title: Why is polypharmacy increasing in aged care facilities? The views of Australian health care professionals.
abstract: OBJECTIVE
  The prevalence of polypharmacy in residential aged care facilities (RACFs) is high and increasing. Although not necessarily inappropriate, polypharmacy has been associated with drug interactions, adverse drug events, geriatric syndromes and hospital admissions. The aim of this study was to identify and prioritize factors contributing to the increasing prevalence of polypharmacy in RACFs.
  
  
  METHODS
  Seventeen health care professionals from metropolitan and regional Victoria and South Australia identified and prioritized factors using a modified nominal group technique.
  
  
  RESULTS
  The top five factors ranked from most important to fifth most important were 'changes in resident mix', 'increasing numbers of prescribers and the reluctance of one prescriber to discontinue a medicine commenced by another prescriber', 'better adherence to clinical practice guidelines', 'increasing reliance on locums' and 'greater recognition and pharmacological management of pain'.
  
  
  CONCLUSIONS
  Reasons for the increase in polypharmacy are multifactorial. Understanding the factors contributing to polypharmacy may help to guide future research and develop interventions to manage polypharmacy in RACFs.
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia. natali.jokanovic@monash.edu.|Pharmacy Department, Alfred Hospital, Melbourne, Victoria, Australia. natali.jokanovic@monash.edu.
authors.forename: Natali
authors.initials: N
authors.lastname: Jokanovic
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia.
authors.forename: Edwin C K
authors.initials: EC
authors.lastname: Tan
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia.|Pharmacy Department, Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Dooley
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia.
authors.forename: Carl M
authors.initials: CM
authors.lastname: Kirkpatrick
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia.|Department of Pharmacy, Austin Health, Heidelberg, Victoria, Australia.
authors.forename: Rohan A
authors.initials: RA
authors.lastname: Elliott
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia.
authors.forename: J Simon
authors.initials: JS
authors.lastname: Bell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D019338:Polypharmacy; D014739:Victoria
keywords: aged; homes for the aged; long-term care; nominal group technique; nursing homes; polypharmacy