None listed
Conditions
Brief summary
ACTMed is a new service designed to proactively find and address medicine problems before they cause harm. Participating pharmacists will use a specially designed software program (ACTionable Medication safety dashboard) that works within health IT systems to detect medicines problems. ACTMed works by bringing pharmacists, consumers and general practitioners together to deal with medicine problems. After the initial co-design/pilot phase, we will run a staged trial across at least 38 health services (Aboriginal Community Controlled Health Organizations (ACCHOs) and general practitioner practices) in Queensland and Victoria to assess how effective it is and whether it is good value for money.
Interventions
To implement and evaluate, using a pragmatic stepped wedge randomized control trial, the use of an actionable and pharmacist-led medication safety dashboard with concurrent general practitioner feedback and economic incentives as a way of targeting serious medication related problems in the primary care setting. The intervention is called ACTMed.
The ACTMed intervention is being co-designed and piloted (subject to a separate ANZCTR registration). The intervention will be finalised and a decis
To implement and evaluate, using a pragmatic stepped wedge randomized control trial, the use of an actionable and pharmacist-led medication safety dashboard with concurrent general practitioner feedback and economic incentives as a way of targeting serious medication related problems in the primary care setting. The intervention is called ACTMed. The ACTMed intervention is being co-designed and piloted (subject to a separate ANZCTR registration). The intervention will be finalised and a decision made to progress to the trial phase made in conjunction with the ACTMed Steering Committee. In this stepped wedge cluster RCT all practices will start without ACTMed. Each month 7 practices will be randomly assigned to have ACTMed introduced. After 7 months all practices will have ACTMed. Data collection will cease 6 months after the last practice has ACTMed. Overview of ACTMed Intervention: 1. ACTMed dashboard collates a list of high risk patients identified by clinical indicators for pharmacist review. Only high-risk patients will be triaged by the pharmacist. 2. Trial Pharmacist triages patients flagged by indicators based on clinical review and creates an action plan to reduce risk. All actions of pharmacist or general practitioner are recorded in MedAdvisor for analysis by research team. Feedback to participating pharmacists and general practitioners of the current proportion of exposed individuals who have been identified as at risk of a serious medication related problem will occur. Additionally, the trial pharmacist will deliver feedback to the general practitioner through a variety of channels including face to face meetings, practice meetings and dissemination of the latest dashboard results. 3. Analysis of the primary outcome will be undertaken using individual-level data, with a supplementary practice-level analysis undertaken for robustness. Details of the ACTMed intervention are highly dependent on the final list of clinical indicators chosen and the consumer/health practitioner co-design process. This includes the anticipated time taken for ACTMed triage and actioning, where and how any consumer contact occurs and when/how feedback to participating practices will occur. All details will be finalised during the co-design and pilot phase. The ANZCTR record will be updated accordingly.
Sponsors
Dr Jean Spinks
Study design
Allocation
Randomised controlled trial
Intervention model
Other
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
All adult consumers who are active at the general practitioner practice (based on the FHT definition of active, that is, not deceased and still attending the practice).
Exclusion criteria
Not able to provide full informed consent Consumers who withdraw consent to be included in the Patron data repository. Pregnant and breastfeeding women.
Outcome results
None listed