Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia.
Res Social Adm Pharm. 2022 Sep;18(9):3687-3693. doi: 10.1016/j.sapharm.2022.03.010. Epub 2022 Mar 22.
New and flexible multidisciplinary workforce models are needed to address unnecessary medication regimen complexity in residential aged care facilities (RACFs). This study will investigate the feasibility of a nurse practitioner-pharmacist telehealth-based collaborative care model to simplify complex medication regimens.
This is a pragmatic, non-randomized pilot and feasibility study of up to 30 permanent residents from 4 RACFs in Western Australia. Simplification will be conducted in accordance with a validated 5-step implicit process. Nurse practitioners will identify residents potentially interested in and who may benefit from simplification, including any regulatory or safety imperatives that might preclude simplification. Medication regimens will be assessed by an off-site clinical pharmacist to identify opportunities for simplification in terms of drug-drug, drug-food, or drug-time interactions, and the availability of alternative formulations. The pharmacist will communicate simplification opportunities to nurse practitioners via video case conferencing. Nurse practitioners will then discuss simplification opportunities with the resident, caregiver and the health and care team, including any unintended consequences for the resident or RACF. The primary outcome measure will be feasibility (stakeholder acceptability, protocol adherence, recruitment and retention rates). Secondary outcomes include change in the number of medication administration times per day, medication and behavioral incidents, falls and fractures, hospitalization and mortality at 4 months.
Ethical approval has been obtained from the Monash University Human Research Ethics Committee. Research findings will be disseminated through industry report, lay summaries, conference presentations and peer-reviewed publications.
需要新的和灵活的多学科劳动力模式来解决住宅养老院（RACF）中不必要的药物治疗方案复杂性问题。本研究将调查护士从业者-药剂师基于远程医疗的协作护理模式简化复杂药物治疗方案的可行性。
这是一项在澳大利亚西部的 4 家 RACF 中对多达 30 名常住居民进行的实用、非随机的试点和可行性研究。简化将按照经过验证的 5 步隐式流程进行。护士从业者将确定对简化感兴趣且可能从中受益的居民，包括任何可能妨碍简化的监管或安全要求。临床药剂师将对药物治疗方案进行评估，以确定药物-药物、药物-食物或药物-时间相互作用以及替代配方的可用性方面的简化机会。药剂师将通过视频病例会议与护士从业者沟通简化机会。然后，护士从业者将与居民、护理人员以及医疗和护理团队讨论简化机会，包括对居民或 RACF 的任何意外后果。主要结局指标将是可行性（利益相关者的可接受性、方案依从性、招募和保留率）。次要结局包括每天药物管理次数、药物和行为事件、跌倒和骨折、住院和 4 个月时的死亡率的变化。
已获得莫纳什大学人类研究伦理委员会的伦理批准。研究结果将通过行业报告、通俗摘要、会议演讲和同行评审出版物进行传播。
