Using telehealth to enable collaboration of pharmacists and geriatricians in residential medication management reviews
Background Practical issues impede optimum collaboration between pharmacists and other clinical specialists in the current Australian residential medication review services which potentially affect efficiency, timeliness and quality of outcomes. Objective This mixed methods study aimed to explore the potential value of an existing telehealth platform to enable collaboration of pharmacists and geriatricians in residential medication reviews. Setting Long term care facilities in Australia. Method Twenty vignettes of aged care residents were prepared and independently reviewed by five pharmacists and five geriatricians using a telehealth platform to record their recommendations for medications. The geriatricians were subsequently asked to re-consider their recommendations after being provided with a pharmacist’s report. Main outcome measure The level of agreement between pharmacists and between geriatricians, changes in the mean number of medications after pharmacists’ and geriatricians’ reviews, number of changes in geriatricians’ recommendations after viewing a pharmacist’s report, and pharmacists’ and geriatricians’ feedback. Results Both pharmacists and geriatricians had fair agreement about their recommendations for medications (kappa of 0.30 and 0.31 respectively). The mean number of medications over 20 cases was significantly reduced from a baseline of 14.9 to 13.4 by pharmacists, and to 12.3 by geriatricians after their reviews. There was disagreement between geriatricians and pharmacists on 430/1485 (29%) recommendations on medications; after viewing a pharmacist’s report, geriatricians changed their mind in 51 occasions. Geriatricians found the pharmacist report useful in 72% of the cases. The majority of the pharmacists (4/5) were prepared to use the online system routinely. Conclusion The tested telehealth platform has the potential of being used as a part of routine practice to improve accessibility of the service and to enable synchronous collaboration among healthcare professionals.
KeywordsAustralia Medication review Nursing home Telehealth
The authors would like to thank the pharmacists and geriatricians who took part in the study. Mr Mark Chatfield (The University of Queensland Centre for Health Services Research) provided statistical help with analysing the level of agreement between pharmacists and geriatricians.
This work was supported by the National Health and Medical Research Council (NHMRC) Partnership Centre for Dealing with Cognitive and Related Functional Decline in Older People (Grant No. GNT9100000). Leila Shafiee Hanjani is supported by an Australian Government Research Training Program (RTP). No other sources of funding were used to assist in the preparation of this article.
Conflicts of interest
The authors declare that they have no conflicts of interest.
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