Keeping medications simple

nurse and patient interacting

A CDPC study focusing on quality use of medicines, “Simplification of Medications Prescribed to Long Term Care Residents” (SIMPLER) will generate evidence to inform practice and policy in the effort to simplify medication use in residential aged care.

Professor Simon Bell, Dr Janet Sluggett and Ms Esa Chen from Monash University’s Centre for Medicine Use and Safety are conducting this CDPC research project with Professor Sarah Hilmer from Northern Clinical School, Sydney Medical School at the University of Sydney, and Helping Hand, a South Australian aged care provider organisation.

Residents of aged care facilities often take multiple medications due to multiple co-existent chronic diseases prevalent with ageing, such as dementia, diabetes, airways disease, arthritis and heart failure.

Complex medication regimens are costly in terms of nursing time and can be burdensome for residents, says Professor Bell.

“Having a complex medication regimen has been linked to poor health outcomes such as hospitalisation and mortality.

Validating medication simplification tools will generate much-needed evidence to inform clinical practice and policy decisions in residential aged care,” Professor Bell said.

The SIMPLER study is an intervention that is currently underway to reduce unnecessary medication complexity in aged care facilities.

The research team from Monash University worked closely with clinicians, consumers and aged care providers to develop a structured tool to guide the process of medication simplification: the five-item Medication Regimen Simplification Guide for Residential Aged Care (MRS GRACE).

MRS GRACE, says Dr Sluggett, assists clinicians to identify opportunities to simplify medication use and ensure medications are given at the same time of day where possible. MRS GRACE has been validated by two independent clinical pharmacists and is being trialled as part of the SIMPLER study.

“SIMPLER is a cluster randomised control trial investigating the use of the regimen simplification guide, MRS GRACE.

An experienced pharmacist is using MRS GRACE to identify opportunities to reduce the number of medication administration times for residents and communicate these findings to GPs, facility staff, residents and family members.

The study will also examine the impact of medication simplification on a range of other outcomes, including resident satisfaction with care, quality of life, time spent administering medications, medication incidents and hospitalisations,” Dr Sluggett said.

The study has recruited residents from eight Helping Hand aged care facilities in metropolitan and regional South Australia.

Helping Hand Director of Research and Development, Megan Corlis, said “This research is unique in that it builds on the plethora of previous evidence to provide an integrated approach to making real change for older people living in residential aged care facilities and better utilising the time of qualified staff. It has the potential to be ground breaking.”

Early next year, an adapted version of MRS GRACE will be trialled more widely among older people receiving aged care services in the home.