Use of an electronic medication management application to support Pharmacists Review to Optimise Medicines in Residential Aged Care (PROMPT-RC): a study protocol for a parallel cluster randomised controlled trial
Introduction Most older adults living in residential aged care facilities (RACFs) have at least one marker of potentially suboptimal prescribing. Pharmacists play a crucial role in medication management, with their effectiveness enhanced by using computerised decision support tools. The Pharmacists...
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BMJ Publishing Group
2025-07-01
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| author | Kenneth Lee Dennis Petrie Dee Mangin Christopher Etherton-Beer Amy Theresa Page Esa Y H Chen Nagham Ailabouni Liza Seubert Rhonda Marise Clifford Kathleen Potter Nahal Mavaddat Sarah Hosking Jacinta Johnson Elton Lobo Kate Wang Hend Almutairi Loretta Baldassar Jenny Tasker |
| author_facet | Kenneth Lee Dennis Petrie Dee Mangin Christopher Etherton-Beer Amy Theresa Page Esa Y H Chen Nagham Ailabouni Liza Seubert Rhonda Marise Clifford Kathleen Potter Nahal Mavaddat Sarah Hosking Jacinta Johnson Elton Lobo Kate Wang Hend Almutairi Loretta Baldassar Jenny Tasker |
| author_sort | Kenneth Lee |
| collection | DOAJ |
| description | Introduction Most older adults living in residential aged care facilities (RACFs) have at least one marker of potentially suboptimal prescribing. Pharmacists play a crucial role in medication management, with their effectiveness enhanced by using computerised decision support tools. The Pharmacists Review to Optimise Medicines in Residential Aged Care (PROMPT-RC) study aims to optimise medicine use by providing pharmacists in RACFs with an electronic medicine management app with integrated decision support (AusTAPER App/Pathway) to use as part of medication reviews they undertake.Methods and analysis The PROMPT-RC study is a parallel cluster randomised controlled trial design involving Australian RACFs. It will assess if pharmacists’ use of the AusTAPER App/Pathway for medication reviews improves medication regimens for RACF residents compared with usual care. Pharmacists in RACFs randomised to the intervention arm will be trained to use the AusTAPER App/Pathway, which flags potentially inappropriate medicines (PIMs) across a person’s entire medicine regimen. Pharmacists in RACFs randomised to the control arm will not have access to the AusTAPER App/Pathway—they will continue to provide usual care. The primary outcome is the difference in the number of regular medicines between treatment arms at 12 months. Secondary outcomes will measure the number of regular and pro re nata medicines, PIMs, medicine administration times, medicine regimen complexity, use of antipsychotics, antidepressants, and benzodiazepines, quality of life, mortality, instances of physical restraint, and the number of falls, hospitalisations and general practitioner/health professional visits. The cost-effectiveness of the AusTAPER App/Pathway compared with usual care will be calculated. Data collection will occur at baseline, 3, 6, 9 and 12 months postrandomisation and 3 and 6 months prebaseline. We aim to recruit 668 participants to adjust for an estimated 10% loss to follow-up, giving 334 participants in each arm. Data analysis will follow an intention-to-treat approach using a linear mixed model.Ethics and dissemination Ethical approval was obtained from The University of Western Australia Human Research Ethics Committee (Reference: 2024/ET000525; approved 14 August 2024). Reciprocal approval was also obtained in other states. This study is registered on the Australian New Zealand Clinical Trials Registry (https://anzctr.org.au). Trial findings will be disseminated through national and international peer-reviewed publications and conferences.Trial registration number ACTRN12624001409561. |
| format | Article |
| id | doaj-art-4fee7c5465bd40f29709c7b09f093645 |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-07-01 |
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| spelling | doaj-art-4fee7c5465bd40f29709c7b09f0936452025-08-20T03:17:43ZengBMJ Publishing GroupBMJ Open2044-60552025-07-0115710.1136/bmjopen-2024-097345Use of an electronic medication management application to support Pharmacists Review to Optimise Medicines in Residential Aged Care (PROMPT-RC): a study protocol for a parallel cluster randomised controlled trialKenneth Lee0Dennis Petrie1Dee Mangin2Christopher Etherton-Beer3Amy Theresa Page4Esa Y H Chen5Nagham Ailabouni6Liza Seubert7Rhonda Marise Clifford8Kathleen Potter9Nahal Mavaddat10Sarah Hosking11Jacinta Johnson12Elton Lobo13Kate Wang14Hend Almutairi15Loretta Baldassar16Jenny Tasker17Pharmacy, School of Allied Health, The University of Western Australia, Crawley, Western Australia, AustraliaCentre for Health Economics, Monash University, Melbourne, Victoria, AustraliaPublic Health and General Practice, Christchurch School of Medicine and Health Sciences, Christchurch, New ZealandMedical School, The University of Western Australia, Crawley, Western Australia, AustraliaCentre for Optimisation of Medicines, The University of Western Australia, Perth, Western Australia, AustraliaCentre for Medicine Use and Safety, Monash University, Parkville, Victoria, AustraliaThe University of Queensland, Brisbane, Queensland, AustraliaSchool of Medicine and Pharmacology, The University of Western Australia, Crawley, Western Australia, AustraliaPharmacy, School of Medicine and Pharmacology, The University of Western Australia, Perth, Western Australia, AustraliaRyman Healthcare, Christchurch, New ZealandSchool of Medicine, The University of Western Australia, Perth, Western Australia, AustraliaDeakin University, Burwood, Victoria, AustraliaUniversity of South Australia, Adelaide, South Australia, AustraliaThe University of Queensland, Brisbane, Queensland, AustraliaRMIT University, Melbourne, Victoria, AustraliaPharmacy, School of Allied Health, The University of Western Australia, Perth, Western Australia, AustraliaEdith Cowan University, Joondalup, Western Australia, AustraliaWA Centre for Health and Ageing, Perth, Western Australia, AustraliaIntroduction Most older adults living in residential aged care facilities (RACFs) have at least one marker of potentially suboptimal prescribing. Pharmacists play a crucial role in medication management, with their effectiveness enhanced by using computerised decision support tools. The Pharmacists Review to Optimise Medicines in Residential Aged Care (PROMPT-RC) study aims to optimise medicine use by providing pharmacists in RACFs with an electronic medicine management app with integrated decision support (AusTAPER App/Pathway) to use as part of medication reviews they undertake.Methods and analysis The PROMPT-RC study is a parallel cluster randomised controlled trial design involving Australian RACFs. It will assess if pharmacists’ use of the AusTAPER App/Pathway for medication reviews improves medication regimens for RACF residents compared with usual care. Pharmacists in RACFs randomised to the intervention arm will be trained to use the AusTAPER App/Pathway, which flags potentially inappropriate medicines (PIMs) across a person’s entire medicine regimen. Pharmacists in RACFs randomised to the control arm will not have access to the AusTAPER App/Pathway—they will continue to provide usual care. The primary outcome is the difference in the number of regular medicines between treatment arms at 12 months. Secondary outcomes will measure the number of regular and pro re nata medicines, PIMs, medicine administration times, medicine regimen complexity, use of antipsychotics, antidepressants, and benzodiazepines, quality of life, mortality, instances of physical restraint, and the number of falls, hospitalisations and general practitioner/health professional visits. The cost-effectiveness of the AusTAPER App/Pathway compared with usual care will be calculated. Data collection will occur at baseline, 3, 6, 9 and 12 months postrandomisation and 3 and 6 months prebaseline. We aim to recruit 668 participants to adjust for an estimated 10% loss to follow-up, giving 334 participants in each arm. Data analysis will follow an intention-to-treat approach using a linear mixed model.Ethics and dissemination Ethical approval was obtained from The University of Western Australia Human Research Ethics Committee (Reference: 2024/ET000525; approved 14 August 2024). Reciprocal approval was also obtained in other states. This study is registered on the Australian New Zealand Clinical Trials Registry (https://anzctr.org.au). Trial findings will be disseminated through national and international peer-reviewed publications and conferences.Trial registration number ACTRN12624001409561.https://bmjopen.bmj.com/content/15/7/e097345.full |
| spellingShingle | Kenneth Lee Dennis Petrie Dee Mangin Christopher Etherton-Beer Amy Theresa Page Esa Y H Chen Nagham Ailabouni Liza Seubert Rhonda Marise Clifford Kathleen Potter Nahal Mavaddat Sarah Hosking Jacinta Johnson Elton Lobo Kate Wang Hend Almutairi Loretta Baldassar Jenny Tasker Use of an electronic medication management application to support Pharmacists Review to Optimise Medicines in Residential Aged Care (PROMPT-RC): a study protocol for a parallel cluster randomised controlled trial BMJ Open |
| title | Use of an electronic medication management application to support Pharmacists Review to Optimise Medicines in Residential Aged Care (PROMPT-RC): a study protocol for a parallel cluster randomised controlled trial |
| title_full | Use of an electronic medication management application to support Pharmacists Review to Optimise Medicines in Residential Aged Care (PROMPT-RC): a study protocol for a parallel cluster randomised controlled trial |
| title_fullStr | Use of an electronic medication management application to support Pharmacists Review to Optimise Medicines in Residential Aged Care (PROMPT-RC): a study protocol for a parallel cluster randomised controlled trial |
| title_full_unstemmed | Use of an electronic medication management application to support Pharmacists Review to Optimise Medicines in Residential Aged Care (PROMPT-RC): a study protocol for a parallel cluster randomised controlled trial |
| title_short | Use of an electronic medication management application to support Pharmacists Review to Optimise Medicines in Residential Aged Care (PROMPT-RC): a study protocol for a parallel cluster randomised controlled trial |
| title_sort | use of an electronic medication management application to support pharmacists review to optimise medicines in residential aged care prompt rc a study protocol for a parallel cluster randomised controlled trial |
| url | https://bmjopen.bmj.com/content/15/7/e097345.full |
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