This project tests the DBI as a tool to improve the quality use of medicines in older Australians. The study will improve the evidence base for the association between overall medication exposure and function in older people. The HMR model is a sustainable government funded service that can be used to bring this research finding into practice if it is found to benefit older Australians.
We hypothesise that the DBI represents a clinically useful tool to guide prescribing for older adults. Use of DBI as a risk assessment measure may help prescribers optimise physical and mental function, independence and quality of life in their older patients. This Application will test the DBI as part of pharmacist-led HMR to systematically guide prescribing in older people.
The DBI will be trialed as an additional component of the accredited pharmacist’s HMR. Software will be developed to calculate the DBI and to generate a report detailing a patient’s DBI, the medications contributing to the DBI and possible association of DBI with functional impairment, which the general practitioner (GP) can consider and discuss with the patient. Additional reports will be provided to any specialists involved in the patients care and to the patients. The software and report will be assessed at the pharmacist, GP, specialist and patient levels in pilot studies. Accredited pharmacists conducting Home Medicines Reviews (HMR) will then be randomised to provide either usual care, or to add the reports on DBI and possible associations with function for General Practitioners, any specialists involved in the patient’s care and the patient. We will assess whether addition of the DBI report to accredited pharmacists’ HMR reports significantly affects:(1) medication changes recommended by HMR pharmacists;(2) uptake of recommended changes by prescribers;(3) physical and cognitive function in older people after undergoing medication review.
The opportunity ID for this research opportunity is 940