Protocol for a pilot and feasibility study of nurse practitioner-pharmacist telehealth collaboration to simplify complex medication regimens |
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| Institution: | 1. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia;2. Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia;3. Brightwater Research Centre, Osborne Park, Western Australia, Australia;4. Brightwater Care Group, Osborne Park, Western Australia, Australia;5. The University of Western Australia, Crawley, Western Australia, Australia;1. School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Private Bag 26, Hobart, Tasmania, 7001, Australia;2. Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Private Bag 34, Hobart, Tasmania, 7001, Australia;3. Royal Hobart Hospital, GPO Box 1061, Hobart, Tasmania, 7001, Australia;1. Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman, United Arab Emirates;2. Center of Medical and Bio-allied Health Sciences, Ajman University, Ajman, United Arab Emirates;3. College of Pharmacy and Health Sciences, Ajman, United Arab Emirates;4. Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates;1. University of Bath, Claverton Down, Bath, BA2 7AY, United Kingdom;2. University of Leicester, University Rd, Leicester, LE1 7RH, United Kingdom;3. Day Lewis PLC, 2 Peterwood Way, Croydon CR0 4UQ, United Kingdom;1. Department of Pharmacy, The First Affiliated Hospital, Sun Yat-sen University, 510080, Guangzhou, China;2. Graduate Institute of Digital Learning and Education, National Taiwan University of Science and Technology, Taipei, Taiwan;3. Research Center for Psychological and Educational Testing, National Taiwan Normal University, Taipei, Taiwan;4. Department of Computer Science and Information Engineering, National Kaohsiung University of Science and Technology, Kaohsiung, Taiwan;5. Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China;1. College of Pharmacy, Ohio State University, Columbus, OH, USA;2. EVP, HealthPlan Data Solutions Inc, USA;3. HealthPlan Data Solutions, Columbus, OH, USA |
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| Abstract: | IntroductionNew 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.MethodsThis 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.Ethics and disseminationEthical 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. |
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| Keywords: | Telehealth Medication regimen simplification Residential aged care Nursing homes Pharmacist Nurse practitioner |
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