Evidence map›Paper›PMID 29844664›Full record

ArticleClinical interventions in aging2018

Development and validation of the Medication Regimen Simplification Guide for Residential Aged CarE (MRS GRACE).

Esa Yh Chen, Janet K Sluggett, Jenni Ilomäki, Sarah N Hilmer, Megan Corlis, Leonie J Picton, Laura Dean, Christopher P Alderman, Nicholas Farinola, Joy Gailer and 5 more

Open access · goldAbstract readValidation StudyVideo-Audio Media
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical interventions in aging, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
2.8field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.

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  14. Optimising medication management during the COVID-19 pandemic.Journal of pharmacy practice and research : official journal of the Society of Hospital Pharmacists of Australia · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 8 institutions in 1 country.

Esa Yh ChenCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia.
Janet K SluggettCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia.
Jenni IlomäkiCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia.
Sarah N HilmerNHMRC Cognitive Decline Partnership Centre, Sydney Medical School - Northern, Hornsby Ku-ring-gai Hospital, Hornsby, NSW, Australia.
Megan CorlisNHMRC Cognitive Decline Partnership Centre, Sydney Medical School - Northern, Hornsby Ku-ring-gai Hospital, Hornsby, NSW, Australia.
Leonie J PictonCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia.
Laura DeanCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia.
Christopher P AldermanSchool of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.
Nicholas FarinolaDepartment of Clinical Pharmacology, Royal Adelaide Hospital, North Terrace, Adelaide, SA, Australia.
Joy GailerDrug and Therapeutics Information Service, Repatriation General Hospital, Daw Park, SA, Australia.
Jane GrigsonHelping Hand Aged Care, North Adelaide, SA, Australia.
Andrew R KellieEast Adelaide Healthcare, Newton, SA, Australia.
Peter Jc PutseyHelping Hand Aged Care, North Adelaide, SA, Australia.
Solomon YuAged and Extended Care Services, The Queen Elizabeth Hospital, Woodville South, SA, Australia.
J Simon BellCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia.
Hornsby Ku-ring-gai Hospital · AUMonash University · AURepatriation General Hospital · AUQueen Elizabeth Hospital · AURoyal Adelaide Hospital · AURoyal North Shore Hospital · AUSA Health · AUUniversity of South Australia · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundResidents of aged care facilities use increasingly complex medication regimens. Reducing unnecessary medication regimen complexity (eg, by consolidating the number of administration times or using alternative formulations) may benefit residents and staff.

objectiveTo develop and validate an implicit tool to facilitate medication regimen simplification in aged care facilities.

methodA purposively selected multidisciplinary expert panel used modified nominal group technique to identify and prioritize factors important in determining whether a medication regimen can be simplified. The five prioritized factors were formulated as questions, pilot-tested using non-identifiable medication charts and refined by panel members. The final tool was validated by two clinical pharmacists who independently applied the tool to a random sample of 50 residents of aged care facilities to identify opportunities for medication regimen simplification. Inter-rater agreement was calculated using Cohen's kappa.

resultsThe Medication Regimen Simplification Guide for Residential Aged CarE (MRS GRACE) was developed as an implicit tool comprising of five questions about 1) the resident; 2) regulatory and safety requirements; 3) drug interactions; 4) formulation; and 5) facility and follow-up considerations. Using MRS GRACE, two pharmacists independently simplified medication regimens for 29/50 and 30/50 residents (Cohen's kappa=0.38, 95% CI 0.12-0.64), respectively. Simplification was possible for all residents with five or more administration times. Changing an administration time comprised 75% of the two pharmacists' recommendations.

conclusionsUsing MRS GRACE, two clinical pharmacists independently simplified over half of residents' medication regimens with fair agreement. MRS GRACE is a promising new tool to guide medication regimen simplification in aged care.

Indexed as

Clinical ProtocolsGuidelines as TopicAgedAged, 80 and overDelivery of Health CareFemaleHumansMaleMedication Therapy ManagementPharmacistsPrescription DrugsPrescription Drugsdrug administrationgeriatricslong-term caremedication regimen complexitymedication therapy management

Identifiers

PMID29844664
PMCPMC5963487
OpenAlexW2803984219

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.