None listed
Conditions
Brief summary
Studies have consistently shown that the use of sedative medications in many residential aged care facilities is excessively high. These agents are associated with side effects such as falls, daytime drowsiness and confusion. The most effective interventions to reduce sedative prescribing involve all key staff in this setting, namely nurses, GPs and pharmacists. The Australian government has recommended that pharmacists become more involved in ensuring appropriate use of sedative medications. The strategies of Drug Usage Evaluation (DUE) cycles and nursing staff training are currently promoted; however, there has been limited training for community pharmacists to effectively deliver these strategies. There are also no co-ordinated DUE and staff training packages that target sedative prescribing in residential aged care. This project aims to develop, trial and evaluate a sustainable program [Residential care: Decreasing Use of Sedatives (‘ReDUSe’)], to address inappropriate sedative prescribing in residential aged care. The strategies that form the ReDUSe program will be co-ordinated by the community pharmacy supplying the aged care home and involve the accredited pharmacist.
Interventions
1. Academic detailing – the research team will present a brief evidence-based educational session on appropriate use of sedatives to General practitioners (GPs) servicing residential aged care facilities (RACFs). This detailing will be conducted in the first three months of the project.
2. Case conferencing at residential aged care facilities. This intervention is part of the "enhanced care initiative" for GPs and involves co-ordinating a meeting between nursing staff, GP, pharmacist and residen
1. Academic detailing – the research team will present a brief evidence-based educational session on appropriate use of sedatives to General practitioners (GPs) servicing residential aged care facilities (RACFs). This detailing will be conducted in the first three months of the project. 2. Case conferencing at residential aged care facilities. This intervention is part of the "enhanced care initiative" for GPs and involves co-ordinating a meeting between nursing staff, GP, pharmacist and resident or their relatives to discuss sedative management. It is estimated that one hundred case conferences will be conducted during the trial duration. 3. Drug Use Evaluation (DUE) - This intervention is similar to a clinical audit of prescribing, and involves individual measurement of sedative use at each RACF for presentation back to the nursing staff at the facility. Three DUE cycles will be completed; however feedback will be given to the nursing facility at baseline and at three months post-intervention. 4. Nursing home staff training - will be conducted by pharmacists and incorporate the results of the DUE and education regarding appropriate use and review of sedatives. Training is already recommended to be supplied by each community pharmacy supplying nursing homes. Two training sessions will be delivered to available nursing staff members throughout the six month duration of the trial.
Sponsors
The Pharmacy Guild of Australia
Study design
Allocation
Non-randomised trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
0 to No maximum
Healthy volunteers
No
Inclusion criteria
Residential Aged Care Facilities - All residential aged care facilities within the metopolitan areas of Hobart and launceston will be invited to participate in the study. Dementia-specific residential aged care facilities are exempt.
Exclusion criteria
The psychotropic prevalence rates of the Residenitial Aged Care Facility will be studied as a whole. All residents will be included. Dementia-specific residential aged care facilities are expempt
Outcome results
None listed