Study underway focuses on simplifying medication regimens

Pharmacist researcher Dr Janet Sluggett is motivated by seeing the impact her research has on aged care residents, she tells Sandy Cheu.

Many seniors have a complex medication regimen but for some aged care residents it is overly so, says Dr Janet Sluggett, a research fellow at the Centre for Medicine Use and Safety at Monash University.

Sluggett is a pharmacist researcher embedded two days a week with South Australian aged care provider Helping Hand, where she is leading a study focused on simplifying medication management in residential care.

The study builds on previous research that looked at the medication charts of 50 residents from a census sample of 439 residents at 10 aged care facilities.

“Although sometimes really complex medicine regimens are necessary, we found that in some cases there were unnecessary complexities,” Sluggett tells Australian Ageing Agenda.

“Residents were having multiple medicines throughout the day. There were different dosage forms such as eye drops, inhalers, injections and tablets with often complex dosage instructions like crushing, taking with food or at very specific times of the day.”

The five-year Cognitive Decline Partnership Centre funded project, known as SImplification of Medications Prescribed to Long-tErm care Residents’ (SIMPLER), has recruited 240 residents across Helping Hand’s eight aged care facilities to participate in the trial of a single multidisciplinary intervention to simplify medication regimens.

The researchers will assess residents’ medications and identify opportunities to reduce complexities using the Medication Regimen Simplification Guide for Residential Aged CarE (MRS GRACE), the first validated tool to help pharmacists and medical practitioners determine whether prescribed medications can be consolidated.

Data will be collected from participants at the beginning of the study and then at the four, eight and twelve-month marks for three years. Data from the first four-months is now being analysed with early results due to be presented at industry conferences this year, Sluggett says.

The study is also looking at the possible side effects of medicines among aged care residents as this group is often not included in clinical trials when medicines are being tested.

“We know that when medications are taken appropriately, they can be very beneficial, they can improve our lives, but sometimes medications can have side effects or unintended consequences,” Sluggett says.

Poor health outcomes include adverse drug events, reduced health and wellbeing, cognitive impairment, falls and hospitalisation, she says.

Sluggett’s involvement with Helping Hand was established through her work with the CDPC developing MRS GRACE. The CDPC is jointly supported by the National Health and Medical Research Council and partners, which include providers Helping Hand, HammondCare and Brightwater Care Group.

At Helping Hand, Sluggett says her day usually starts with meetings with facility staff to share updates on the project and discuss any issues that may have come up during the week and plan the next steps.

“Recently we’ve been working on a process evaluation, which is an evaluation of how the trials are going, the enablers and barriers of the wider uptake of the project and looking at whether the trials have been effective,” she says.

After the meetings, she usually sets up and undertakes interviews with clients, residents and their family members, general practitioners, pharmacists and aged care staff to discuss their experiences and participation in the trial.

Later in the day, Sluggett says she is often working with Helping Hand consumer and carer reference group members to ensure the best implementation of the study is achieved, such as looking at how processes can be embedded and developing resources and tools.

Sluggett says she is most passionate about the challenge of research, collaborating with others towards a common goal and looking at patterns of medication.

“It’s rewarding to be able to work as an embedded researcher and see the impact the research has. Getting to speak to residents and their family members and aged care staff and seeing the positive benefits that can come from research keeps me motivated to work in this field,” she says.

Alongside her research work, Sluggett, an accredited pharmacist, works with CPIE Pharmacy Services, a community and hospital pharmacy, once a week as a professional services pharmacist.

The Pharmaceutical Society of Australia SA and NT named Sluggett the 2018 Pharmacist of the Year, which acknowledges an achiever within the profession who is pursuing innovative practice, striving to raise standards and providing a model of practice for others in related disciplines.

She says the award is an honour and a reflection on the wider team of excellent people she works with.

Sluggett encourages anyone wanting to get more involved with medicine management and pharmaceuticals to approach an aged care organisation or local community pharmacist to ask about opportunities.

“Depending on your interests, you could request to observe dose administration aid packing at a community pharmacy, accompany an accredited pharmacist while they undertake a residential medication management review or observe a local medication advisory committee,” she says.

This article appears in the current July-August edition of Australian Ageing Agenda magazine.

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