IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v18y2021i11p5778-d563805.html
   My bibliography  Save this article

Process Evaluation of the SImplification of Medications Prescribed to Long-tErm Care Residents (SIMPLER) Cluster Randomized Controlled Trial: A Mixed Methods Study

Author

Listed:
  • Janet K. Sluggett

    (UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA 5001, Australia
    Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia
    NHMRC Cognitive Decline Partnership Centre, Hornsby Ku-ring-gai Hospital, Hornsby, NSW 2077, Australia)

  • Georgina A. Hughes

    (UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA 5001, Australia)

  • Choon Ean Ooi

    (Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia)

  • Esa Y. H. Chen

    (Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia
    NHMRC Cognitive Decline Partnership Centre, Hornsby Ku-ring-gai Hospital, Hornsby, NSW 2077, Australia)

  • Megan Corlis

    (UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA 5001, Australia
    NHMRC Cognitive Decline Partnership Centre, Hornsby Ku-ring-gai Hospital, Hornsby, NSW 2077, Australia)

  • Michelle E. Hogan

    (Helping Hand Aged Care, North Adelaide, SA 5006, Australia)

  • Tessa Caporale

    (Helping Hand Aged Care, North Adelaide, SA 5006, Australia)

  • Jan Van Emden

    (NHMRC Cognitive Decline Partnership Centre, Hornsby Ku-ring-gai Hospital, Hornsby, NSW 2077, Australia
    UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA 5001, Australia)

  • J. Simon Bell

    (Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia
    NHMRC Cognitive Decline Partnership Centre, Hornsby Ku-ring-gai Hospital, Hornsby, NSW 2077, Australia
    Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia)

Abstract

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.

Suggested Citation

  • Janet K. Sluggett & Georgina A. Hughes & Choon Ean Ooi & Esa Y. H. Chen & Megan Corlis & Michelle E. Hogan & Tessa Caporale & Jan Van Emden & J. Simon Bell, 2021. "Process Evaluation of the SImplification of Medications Prescribed to Long-tErm Care Residents (SIMPLER) Cluster Randomized Controlled Trial: A Mixed Methods Study," IJERPH, MDPI, vol. 18(11), pages 1-17, May.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:11:p:5778-:d:563805
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/18/11/5778/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/18/11/5778/
    Download Restriction: no
    ---><---

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:18:y:2021:i:11:p:5778-:d:563805. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.