Sponsored Editorial: When ACC meets OZ-ABCD

SPONSORED EDITORIAL 

Point-of-care resources to curb medication harm in aged care 

John Kron, Editor, AMH 
 

The new ‘OZ-ABCD’ list, together with the Australian Medicines Handbook (AMH) and the AMH Aged Care Companion (ACC), can support healthcare professionals to reduce high-risk medication errors. 

Over 95% of aged care residents have at least one medication-related problem identified during a medicines review, with most having three problems. In addition to this, one in five unplanned hospital admissions are due to taking inappropriate medicines, according to a recent study.¹ 

Dr Amanda Cross is a senior research fellow from the Centre for Medicine Use and Safety at the Monash Institute of Pharmaceutical Sciences. She says practical, point-of-care tools can help reduce medication-related risks. 

Dr Cross was lead author of a study that developed the first national consensus list of the top 10 medicines with a high risk of harm in Australian residential aged care. She and her team have developed the OZ-ABCD mnemonic tool to help clinicians and staff identify high-risk medicines.   

Dr Cross says that using the AMH and its newly updated ACC with the OZ-ABCD tool will aid medicines safety in residential aged care settings. 

Identifying high-risk medicines in aged care 

High-risk medicines are those associated with serious harm or death if misused or used in error. ‘OZ-ABCD’ stands for ‘Opioids, Z-drugs and benzodiazepines, Antipsychotics and lithium, Blood thinners, Chemotherapeutic agents and methotrexate, and Diabetes agents with high risk of hypoglycaemia.’  

‘In daily practice, the OZ-ABCD mnemonic tool provides a simple, memorable way to identify that a medicine is high-risk,’ says Dr Cross.  

‘We've all seen those horror situations where instead of a weekly dose of low-dose methotrexate, a daily dose that is only appropriate in a few very specific cancer regimens has been accidentally put in a Webster-pak,’ she says. 

Using point-of-care resources to reduce risk 

Resources such as the AMH and the ACC can support safer decision-making at the point of care. 

‘You can use the AMH and ACC to check the correct dose, what adverse effects to look out for and also to help determine potential harms if an incorrect dose has been given,’ says Dr Cross. 

‘Another example is benzodiazepines. The ACC has excellent information on topics such as “insomnia” and “behavioural and psychological symptoms of dementia” in the chapter on neurological and mental health. It provides practical advice on non-drug treatment, recommended duration of use and correct doses for older aged people,’ says Dr Cross.  

The ACC can also be used by nurses in community settings, such as general practice, to help administer all medicines, not just high-risk ones. 

Tailored guidance for older people 

‘The ACC is focused on the unique needs of people aged 65 and over, and the conditions and medicines most commonly seen and prescribed for them,’ says Jane Curtis, AMH Content Team Manager and ACC Lead. 

For each condition or medicine class, the ACC typically provides one representative medicine example selected based on suitability for older people, such as omeprazole for proton pump inhibitors for gastro-oesophageal reflux disease. 

‘We select the medicine that is most appropriate, such as when it has different formulations for people with swallowing difficulties, and provide specific advice, such as a lower starting dose and adverse effects that have a higher prevalence in older people,’ says Ms Curtis. 

For more detailed prescribing information, clinicians can refer to the AMH. 

‘The AMH provides concise, easy-to-use information about all medicines, with full lists of precautions, adverse effects, dosages, counselling and practical advice,’ Ms Curtis says. ‘It also seamlessly cross-links with the ACC.’ 

A continued focus on medication safety 

Aged care providers are required to establish clear policies and procedures for identifying, documenting, monitoring and reviewing high-risk medicines under the Australian Government’s Strengthened Aged Care Quality Standards. 

Medication use remains widespread in residential aged care, with opioids prescribed to up to 50% of residents, antipsychotics to 42%, and benzodiazepines to 33% of all residents. Analgesics and hypnotics are among the most common classes involved in medication errors. 

The AMH and ACC provide practical, point-of-care support to help clinicians identify risks, check dosing, and support safer prescribing decisions in aged care settings, and can be used alongside the OZ-ABCD list.  

The 2026 AMH Aged Care Companion has now been released. Learn more about the latest update at amh.net.au. 

References 

1. AJ Cross, M Chaudhry, D Goordeen et al., ‘Development of a high-risk medication list for Australian residential aged care: a modified Delphi study’, Australas J Ageing, 2026, 45(1):e70141, doi:10.1111/ajag.70141.