Residential Aged Care Pharmacist: An Australian Pilot Trial Exploring the Impact on Quality Use of Medicines Indicators

Abstract

Background: This pilot study aimed to assess whether an on-site pharmacist could influence indicators of quality use of medicines in residential aged care. Methods: A pharmacist was embedded in a residential aged care home for six months. A similar control site received usual care. Polypharmacy, drug burden index, antipsychotic and benzodiazepine use, hospital admission rates and length of stay, and emergency department presentation rates were outcomes used to indicate medication use quality. Data were extracted from participating resident health records. Results: Fifty-eight residents at the study site and 39 residents at the control site were included in the analysis. There was a reduction in the proportion of residents at the study site who had at least one hospital admission at follow-up (28% to 12%, p < 0.01), but no significant difference in other outcomes. Conclusions: This pilot study suggests that a residential care pharmacist may positively influence indicators of medication use quality in aged care; however, further research is needed to expand on these findings.

Integrating pharmacists into aged care facilities to improve the quality use of medicine (PiRACF Study): Protocol for a cluster randomised controlled trial

“…The initial pilot study [45][46][47][48][49][50] con rmed the feasibility of the model and no adverse events were identi ed. This is the rst cluster RCT to our knowledge, that investigates the effectiveness of integrating pharmacists in RACFs on improving medication management.…”

“…The intervention (model of care) was informed by the ndings from the pilot study [45][46][47][48][49][50] and discussion with RACF managers, GPs, pharmacists and a consumer representative who participated in the pilot. Components of this model of care are informed by integration of pharmacists into non-dispensing primacy care roles [52,53].…”

“…Integrating an on-site pharmacist as part of the RACF health care team may address the gap in provision of medication management practices, policies and processes. The on-site pharmacist can assume overall responsibility for medication management, in collaboration with nurses, GPs, specialists and community pharmacists to ensure the quality use of medicines at the facility [45][46][47][48]. This new model can improve communication among the healthcare team and enhance resident and family's involvement in medication management decisions for individuals [46], leading to improved person-centred care.…”

“…A proposed model of integrated on-site pharmacist services into the RACF health care team was examined in a pilot study which was conducted by the lead author [45][46][47][48][49][50]. The conceptual foundation of the new model was to improve multi-disciplinary care, communication and collaboration in RACF's healthcare team to enhance medication management [45,46].…”

What Is the Community Pharmacists’ Role in Supporting Older Australians with Palliative Care Needs?

“…Older Australians in HC and RAC settings have an increased risk of medication misadventure [ 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. Furthermore, people with palliative care needs have additional complexities in how their medicines are managed, resulting from, for example, poor swallowing, the need for subcutaneous administration of medications, and a greater reliance on the carer for medication management [ 11 , 12 ].…”