SA Tall Poppies pursue a prescription for safer aged care

Dr Janet Sluggett

Two UniSA researchers working to improve medication use and the quality of aged care in Australia have been named Young Tall Poppies of Science for 2020.

Clinical pharmacist Dr Janet Sluggett and epidemiologist Associate Professor Maria Inacio are among 10 outstanding young South Australian researchers to be honoured this year, showcasing the high standard of world-leading research being carried out in the state.

Dr Janet Sluggett, an NHMRC Early Career Fellow, is credited with developing and testing a new pharmacist service in aged care homes to simplify medication schedules for residents.

Polypharmacy is rife in Australia and worldwide, putting aged care residents at increased risk of falls, confusion, memory loss, medication errors and hospitalisations, among other health issues.

The UniSA researcher gave expert testimony to the 2019 Aged Care 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.

Described in her nomination as a young scientist with “an outstanding track record,” Dr Sluggett is one of a handful of university early career researchers who has worked collaboratively at the industry coalface, embedded for a period in an aged care facility to co-design and implement solutions.

The interdisciplinary team she led to successfully trial new medication services at Helping Hand Aged Care is now a finalist in the 2020 SA/NT LASA Excellence in Age Services Team Awards.

Dr Sluggett 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,” Dr Sluggett 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.”

Dr Sluggett is now based at the South Australian Health and Medical Research Institute (SAHMRI), working with the Registry of Senior Australians (ROSA) to analyse medication and health data to inform treatment decisions for more than 240,000 older Australians who access residential aged care annually.

Her research shows a sustained escalation in antibiotic prescribing for older Australians living in residential aged care homes, with more than 5.6 million antibiotics dispensed to residents between 2005 and 2016.

Daily antibiotic doses dispensed per 1000 residents jumped by 39 per cent over 11 years, potentially compounding the risk of antibiotic resistance, Dr Sluggett reported in an Australian-first study published in May.

In 2019, Dr Sluggett was awarded the Winnovation Social Impact Prize, recognising South Australia’s most innovative women, and in 2017 was named the SA/NT Pharmacist of the Year by the Pharmaceutical Society of Australia. She has won $2.8 million in funding, and co-authored 13 high-quality papers this year alone.

Associate Professor Maria Inacio

Assoc Professor Maria Inacio is also an NHMRC Fellow and Hospital Research Foundation Mid-Career Fellow, investigating better ways to monitor and deliver safe and quality aged care services to older people.

A joint UniSA and SAHMRI researcher, Assoc Prof Inacio has been instrumental in developing ROSA, a national database which identifies who accesses aged care services and how it affects their health and wellbeing.

Under her leadership, ROSA has published 25 studies, delivered three reports to the Royal Commission into Aged Care and received $5.74 million in additional funding to expand its work on areas affecting vulnerable individuals in aged care.

In 2019 she won a SAHMRI Leadership Award, an Information Technology in Aged Care Award and a year earlier was honoured for outstanding contributions to musculoskeletal health, winning the 2018 US OREF Clinical Research Award.

Assoc Prof Inacio’s work is focused on addressing the “shocking tale of neglect” in Australia’s aged care sector which was exposed in 2019 following an increase in disturbing incidents in aged care facilities across the country.

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

This week, it was also reported that Australia has one of the worst COVID-19 death rates in the world for aged care residents, with 68 per cent of Australia’s coronavirus fatalities occurring in aged care due to a failure by federal authorities to plan for it in the sector.

“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.”

Assoc Prof Inacio’s work is initially focusing on major concerns in the aged care sector, including falls, fractures, pressure injuries, premature mortality, unplanned/emergency hospitalisations and quality use of medicines.

SA’s Young Tall Poppies of Science finalists will be officially congratulated on Monday 21 September, when the Young Tall Poppy of the Year for South Australia will be named.

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