Monash trial finds system support can improve dementia medication care

A care guideline can be accurate and still fail to reach the person giving the medication. Across 19 residential facilities in New South Wales, Queensland, Western Australia and Victoria, Monash University researchers tested a systems-level response: not a manual left to circulate, but a package designed to move dementia medication guidance into daily care.

The multistate EMBRACE trial worked with four long-term care provider organizations. Its tools included nine targeted fact sheets, a practical 10-item checklist for monitoring medication side effects and a companion guide for people living with dementia and their families. The intervention was built around Australia’s clinical guidelines for the appropriate use of psychotropic medications in dementia and residential care.

The second part of the research followed knowledge brokers—intermediaries who bridge the gap between evidence and practice. Over a 12-month trial, these brokers learned how each facility worked, built relationships with staff and developed local quality-improvement initiatives. Professor Simon Bell, director of Monash’s Centre for Medicine Use and Safety, said their role evolved from the ground up rather than arriving as a fixed template.

That local work also sets a boundary around the result. Dr. Amanda Cross, a senior research fellow at the center, said knowledge brokers were shaped by facility leadership, organizational culture and dedicated implementation support. The published account reports that systems-level strategies can significantly improve adherence to guidelines. New Australian guidelines developed under National Health and Medical Research Council standards are incorporating knowledge translation from the outset, including whether recommendations will be acceptable and feasible in practice.

Concretely, the approach gives care teams usable tools for checking side effects, locating guidance and adapting improvement work to their facility, while giving families a companion resource rather than a document written only for professionals. For residents, that could support more consistent evidence-based medication care, although the report does not claim that every facility has reached that outcome. The researchers see the same framework extending beyond medication management as Australia introduces new care models and integrated roles such as on-site pharmacists.