Journal of Pharmacy Practice and Research Volume 41, No. 2, 2011. 98 ABSTRACT Background: Older residents in supported residential services (SRS) are often on multiple medications and may be at risk of medication misadventure. Their medication risk and uptake of medication reviews by pharmacists has not been investigated. Aim: To investigate medication use, risk factors for medication misadventure and uptake of home medicines review (HMR) among older residents in SRS. Method: A pre-piloted postal survey was distributed to 361 residents from 14 SRS in Victoria. The questionnaire included validated items on medication risk, medication use, health information and uptake of HMR. The questionnaire was completed by residents, SRS care staff or family members. Results: Of the 77 respondents (21% response rate) aged 53 to 98 years, 73 (95%, 95%CI 90–100) reported taking prescribed medications. Risk factors for medication-related problems were present in 56 respondents (73%; 95%CI 63–83) and included: ≥ 5 regular medications (n = 41; 53%; 95%CI 42–64), ≥ 3 comorbidities (n = 31; 40%; 95%CI 29–51), medications with low therapeutic index (n = 15; 20%; 95%CI 11–28), recent hospitalisations (n = 12; 16%; 95%CI 7.5–24), recent changes to medication regimens (n = 10; 13%; 95%CI 5.5–21) and ≥ 12 tablets/capsules a day (n = 9; 12%; 95%CI 4.5–19). Of these at-risk respondents, only 3 (5.4%; 95%CI 0.4–11) reported receiving an HMR in the previous 12 months. Conclusion: High prevalence of medication use and medication- related risk factors, but low awareness and uptake of HMR were identified among SRS residents. J Pharm Pract Res 2011; 41: 98-101. INTRODUCTION In Victoria, supported residential services (SRS) (Licensed Residential Centres/Licensed Boarding Houses in New South Wales, Supported Accommodation and Private Boarding Houses in Queensland, Supported Residential Facilities in South Australia) are mostly private for-profit businesses that provide assisted-living accommodation and personal care for older frail or disabled people who can no longer live at home independently. 1,2 Proprietors do not receive government funding for their operations, but they must be registered with the Victorian Department of Health and operate according to state legislation. 2 As of August 2008, there were 181 SRS accommodating around 6000 residents, of whom 69% were aged 60 years and over. 3 RESEARCH Exploring Medication Risk among Older Residents in Supported Residential Services: A Cross-Sectional Study Cik Yin Lee, Johnson George, Rohan A Elliott, Colin B Chapman, Kay Stewart Cik Yin Lee, BPharm (Hons), PhD Candidate, Johnson George, BPharm, MPharm, PhD, Lecturer, Rohan A Elliott, BPharm, BPharmSc (Hons), MClinPharm, Clinical Senior Lecturer, Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Colin B Chapman, BPharm, BVSc (Hons), PhD, Professorial Fellow, Australian Health Workforce Institute, University of Melbourne, Kay Stewart, BPharm (Hons), PhD, Associate Professor, Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria Address for correspondence: Associate Professor Kay Stewart, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville Vic. 3052, Australia. E-mail: kay.stewart@monash.edu Residents in SRS represent a group of people who are vulnerable and at risk of social and financial disadvantage. 1 A high prevalence of chronic health conditions (59%) and functional disabilities (89%) have been reported in SRS residents. 3 However, data on their use of medications are lacking. There is anecdotal evidence that SRS residents are at high risk of medication misadventure. No study has investigated the extent of medication use in older SRS residents and their risk factors for medication-related problems. Studies conducted in similar populations in the US have identified a range of medication-related issues and risk factors. 4-7 Most research on medication use among older Australians has focused on residents of Commonwealth-funded aged care homes, home-dwelling elderly, retirement village residents and war veterans. 8-11 In the only published study of SRS residents, an estimated 34% of residents were using psychotropic medications. 12 However, this study primarily examined the prevalence of mental illness and the use of psychotropic medications, without investigating medication use in general. The National Strategy for Quality Use of Medicines states medication review is a primary care service to reduce medication misadventure among at-risk people. 4 Poor access to medication reviews by those at high risk of medication misadventure and the benefits from medication reviews for these groups have been reported. 13 Residential medication management review (RMMR) and home medicines review (HMR) are Medicare-subsidised services provided by accredited pharmacists for at-risk patients. RMMRs are for residents of Commonwealth- funded aged care homes and HMRs are for people living elsewhere; residents of SRS are eligible for HMRs. The uptake of HMRs in Australia has been low (around 40 000 HMRs per annum) and only 10% of those eligible receive them. 14,15 The uptake of HMRs in SRS is not known. Therefore, the aim of this study was to investigate medication use, risk factors for medication misadventure and uptake of HMR among older residents in SRS. METHOD A cross-sectional postal survey of SRS residents in metropolitan Victoria was conducted from September to December 2009. Minor modifications were made to the pre-piloted questionnaire to ensure the items were relevant and suitable. 11 The four-page anonymous questionnaire contained items on demographics, information on general health and medication use, use of health services, medication management, use of medications associated with increased risk of adverse events or drug-related hospitalisations in older people, validated scales for measuring comorbidity (Charlson comorbidity index) and medication risk (HMR criteria and Medication Risk Questionnaire). 10,16-20 The Charlson comorbidity index total score predicts a patient’s risk of mortality (a score of 5 or more denotes high risk) based