A Digitally Enabled, Pharmacist service to detecT medicine harms in residential aged care (nursing home) (ADEPT): protocol for a feasibility study

Monique S. Boord, Peter Brown, Julian Soriano, Tahlia Meola, Dorothea Dumuid, Rachel Milte, Elizabeth E. Roughead, Nigel H. Lovell, Helen Stone, Joseph Whitehouse, Jack L. Janetzki, Eyob Alemayehu Gebreyohannes, Renly Lim

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Abstract

Introduction: This feasibility study aims to develop and test a new model of practice in Australia using digital technologies to enable pharmacists to monitor early signs and symptoms of medicine-induced harms in residential aged care.

Methods and analysis: Thirty residents will be recruited from an aged care facility in South Australia. The study will be conducted in two phases. In phase I, the study team will work with aged care software providers and developers of digital technologies (a wearable activity tracker and a sleep tracking sensor) to gather physical activity and sleep data, as well as medication and clinical data from the electronic medication management system and aged care clinical software. Data will be centralised into a cloud-based monitoring platform (TeleClinical Care (TCC)). The TCC will be used to create dashboards that will include longitudinal visualisations of changes in residents’ health, function and medicine use over time. In phase II, the onsite pharmacist will use the centralised TCC platform to monitor each resident’s medicine, clinical, physical activity and sleep data to identify signs of medicine-induced harms over a 12-week period. A mixed methods process evaluation applying the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) evaluation framework will be used to assess the feasibility of the service. Outcome measures include service reach, changes in resident symptom scores (measured using the Edmonton Symptom Assessment System), number of medication adverse events detected, changes in physical activity and sleep, number of pharmacist recommendations provided, cost analysis and proportion of all pharmacists’ recommendations implemented at 4-week, 8-week and 12-week postbaseline period. 

Ethics and dissemination: Ethical approval has been obtained from the University of South Australia’s Human Research Ethics Committee (205098). Findings will be disseminated through published manuscripts, conference presentations and reporting to the study funder. 

Trial registration number: ACTRN12623000506695.

Original languageEnglish
Article numbere080148
Number of pages9
JournalBMJ Open
Volume14
Issue number2
DOIs
Publication statusPublished - 10 Feb 2024

Keywords

  • Digital Technologies
  • Feasibility Study
  • Pharmacist services
  • Residential Aged Care

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