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@items = ( { item_key         => '1',
             item_description => 'description 1',
...
           },
           ...
         );

my $items_sth   = $dbh->prepare('SELECT * FROM Items');
my $actions_sth = $dbh->prepare('SELECT * FROM Actions WHERE item_key 
+= ?');
...

   push @items, $item;
}

my @items;
my $last_key;
...
      summary => $row->{action_summary},
   };
}

my %items;
my @items;
...
      summary => $row->{action_summary},
   };
}