Activating pharmacists to reduce the frequency of medication‐related problems (ACTMed ): a stepped wedge cluster randomised trial
Jean Spinks, Richard Violette, Douglas IR Boyle, Dennis Petrie, Laura Fanning, Kerry K Hall, Fiona Kelly, Amanda J Wheeler, Robert S Ware, Joshua Byrnes, Esa Chen, Andrew Donald, Nicolette Ellis, Megan DelDot, Lisa Nissen - General Medicine
Abstract
Background
Medicines are the most frequent health care intervention type; their safe use provides significant benefits, but inappropriate use can cause harm. Systemic primary care approaches can manage serious medication‐related problems in a timely manner.
Objectives
ACTMed (ACTivating primary care for MEDicine safety) uses information technology and financial incentives to encourage pharmacists to work more closely with general practitioners to reduce the risk of harm, improve patients’ experience of care, streamline workflows, and increase the efficiency of medical care.
Methods and analysis
The stepped wedge cluster randomised trial in 42 Queensland primary care practices will assess the effectiveness of the ACTMed intervention. The primary outcome will be the proportion of people at risk of serious medication‐related problems — patients with atrial fibrillation, heart failure, cardiovascular disease, type 2 diabetes, or asthma or congestive obstructive pulmonary disease — who experience such problems. We will also estimate the cost per averted serious medication‐related problem and the cost per averted potentially preventable medication‐related hospitalisation.
Ethics approval
The University of Queensland Human Research Ethics Committee approved the pilot (2021/HE002189) and trial phases of the ACTMed study (2022/HE002136). Access to Patron data was granted by the Patron Data Governance Committee (PAT052ACTMed). Access to linked hospitalisations and deaths data are subject to Public Health Act approval (pending).
Dissemination of findings
A comprehensive dissemination plan will be co‐developed by the researchers, the ACTMed steering committee and consumer advisory group, project partners, and trial site representatives. Aboriginal and Torres Strait Islander communities will be supported in leading community‐level dissemination.
Trial registration
Australian New Zealand Clinical Trials Registry (pilot: ACTRN12622000595718; 21 April 2022; full trial: ACTRN12622000574741; 14 April 2022).