Primary and Secondary Care Related Quality Indicators for Dementia Care Among Australian Aged Care Users: National Trends, Risk Factors, and Variation

Rahja, Miia; Air, Tracy; Ahern, Susannah; Ward, Stéphanie; Caughey, Gillian E.; Sluggett, Janet K.; Cations, Monica; Lin, Xiaoping; Wallis, Kasey; Crotty, Maria; Inacio, Maria C.S.

doi:10.3233/jad-220336

Cited by 4 publications

(3 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To understand long-term health outcomes and service use of registry participants, the ADNeT CQR will conduct data linkage on a regular basis to access data that is routinely collected by various government bodies, such as data on medication and hospital and aged care utilization. To facilitate this, the ADNeT CQR has collaborated with the Registry of Senior Australians (ROSA) and explored the feasibility of post-diagnostic data collection for the registry using ROSA datasets [15].…”

Section: The Clinical Quality Registry Initiativementioning

confidence: 99%

Tackling Dementia Together via The Australian Dementia Network (ADNeT): A Summary of Initiatives, Progress and Plans

Naismith,

Michaelian,

Santos

et al. 2023

JAD

Self Cite

View full text Add to dashboard Cite

In 2018, the Australian Dementia Network (ADNeT) was established to bring together Australia’s leading dementia researchers, people with living experience and clinicians to transform research and clinical care in the field. To address dementia diagnosis, treatment, and care, ADNeT has established three core initiatives: the Clinical Quality Registry (CQR), Memory Clinics, and Screening for Trials. Collectively, the initiatives have developed an integrated clinical and research community, driving practice excellence in this field, leading to novel innovations in diagnostics, clinical care, professional development, quality and harmonization of healthcare, clinical trials, and translation of research into practice. Australia now has a national Registry for Mild Cognitive Impairment and dementia with 55 participating clinical sites, an extensive map of memory clinic services, national Memory and Cognition Clinic Guidelines and specialized screening for trials sites in five states. This paper provides an overview of ADNeT’s achievements to date and future directions. With the increase in dementia cases expected over coming decades, and with recent advances in plasma biomarkers and amyloid lowering therapies, the nationally coordinated initiatives and partnerships ADNeT has established are critical for increased national prevention efforts, co-ordinated implementation of emerging treatments for Alzheimer’s disease, innovation of early and accurate diagnosis, driving continuous improvements in clinical care and patient outcome and access to post-diagnostic support and clinical trials. For a heterogenous disorder such as dementia, which is now the second leading cause of death in Australia following cardiovascular disease, the case for adequate investment into research and development has grown even more compelling.

show abstract

Section: The Clinical Quality Registry Initiativementioning

confidence: 99%

Tackling Dementia Together via The Australian Dementia Network (ADNeT): A Summary of Initiatives, Progress and Plans

Naismith,

Michaelian,

Santos

et al. 2023

JAD

Self Cite

View full text Add to dashboard Cite

show abstract

“…We have also determined that hip fracture outcomes (ie, mortality, institutionalisation) are worse in people with dementia, providing insights for service planning for those in aged care settings 21. We have described a relatively unchanged quality of care pattern between 2011 and 2016 for older people with dementia, but with significant national variation, measured by quality indicators that include the use of antipsychotics, acetylcholinesterase inhibitor or memantine, experience of high sedative load, incidence of hospitalisations for dementia or delirium and access to services like health assessments or chronic disease management plans 22 23…”

Section: Findings To Datementioning

confidence: 99%

Registry of Senior Australians (ROSA): integrating cross-sectoral information to evaluate quality and safety of care provided to older people

2022

View full text Add to dashboard Cite

PurposeThe Registry of Senior Australians (ROSA) was established to evaluate aged care experiences in Australia. In this manuscript, we describe the ROSA framework, the two ROSA cohorts, highlights from research findings, and future plans.ParticipantsThe South AustralianROSA Prospective Cohort(August 2018–June 2020) enrolled 26 605 participants, of which 59.2% (N=15 745) are women, with a median age of 83 (interquartile range (IQR) 77–88). The NationalROSA Historical Cohort(January 2002–June 2020) includes 1 694 206 participants with an aged care eligibility assessment, of which 59.1% (N=1 001 705) are women and the median age is 78 (IQR 72–83).Findings to dateMost research using the ROSA has focused on dementia, service accessibility, quality and safety of care, falls and injuries and quality use of medicines. The ROSA has also examined the experience of individuals with highly prevalent and understudied conditions in aged care settings (eg, eye and mental health) and aspects of services (eg, built environment) and innovation (eg, mobile radiological services) that can affect older people’s health. Important learnings from the ROSA’s development include the significant resources and multidisciplinary expertise required for establishing this platform. Between 2018 and 2022, 43 academic publications, eight reports of the Australian Government Royal Commission into Aged Care Quality and Safety, and several reports to state health authorities and professional societies have used the ROSA.Future plansOur plans include to: (1) continue delivering high-quality evidence to support the improvement of ageing and aged care services; (2) influence and improve the quality of research in and for the aged care sector; (3) expand scope to facilitate examining aims in more depth; (4) include future aged care sector data collections within the ROSA; (5) inform best practices and innovate how consumer engagement occurs in research; (6) monitor and evaluate the impact of the 2021 Australian Aged Care Reforms.

show abstract

“…Understanding duration of antipsychotic use in this population is necessary to ascertain if national efforts are improving care practices and inform next steps. Building on existing work to develop and test CQIs for inclusion in the newly established Australian Dementia Network (ADNet) Registry (a nationwide clinical quality registry for people newly diagnosed with mild cognitive impairment or dementia), 24,25 this study aimed to (i) develop a CQI for antipsychotic use of >90 days among people with dementia and examine annual trends, associated factors, and geographical and PRAC facility variation in CQI incidence and (ii) examine duration of use among individuals with dementia accessing aged care services who were new antipsychotic users.…”

Section: Introductionmentioning

confidence: 99%

National surveillance using a clinical quality indicator for prolonged antipsychotic use among older Australians with dementia who access aged care services

Sluggett,

Caughey,

Air

et al. 2024

Int J Geriat Psychiatry

Self Cite

View full text Add to dashboard Cite

ObjectivesDementia guidelines recommend antipsychotics are only used for behavioral and psychological symptoms when non‐drug interventions fail, and to regularly review use. Population‐level clinical quality indicators (CQIs) for dementia care in permanent residential aged care (PRAC) typically monitor prevalence of antipsychotic use but not prolonged use. This study aimed to develop a CQI for antipsychotic use >90 days and examine trends, associated factors, and variation in CQI incidence; and examine duration of the first episode of use among individuals with dementia accessing home care packages (HCPs) or PRAC.MethodsRetrospective cohort study, including older individuals with dementia who accessed HCPs (n = 50,257) or PRAC (n = 250,196). Trends in annual CQI incidence (2011–12 to 2015–16) and associated factors were determined using Poisson regression. Funnel plots examined geographical and facility variation. Time to antipsychotic discontinuation was estimated among new antipsychotic users accessing HCP (n = 2367) and PRAC (n = 15,597) using the cumulative incidence function.ResultsBetween 2011–12 and 2015–16, antipsychotic use for >90 days decreased in HCP recipients from 10.7% (95% CI 10.2–11.1) to 10.1% (95% CI 9.6–10.5, adjusted incidence rate ratio (aIRR) 0.97 (95% CI 0.95–0.98)), and in PRAC residents from 24.5% (95% CI 24.2–24.7) to 21.8% (95% CI 21.5–22.0, aIRR 0.97 (95% CI 0.96–0.98)). Prior antipsychotic use (both cohorts) and being male and greater socioeconomic disadvantage (PRAC cohort) were associated with higher CQI incidence. Little geographical/facility variation was observed. Median treatment duration in HCP and PRAC was 334 (interquartile range [IQR] 108–958) and 555 (IQR 197–1239) days, respectively.ConclusionsWhile small decreases in antipsychotic use >90 days were observed between 2011–12 and 2015–16, findings suggest antipsychotic use among aged care recipients with dementia can be further minimized.

show abstract

Primary and Secondary Care Related Quality Indicators for Dementia Care Among Australian Aged Care Users: National Trends, Risk Factors, and Variation

Cited by 4 publications

References 31 publications

Tackling Dementia Together via The Australian Dementia Network (ADNeT): A Summary of Initiatives, Progress and Plans

Tackling Dementia Together via The Australian Dementia Network (ADNeT): A Summary of Initiatives, Progress and Plans

Registry of Senior Australians (ROSA): integrating cross-sectoral information to evaluate quality and safety of care provided to older people

National surveillance using a clinical quality indicator for prolonged antipsychotic use among older Australians with dementia who access aged care services

Contact Info

Product

Resources

About