OBJECTIVE To assess the application of a structured process to consolidate the number of medication administration times for residents of aged care facilities. DESIGN A nonblinded, matched-pair, cluster randomized controlled trial. SETTING AND PARTICIPANTS Permanent residents who were English-speaking and taking at least 1 regular medication, recruited from 8 South Australian residential aged care facilities (RACFs). METHODS The intervention involved a clinical pharmacist applying a validated 5-step tool to identify opportunities to reduce medication complexity (eg, by administering medications at the same time or through use of longer-acting or combination formulations). Residents in the comparison group received routine care. The primary outcome at 4-month follow-up was the number of administration times per day for medications charted regularly. Resident satisfaction and quality of life were secondary outcomes. Harms included falls, medication incidents, hospitalizations, and mortality. The association between the intervention and primary outcome was estimated using linear mixed models. RESULTS Overall, 99 residents participated in the intervention arm and 143 in the comparison arm. At baseline, the mean resident age was 86 years, 74% were female, and medications were taken an average of 4 times daily. Medication simplification was possible for 62 (65%) residents in the intervention arm, with 57 (62%) of 92 simplification recommendations implemented at follow-up. The mean number of administration times at follow-up was reduced in the intervention arm in comparison to usual care (-0.36, 95% confidence interval -0.63 to -0.09, P = .01). No significant changes in secondary outcomes or harms were observed. CONCLUSIONS AND IMPLICATIONS One-off application of a structured tool to reduce regimen complexity is a low-risk intervention to reduce the burden of medication administration in RACFs and may enable staff to shift time to other resident care activities.

中文翻译：

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减轻复杂用药方案的负担：简化长期护理居民处方药 (SIMPLER) 集群随机对照试验

目的 评估结构化流程的应用，以整合老年护理机构居民的用药次数。设计 一项非盲法、配对、整群随机对照试验。地点和参与者 从 8 个南澳大利亚住宅老年护理机构 (RACF) 招募的会说英语并服用至少 1 种常规药物的永久居民。方法 干预涉及临床药剂师应用经过验证的 5 步工具来确定降低药物复杂性的机会（例如，通过同时给药或通过使用长效或组合制剂）。对照组的居民接受常规护理。4 个月随访的主要结果是定期绘制的药物每天的给药次数。居民满意度和生活质量是次要结果。危害包括跌倒、用药事故、住院和死亡。使用线性混合模型估计干预和主要结果之间的关联。结果 总体而言，99 名居民参加了干预组，143 名居民参加了比较组。在基线时，平均住院年龄为 86 岁，74% 为女性，平均每天服用 4 次药物。干预组 62 (65%) 名居民可以简化药物治疗，92 项简化建议中有 57 项 (62%) 在随访时实施。与常规护理相比，干预组的平均随访给药次数减少（-0.36，95% 置信区间 -0.63 至 -0.09，P = .01）。没有观察到次要结果或危害的显着变化。结论和意义 一次性应用结构化工具来降低治疗方案的复杂性是一种低风险的干预措施，可减轻 RACF 中药物管理的负担，并可能使工作人员能够将时间转移到其他住院医师护理活动上。