Integrating pharmacists into aged care facilities to improve the quality use of medicine (PiRACF Study): protocol for a cluster randomised controlled trial
Abstract Background Medication management in residential aged care facilities is an ongoing concern. Numerous studies have reported high rates of inappropriate prescribing and medication use in aged care facilities, which contribute to residents’ adverse health outcomes. There is a need for new mode...
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doaj-d124ce35e4e640c3b71a370e2a57ad6d2021-06-13T11:36:14ZengBMCTrials1745-62152021-06-0122111210.1186/s13063-021-05335-0Integrating pharmacists into aged care facilities to improve the quality use of medicine (PiRACF Study): protocol for a cluster randomised controlled trialSam Kosari0Jane Koerner1Mark Naunton2Gregory M. Peterson3Ibrahim Haider4Emily Lancsar5David Wright6Theo Niyonsenga7Rachel Davey8Discipline of Pharmacy, Faculty of Health, University of CanberraHealth Research Institute, Faculty of Health, University of CanberraDiscipline of Pharmacy, Faculty of Health, University of CanberraDiscipline of Pharmacy, Faculty of Health, University of CanberraHealth Research Institute, Faculty of Health, University of CanberraDepartment of Health Services Research and Policy, Research School of Population Health, Australian National UniversitySchool of Pharmacy, University of East AngliaHealth Research Institute, Faculty of Health, University of CanberraHealth Research Institute, Faculty of Health, University of CanberraAbstract Background Medication management in residential aged care facilities is an ongoing concern. Numerous studies have reported high rates of inappropriate prescribing and medication use in aged care facilities, which contribute to residents’ adverse health outcomes. There is a need for new models of care that enhance inter-disciplinary collaboration between residential aged care facility staff and healthcare professionals, to improve medication management. Pilot research has demonstrated the feasibility and benefits of integrating a pharmacist into the aged care facility team to improve the quality use of medicines. This protocol describes the design and methods for a cluster randomised controlled trial to evaluate the outcomes and conduct economic evaluation of a service model where on-site pharmacists are integrated into residential aged care facility healthcare teams to improve medication management. Methods Intervention aged care facilities will employ on-site pharmacists to work as part of their healthcare teams 2 to 2.5 days per week for 12 months. On-site pharmacists, in collaboration with facility nurses, prescribers, community pharmacists, residents and families will conduct medication management activities to improve the quality use of medicines. Aged care facilities in the control group will continue usual care. The target sample size is 1188 residents from a minimum of 13 aged care facilities. The primary outcome is the appropriateness of prescribing, measured by the proportion of residents who are prescribed at least one potentially inappropriate medicine according to the 2019 Beers Criteria. Secondary outcomes include hospital and emergency department presentations, fall rates, prevalence and dose of antipsychotics and benzodiazepines, Anticholinergic Cognitive Burden Score, staff influenza vaccination rate, time spent on medication rounds, appropriateness of dose form modification and completeness of resident’s allergy and adverse drug reaction documentation. A cost-consequence and cost-effectiveness analysis will be embedded in the trial. Discussion The results of this study will provide information on clinical and economic outcomes of a model that integrates on-site pharmacists into Australian residential aged care facilities. The results will provide policymakers with recommendations relevant to further implementation of this model. Trial registration ACTRN12620000430932 . Registered on 1 April 2020 with ANZCTRhttps://doi.org/10.1186/s13063-021-05335-0Residential aged care facilityAged careCare homeQuality use of medicinesElderlyPotentially inappropriate medicine |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sam Kosari Jane Koerner Mark Naunton Gregory M. Peterson Ibrahim Haider Emily Lancsar David Wright Theo Niyonsenga Rachel Davey |
spellingShingle |
Sam Kosari Jane Koerner Mark Naunton Gregory M. Peterson Ibrahim Haider Emily Lancsar David Wright Theo Niyonsenga Rachel Davey Integrating pharmacists into aged care facilities to improve the quality use of medicine (PiRACF Study): protocol for a cluster randomised controlled trial Trials Residential aged care facility Aged care Care home Quality use of medicines Elderly Potentially inappropriate medicine |
author_facet |
Sam Kosari Jane Koerner Mark Naunton Gregory M. Peterson Ibrahim Haider Emily Lancsar David Wright Theo Niyonsenga Rachel Davey |
author_sort |
Sam Kosari |
title |
Integrating pharmacists into aged care facilities to improve the quality use of medicine (PiRACF Study): protocol for a cluster randomised controlled trial |
title_short |
Integrating pharmacists into aged care facilities to improve the quality use of medicine (PiRACF Study): protocol for a cluster randomised controlled trial |
title_full |
Integrating pharmacists into aged care facilities to improve the quality use of medicine (PiRACF Study): protocol for a cluster randomised controlled trial |
title_fullStr |
Integrating pharmacists into aged care facilities to improve the quality use of medicine (PiRACF Study): protocol for a cluster randomised controlled trial |
title_full_unstemmed |
Integrating pharmacists into aged care facilities to improve the quality use of medicine (PiRACF Study): protocol for a cluster randomised controlled trial |
title_sort |
integrating pharmacists into aged care facilities to improve the quality use of medicine (piracf study): protocol for a cluster randomised controlled trial |
publisher |
BMC |
series |
Trials |
issn |
1745-6215 |
publishDate |
2021-06-01 |
description |
Abstract Background Medication management in residential aged care facilities is an ongoing concern. Numerous studies have reported high rates of inappropriate prescribing and medication use in aged care facilities, which contribute to residents’ adverse health outcomes. There is a need for new models of care that enhance inter-disciplinary collaboration between residential aged care facility staff and healthcare professionals, to improve medication management. Pilot research has demonstrated the feasibility and benefits of integrating a pharmacist into the aged care facility team to improve the quality use of medicines. This protocol describes the design and methods for a cluster randomised controlled trial to evaluate the outcomes and conduct economic evaluation of a service model where on-site pharmacists are integrated into residential aged care facility healthcare teams to improve medication management. Methods Intervention aged care facilities will employ on-site pharmacists to work as part of their healthcare teams 2 to 2.5 days per week for 12 months. On-site pharmacists, in collaboration with facility nurses, prescribers, community pharmacists, residents and families will conduct medication management activities to improve the quality use of medicines. Aged care facilities in the control group will continue usual care. The target sample size is 1188 residents from a minimum of 13 aged care facilities. The primary outcome is the appropriateness of prescribing, measured by the proportion of residents who are prescribed at least one potentially inappropriate medicine according to the 2019 Beers Criteria. Secondary outcomes include hospital and emergency department presentations, fall rates, prevalence and dose of antipsychotics and benzodiazepines, Anticholinergic Cognitive Burden Score, staff influenza vaccination rate, time spent on medication rounds, appropriateness of dose form modification and completeness of resident’s allergy and adverse drug reaction documentation. A cost-consequence and cost-effectiveness analysis will be embedded in the trial. Discussion The results of this study will provide information on clinical and economic outcomes of a model that integrates on-site pharmacists into Australian residential aged care facilities. The results will provide policymakers with recommendations relevant to further implementation of this model. Trial registration ACTRN12620000430932 . Registered on 1 April 2020 with ANZCTR |
topic |
Residential aged care facility Aged care Care home Quality use of medicines Elderly Potentially inappropriate medicine |
url |
https://doi.org/10.1186/s13063-021-05335-0 |
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