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

Area of Science:

• Gerontology
• Pharmacology
• Pharmacy Practice

Background:

• Medication regimens in aged care facilities are becoming increasingly complex.
• Simplifying these regimens may offer benefits to residents and staff.

Purpose of the Study:

• To develop and validate an implicit tool for medication regimen simplification in aged care.
• The tool aims to facilitate the process of simplifying medication regimens.

Main Methods:

• A multidisciplinary expert panel used a modified nominal group technique to identify key factors for simplification.
• These factors were formulated into five questions, pilot-tested, and refined.
• The final tool was validated by two clinical pharmacists on 50 residents' medication charts, with inter-rater agreement assessed using Cohen's kappa.

Main Results:

• The developed tool, MRS GRACE (Medication Regimen Simplification Guide for Residential Aged CarE), consists of five questions covering resident, regulatory, safety, drug interaction, formulation, and facility considerations.
• Two pharmacists independently applied MRS GRACE to 50 residents, identifying simplification opportunities in 29/50 and 30/50 cases (Cohen's kappa=0.38).
• Simplification was feasible for all residents with five or more daily administration times, with 75% of recommendations involving changes to administration times.

Conclusions:

• The MRS GRACE tool demonstrated potential in simplifying medication regimens for over half of the residents, with fair inter-rater agreement.
• MRS GRACE is a promising new tool to guide medication regimen simplification in aged care settings.