Medicines
Medicines and deprescribing
Most people in residential aged care take many medicines, each started for a reason at some point. This section explains what the evidence shows about reviewing those medicines, which ones are worth a second look, and what happens when they are reduced or stopped.
By Dr Josh Hatch, FRACGP
Where to start
Residents & families
Aged care staff
GPs & clinicians
All topics
Why medicines need regular review in aged care
How many medicines residents take, how often problems turn up, and why a list that made sense once may not now
Deprescribing: what the trials show
What happens when medicines are reviewed and stopped in residential care, and where the evidence is thin
Antipsychotics, benzodiazepines and chemical restraint
Why these medicines are reviewed closely, what happens when they are reduced, and the consent rules
Anticholinergic burden
Medicines that block acetylcholine, why the total load matters, and what reducing it has and has not shown
Preventive medicines when life expectancy is limited
Statins, aspirin, blood pressure and bone medicines: time to benefit, and what happened when they were stopped
Diabetes in frail residents
Why tight glucose control can do more harm than good in frailty, and what to look for on the chart
Stomach and bowel medicines
Long-term proton pump inhibitors, laxatives, and the evidence for stepping down
Sleeping tablets
What sedatives do for sleep in older people, what they cost in side effects, and what helps people stop
Medication reviews and pharmacists in aged care
What a Residential Medication Management Review involves, the on-site pharmacist program, and what the evidence shows
Medicines: a guide for facility leadership
What Outcome 5.3 requires, what the medication indicators measure, and where effort is likely to count
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How the evidence is graded
Interventions are graded on randomised trial evidence for the outcome that matters: symptoms, function, quality of life, hospital admission or survival. Trials in residential care are preferred. Evidence from hospitals, from people living at home, or from studies that were not randomised is labelled where it is used. Numbers in the text link to the source they come from. Where the evidence is weak, conflicting or absent, that is stated. This section does not give doses or tapering schedules.
- Supported by trial evidence Consistent randomised trial evidence of a benefit that matters.
- Promising, not yet proven A real signal, usually from one trial or from studies that were not randomised, not yet confirmed.
- Uncertain / conflicting Trials conflict, or the evidence is too weak to say.
- Not supported Tested in adequate trials without showing a benefit.
- Risk outweighs benefit Evidence of net harm.
Last full evidence review: October 2026.