Audit Tool). All MAC representatives were recruited using a comprehensive and purposive strategy including the Department of Health and Aged Care newsletter, professional organisations, social media and professional contacts. Outcomes included self-reported MAC structure and function across four key roles as per the Audit Tool, including policy development, risk management, education and quality improvement. Results: Responses were received from 120 MACs covering 642 residential care facilities (24% of Australian residential care facilities) in all Australian states and mainland territories. The MACs provided oversight to a median (IQR) 116 (61–196) beds/residents and a median (IQR) 1 (1–4) facilities. Over half (58%) of MACs were multidisciplinary (nursing, pharmacist and prescriber representation). More than half of MACs reported performing all functions listed in the Audit Tool relating to policy development (59%) and risk management (53%). Only 41% and 28% of MACs reported they performed all functions in the Audit Tool related to education and quality improvement, respectively. Conclusion: There is extensive heterogeneity in the structure and function of MACs with scope for MACs to become more multidisciplinary, identify staff training needs and proactively lead quality improvement.