Process evaluation of the SImplification of Medications Prescribed to Long-tErm Care Residents (SIMPLER) cluster randomized controlled trial: a mixed methods study
| Autor: | Megan Corlis, Jan Van Emden, Esa Y. H. Chen, J. Simon Bell, Janet K. Sluggett, Tessa Caporale, Georgina A. Hughes, Choon Ean Ooi, Michelle Hogan |
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| Přispěvatelé: | Sluggett, Janet K, Hughes, Georgina A, Ooi, Choon Ean, Chen, Esa YH, Corlis, Megan, Hogan, Michelle E, Caporale, Tessa, Van Emden, Jan, Bell, J Simon |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
process assessment
Health Toxicology and Mutagenesis nursing homes Pharmacists Article law.invention medication therapy management 03 medical and health sciences 0302 clinical medicine Nursing Randomized controlled trial law Assisted Living Facilities Health care Medication therapy management Humans 030212 general & internal medicine Protocol (science) medication administration Descriptive statistics business.industry Public Health Environmental and Occupational Health Australia residential facilities Long-Term Care health care Long-term care Regimen aged Pharmaceutical Preparations randomized controlled trial Medicine long-term care Psychology business 030217 neurology & neurosurgery qualitative research Qualitative research medication systems |
| Zdroj: | International Journal of Environmental Research and Public Health Volume 18 Issue 11 International Journal of Environmental Research and Public Health, Vol 18, Iss 5778, p 5778 (2021) |
| Popis: | Complex medication regimens are highly prevalent, burdensome for residents and staff, and associated with poor health outcomes in residential aged care facilities (RACFs). The SIMPLER study was a non-blinded, matched-pair, cluster randomized controlled trial in eight Australian RACFs that investigated the one-off application of a structured 5-step implicit process to simplify medication regimens. The aim of this study was to explore the processes underpinning study implementation and uptake of the medication simplification intervention. A mixed methods process evaluation with an explanatory design was undertaken in parallel with the main outcome evaluation of the SIMPLER study and was guided by an established 8-domain framework. The qualitative component included a document analysis and semi-structured interviews with 25 stakeholders (residents, family, research nurses, pharmacists, RACF staff, and a general medical practitioner). Interviews were transcribed verbatim and reflexively thematically content analyzed. Descriptive statistics were used to summarize quantitative data extracted from key research documents. The SIMPLER recruitment rates at the eight RACFs ranged from 18.9% to 48.6% of eligible residents (38.4% overall). Participation decisions were influenced by altruism, opinions of trusted persons, willingness to change a medication regimen, and third-party hesitation regarding potential resident distress. Intervention delivery was generally consistent with the study protocol. Stakeholders perceived regimen simplification was beneficial and low risk if the simplification recommendations were individualized. Implementation of the simplification recommendations varied between the four intervention RACFs, with simplification implemented at 4-month follow-up for between 25% and 86% of residents for whom simplification was possible. Good working relationships between stakeholders and new remunerated models of medication management were perceived facilitators to wider implementation. In conclusion, the one-off implicit medication simplification intervention was feasible and generally delivered according to the protocol to a representative sample of residents. Despite variable implementation, recommendations to simplify complex regimens were valued by stakeholders, who also supported wider implementation of medication simplification in RACFs. Refereed/Peer-reviewed |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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