Developing a framework for a novel multi-disciplinary, multi-agency intervention(s), to improve medication management in older people on complex medication regimens resident in the community.
Award Number
15/137/01Programme
Health and Social Care Delivery ResearchStatus / Stage
CompletedDates
2 May 2017 -31 December 2018
Duration (calculated)
01 years 07 monthsFunder(s)
NIHRFunding Amount
£199,220.04Funder/Grant study page
NIHRContracted Centre
Aston UniversityPrincipal Investigator
Dr Ian MaidmentPI ORCID
0000-0003-4152-9704WHO Catergories
Legislative and regulatory environmentsMethodologies and approaches for risk reduction research
Tools and methodologies for interventions
Disease Type
Dementia (Unspecified)CPEC Review Info
| Reference ID | 200 |
|---|---|
| Researcher | Reside Team |
| Published | 12/06/2023 |
Data
| Award Number | 15/137/01 |
|---|---|
| Status / Stage | Completed |
| Start Date | 20170502 |
| End Date | 20181231 |
| Duration (calculated) | 01 years 07 months |
| Funder/Grant study page | NIHR |
| Contracted Centre | Aston University |
| Funding Amount | £199,220.04 |
Abstract
Older people are the major users of medication. The Francis Report emphasised that patients should be protected from avoidable harm. Yet, there is increasing evidence that medication is poorly managed exposing older people to harm. Medication related adverse events have been estimated to be responsible for 5,700 deaths and cost the UK £750 million every year. Realist research approaches are designed to explore how and why a complex social programme involving human actions may or may not work. Outcomes from medication management interventions are caused by multiple context sensitive mechanisms. Outcomes happen, not because of the intervention, but because of the ways people respond ( mechanism ) to the intervention. Realist research aims to explain how the context (situations around a person) affects any mechanism, to generate an outcome (intended or not), and so answer the question; What works for whom, in what circumstances, how and why? This project combines a literature review with interviews to inform the design of a complex intervention(s). Aim: to develop a framework for a novel multi-disciplinary, multi-agency intervention(s), to improve medication management in older people on complex medication regimens resident in the community. WP1: Literature Review Contains five stages to develop a programme theory (PrT) using the literature: 1. Focussing: the focus is to develop a PrT for an intervention(s) to support older people in the community to manage their medication 2. Developing Initial PrT: sets out how and why outcomes occur. The initial PrT will be refined as the synthesis progresses with input from project team members and stakeholders. 3. Developing Search Strategy: a CIMO (Context, Intervention, Mechanisms, Outcome) framework will be used to construct an initial sampling frame from which distinct subsets of literature may be selected to test the PrT. 4. Selection and Appraisal: based on relevance and rigour. Relevant data will be coded into NVIVO. 5. Data Analysis and synthesis: will develop and refine the PrT and CMO configurations by piecing together data from different sources. WP2: Interviews Realist interviews will explore and refine our understanding of the CMO configurations and PrT developed in WP1. Realist interviews are a type of qualitative interview where the researcher does a ‘show and tell’ with the participant. The participant is questioned in as neutral a way as possible about the PrT. Sample size: Up to 30 older people and their informal carers (15 older people with multi-morbidity, 10 informal carers and 5 older people with dementia), and 20 care staff. Data Analysis: NVIVO will be used to organise and understand the data. The data will be coded in a similar way to the data from WP1. WP3: Developing a Framework for the Intervention(s)/Dissemination Data from WP1 and WP2 will be combined to refine the realist PrT for the intervention(s) to identify: a. most important mechanisms that need to be ‘triggered’; b. contexts related to these ‘key’ mechanisms; Ultimately, we will identify which intervention strategies we might be able to use to change the contexts in such a way that ‘key’ mechanisms are triggered. This will provide information on the development of required intervention strategies. These strategies will be presented to the project event to obtain further feedback and develop the framework for a future intervention(s)
Aims
To develop outline way(s) (‘intervention[s]’) of supporting older people living in the community and their carers to safely manage their medication.