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Pharmacy
Technology in aged care
Workforce training
Grant Funding Round 2
POSTED 17 Jul 2023

A Digitally Enabled, Pharmacist service to detect medicine harms in residential aged care: the ADEPT project

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The University of South Australia in partnership with Tanunda Lutheran Homes, the University of NSW, Pharmaceutical Society of Australia Ltd and Health Care Services Pty Ltd has been awarded an ARIIA grant for their project ‘A Digitally Enabled, Pharmacist service to detect medicine harms in residential aged care: the ADEPT project’.

In March 2022, the Australian government announced $345 million of funding over 4 years to employ on-site pharmacists in residential aged care. The proposed roles of the new on-site pharmacists include, among others, medication reviews, whole-of-facility quality use of medicines activities and collaboration with the health care teams.

These activities will reduce some medicine harms (e.g., due to use of inappropriate medicines) experienced by aged care residents; however, many medicines cause “milder” harms (e.g., poor balance, sedation) that are difficult to detect without the right tools. Left unmanaged, these “milder” harms can lead to serious adverse events such as injurious falls.

We propose using digital technologies and an evidence-based digital platform to assist the pharmacists with actively monitoring medicine harms. Over 12 months, our interdisciplinary team at the University of South Australia (UniSA), University of New South Wales (UNSW) and Flinders University will implement the TeleClinical Care platform incorporating data from a suite of digital technologies (e.g., activity tracker) at the Tanunda Lutheran Home, South Australia.

Our proposed project will complement the government’s model by providing pharmacists with the right tools and training so that pharmacists can effectively detect and manage medicine harms to improve resident outcomes.

 

What we did

The ADEPT project tested the feasibility of a digitally enabled, pharmacist service to actively detect medicine harms in residential aged care. We developed a centralised, cloud-based monitoring platform (TeleClinical Care (TCC)-ADEPT) for aged care pharmacists to view residents’ clinical, medication and activity data. Prior to this, pharmacists had to retrieve the information from multiple sources, if available. The TCC-ADEPT allows for longitudinal visualisations of changes in residents’ health, function, and medication use over time.

We tested the service in a 12-week feasibility study at a single residential aged care facility in the Barossa Valley, South Australia. The on-site pharmacist used the centralised TCC-ADEPT platform to monitor 29 residents’ medicine, clinical, physical activity, and sleep data to identify signs of medicine-induced harms.

 

Outcomes

The TCC-ADEPT platform equipped the on-site pharmacist with a comprehensive tool to monitor residents’ health in a centralised and efficient manner. Our initial analysis shows that this platform enabled the on-site pharmacist to promptly identify signs of medicine-induced harms, facilitating rapid intervention and mitigation strategies to prevent further harms.

Study outcomes that were collected include changes in resident symptom scores, number of medication adverse events detected, changes in physical activity and sleep, number of pharmacist interventions provided, cost analysis, and proportion of all pharmacists’ recommendations implemented at 4-, 8-, and 12-weeks post-baseline period. The data collected is currently being analysed, and the results will be shared in a peer-reviewed publication.

 

Impact on Aged Care Workforce

Our innovative service model, coupled with findings from our feasibility study, is likely to complement the Australian government’s new funding model for employing on-site pharmacists in residential aged care. The ADEPT project has the potential to improve the detection of medicine-related harms, mitigate associated adverse events, and supplement current resources in residential aged care. Findings from this study will be useful in informing aged care policy, aiming to reduce medicine-related harms through active involvement of pharmacists, utilising the technology developed and tested in our study.

 

Resources Developed

The TCC-ADEPT platform, developed by UNSW Tyree Foundation Institute of Health Engineering (IHealthE), is owned by the institute. Access to the TCC-ADEPT platform can be granted through the purchase of a license from UNSW IHealthE.

The training materials for staff involved in the study, such as how to administer and score the MoCA, how to set up and connect the accelerometers and sleep mats, can be made available upon request.

 

Next Steps

We plan to expand on the ADEPT study by implementing the digital pharmacist in multiple aged care facilities for proactive monitoring and prevention of adverse events and medicine harms. We plan to use the findings from the ADEPT study to apply for further funding to continue the project into broader implementation.

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