Simplifying medications in aged care homes: pharmacist and physician use of a structured simplification tool
Tracks
Ballroom 1
Evidence based practice
Medications
Models of Care
Quality improvement
Residential
| Thursday, November 14, 2024 |
| 9:30 AM - 9:45 AM |
Speaker
Assoc Prof Janet Sluggett
Associate Professor In Pharmacy & Pharmacoepidemiology
University of South Australia
Simplifying medications in aged care homes: pharmacist and physician use of a structured simplification tool
Abstract
Background: Pharmacist-led medication simplification using a structured approach can reduce unnecessary medication regimen complexity in residential aged care facilities (RACFs), but no studies have investigated simplification by different health professionals, nor the extent to which simplification is recommended during comprehensive medication reviews. This study i) compared medication regimen simplification opportunities identified by pharmacists, general medical practitioners (GPs) and geriatricians, and ii) determined if pharmacists identified simplification opportunities during routinely conducted comprehensive medication reviews in RACFs for these same residents.
Methods: Three pharmacists, three GPs and three geriatricians independently applied the Medication Regimen Simplification Guide for Residential Aged CarE (MRS GRACE) to medication data for 83 residents. Interrater agreement was calculated using Fleiss’s kappa. Pharmacist medication review reports for the same 83 residents were then examined to identify if the pharmacists conducting these reviews had recommended any of the simplification strategies.
Results: Overall, 77 residents (92.8%) could have their medication regimen simplified by at least one health professional. Pharmacists independently simplified 53.0-77.1% of regimens (Κ=0.60, 95%CI 0.46-0.75, indicating moderate agreement), while GPs simplified 74.7-89.2% (Κ=0.44, 95%CI 0.24-0.64, moderate agreement) and geriatricians simplified 41.0-66.3% (Κ=0.30, 95%CI 0.16-0.44, fair agreement). No simplification recommendations were included in the reports previously prepared by pharmacists as part of the medication reviews undertaken for these residents.
Conclusion: Pharmacists, GPs, and geriatricians can all identify medication regimen simplification opportunities, although recommendations differ within and between professional groups. Although opportunities to simplify medication regimens exist, simplification is not currently routinely recommended by pharmacists performing medication reviews in Australian RACFs.
Methods: Three pharmacists, three GPs and three geriatricians independently applied the Medication Regimen Simplification Guide for Residential Aged CarE (MRS GRACE) to medication data for 83 residents. Interrater agreement was calculated using Fleiss’s kappa. Pharmacist medication review reports for the same 83 residents were then examined to identify if the pharmacists conducting these reviews had recommended any of the simplification strategies.
Results: Overall, 77 residents (92.8%) could have their medication regimen simplified by at least one health professional. Pharmacists independently simplified 53.0-77.1% of regimens (Κ=0.60, 95%CI 0.46-0.75, indicating moderate agreement), while GPs simplified 74.7-89.2% (Κ=0.44, 95%CI 0.24-0.64, moderate agreement) and geriatricians simplified 41.0-66.3% (Κ=0.30, 95%CI 0.16-0.44, fair agreement). No simplification recommendations were included in the reports previously prepared by pharmacists as part of the medication reviews undertaken for these residents.
Conclusion: Pharmacists, GPs, and geriatricians can all identify medication regimen simplification opportunities, although recommendations differ within and between professional groups. Although opportunities to simplify medication regimens exist, simplification is not currently routinely recommended by pharmacists performing medication reviews in Australian RACFs.
Biography
Dr Janet Sluggett is an Associate Professor at the University of South Australia and an Affiliate Post-Doctoral Researcher at the South Australian Health and Medical Research Institute. Janet is a pharmacist and her research seeks to improve medicines use, safety and effectiveness in older people accessing aged care services. Janet is also interested in the delivery and outcomes of pharmacist services in aged care settings.
Session Chair
Kaylee Rudd
Phd Student
University Of Tasmania
