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Trial registered on ANZCTR
Registration number
ACTRN12624000827538
Ethics application status
Approved
Date submitted
4/06/2024
Date registered
4/07/2024
Date last updated
4/07/2024
Date data sharing statement initially provided
4/07/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
On-site Pharmacist Implementation Trial In Residential Aged Care Homes in Urban, Regional, Rural and Remote (OPTIMISER3) Australia
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Scientific title
On-site Pharmacist Implementation Trial In Residential Aged Care Homes in Urban, Regional, Rural and Remote (OPTIMISER3) Australia
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Secondary ID [1]
311947
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Nil known
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Universal Trial Number (UTN)
U1111-1306-8406
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Trial acronym
OPTIMISER3
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Public Health
333544
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Condition category
Condition code
Public Health
330222
330222
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0
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Health service research
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Integrating of on-site pharmacists in residential aged care facilities to improve the quality use of medicine and reduce hospitalisations of residential aged care residents. The intervention is the integration of the role of Pharmacist as a position on the aged care facility staff. The position description of the pharmacist is based on the previous Australian Capital Territory trial - Pharmacists in Residential Aged Care Facilities (PiRACF) Study ACTRN12620000430932: https://www.chnact.org.au/for-health-professionals/pharmacists-in-residential-aged-care-facilities-study/). A pharmacist will be employed either by the aged care home, community pharmacy or PHN for a period of 12 months. The On-site pharmacist is being integrated into the staff and operations of the aged care facility.
Prior to the commencement of the on-site pharmacist role, aged care staff, pharmacists, community pharmacists, GPs and residents will participate in a co-design workshop to adapt and agree on the position description of the on-site pharmacist. At the end of the 12-month trial aged care staff, on-site pharmacists, community pharmacist, GP's, residents and family members/carers will participate in a focus group discussion. Transcripts of stakeholder co-design sessions and focus group transcripts will be collected and analyzed using deductive coding based on Mays et al 2022, Coding framework for NPT.
The co-designed position description adapted for regional, rural, remote and non-ACT urban sites developed by the participants forms the basis of the role during the intervention period.
During the 12-month intervention period the on-site Pharmacist will keep an on-line activity diary using Redcap. The on-site pharmacist online activity diary will record the activities undertaken within the aged care home as part of the on-site pharmacist role, for example undertaking medication reviews, providing training, participation in clinical governance activities etc.).
At the conclusion of the 12-month period, Quality indicator data from aged care facility information management systems collected during the 12-month trial of the on-site pharmacist intervention will be analyzed to determine the impact of the on-site pharmacist role. The on-site Pharmacists will follow agreed job description, participate in workshops/focus groups and keep the on-line activity diary.
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Intervention code [1]
328842
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Treatment: Other
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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A composite outcome of barriers and enablers to sustainable implementation of the on-site pharmacist in RACH model in regional, rural, remote, and non-ACT urban areas
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Assessment method [1]
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Interactive stakeholder workshops of group of between 5-10 participants held face to face or online with members of the research team, focus group discussion of between 5-10 participants held face to face or online with members of the research team.
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Timepoint [1]
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Interactive stakeholder workshop held pre-trial, On-site pharmacists will work in the role for 12 months and following the 12-month period stakeholders (i.e. aged care staff, on-site pharmacists, community pharmacy, GP, residents, family members/carers) will participate in a focus group.
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Secondary outcome [1]
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Mean anticholinergic burden score
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Assessment method [1]
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Residents’ medications will be screened to calculate the Anticholinergic Burden Score (ACB) for each resident. Mean ACB value of all residents will be calculated and recorded at baseline and endpoint.
Numerator: Total of anticholinergic score of the residents present on the collection date
Denominator: Total number of residents present on the collection date
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Timepoint [1]
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12 months' worth of medical record data extracted from the aged care facility post-trial. (ie after the on-site pharmacist has been working in the role for 12 months)
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Secondary outcome [2]
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Polypharmacy: number of residents with 9 or more than 9 medicines taken regularly,
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Assessment method [2]
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Numerator: Total of residents who are taking 9 or more than 9 medicines
Denominator: Total number of residents present at the facility on the collection date
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Timepoint [2]
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12 months' worth of medical record data extracted from the aged care facility post-trial. (ie after the on-site pharmacist has been working in the role for 12 months)
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Secondary outcome [3]
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Number of residents with at least one antimicrobial (using point-in-time snapshot),
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Assessment method [3]
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All resident in the RACHs will be screened to determine the number of antimicrobial prescriptions noted on their medication chart on the day of data collection. This is aligned by the Australian National Antibiotic Survey. Attempt will be made to synchronize the timing of the survey with all participating RACHs.
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Timepoint [3]
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12 months' worth of medical record data extracted from the aged care facility post-trial. (ie after the on-site pharmacist has been working in the role for 12 months)
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Secondary outcome [4]
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Number of residents taking at least one opioids or antipsychotics prescriptions (risk-adjusted for antipsychotics)
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Assessment method [4]
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Medication charts will be screened to count the number of opioids prescriptions are being used by the residents.
Numerator: Total of residents with a prescription of opioid.
Denominator: Total number of residents present on the collection date
Residents who were admitted in the hospital on the day of the assessment will be excluded from the study.
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Timepoint [4]
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12 months' worth of data extracted from the aged care facility post-trial. (ie after the on-site pharmacist has been working in the role for 12 months)
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Secondary outcome [5]
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Number of medication review per resident over 12 months,
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Assessment method [5]
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Number of medication reviews conducted per resident will be calculated using the data available in the online pharmacists’ diaries for over 12 months
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Timepoint [5]
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12 months' worth of data extracted from the aged care facility post-trial. (ie after the on-site pharmacist has been working in the role for 12 months)
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Secondary outcome [6]
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Number of education sessions provided by the OSP,
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Assessment method [6]
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Number of educational sessions conducted by the pharmacist in each facility throughout one year will be calculated using the data available in the online diary.
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Timepoint [6]
436776
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12 months' worth of data extracted from the aged care facility post-trial. (ie after the on-site pharmacist has been working in the role for 12 months)
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Secondary outcome [7]
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Number of quality improvement activities (including reviewing/updating policies
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Assessment method [7]
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Number of quality improvements activities conducted by the pharmacist in each facility throughout one year will be calculated using the data available in the online diary
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Timepoint [7]
436777
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12 months' worth of data extracted from the aged care facility post-trial. (ie after the on-site pharmacist has been working in the role for 12 months)
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Eligibility
Key inclusion criteria
Inclusion criteria for residential aged care homes:
- An accredited facility
- Located in a non-ACT area
- More than 20 beds and less than 150 beds
Inclusion criteria for residential aged care residents:
- Permanent resident in a facility that fits inclusion criteria
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
None
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
8/07/2024
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Actual
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Date of last participant enrolment
Anticipated
31/08/2024
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Actual
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Date of last data collection
Anticipated
31/12/2025
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Actual
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Sample size
Target
400
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,NT,QLD,SA,TAS,WA,VIC
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Funding & Sponsors
Funding source category [1]
316287
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Government body
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Name [1]
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Medical Research Future Fund - Department of Health and Aged Care
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Address [1]
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Country [1]
316287
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Australia
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Primary sponsor type
University
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Name
University of Canberra
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Address
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Country
Australia
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Secondary sponsor category [1]
318855
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None
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Name [1]
318855
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Address [1]
318855
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Country [1]
318855
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
315103
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University of Canberra Human Research Ethics Committee
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Ethics committee address [1]
315103
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http://www.canberra.edu.au/research/ucresearch/integrityandethics/human-ethics
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Ethics committee country [1]
315103
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Australia
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Date submitted for ethics approval [1]
315103
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27/03/2024
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Approval date [1]
315103
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08/04/2024
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Ethics approval number [1]
315103
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13769
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Summary
Brief summary
This study is evaluating the adaptations required to implement on-site pharmacists into residential aged care facilities (RACHs) in urban, regional, rural and remote areas. The study is seeking to understand what are the barriers and enablers that assist rural, regional and remote aged care homes to employ a pharmacist as part of the aged care home operations. The study will also assess the impact that having an on-site pharmacist with an aged care home has on aged care quality indicators.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Sam Kosari
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Address
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Health Research Insitute, 11 Kirinari St, Bruce ACT 2617
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Country
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Australia
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Phone
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+61 2 6201 2158
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Sam Kosari
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Address
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Health Research Insitute, 11 Kirinari St, Bruce ACT 2617
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Country
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Australia
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Phone
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+61 2 6201 2158
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Sam Kosari
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Address
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Health Research Insitute, 11 Kirinari St, Bruce ACT 2617
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Country
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Australia
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Phone
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+61 2 6201 2158
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Fax
133692
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Data is subject to privacy and third-party approval therefore is not being considered for sharing
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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