Learning Objectives
At the completion of this module, participants will:- Have knowledge of how a home medicines review can prevent unnecessary hospitalisation
- Understand the reasons for poor compliance
Home Medicines Review (HMR)Overview
Home Medicines Review (HMR) was introduced to prevent medication related morbidity and mortality. The Division is actively involved in the delivery of the HMR Program (also known as Domiciliary Medication Management Review) in partnership with the Pharmacy Guild of Australia, to optimise the quality use of medicines and consumer understanding.
HMR Information
Medication related problems cause many unnecessary hospital admissions and deaths in Australia every year. Each year 140,000 hospital admissions and 4,000,000 visits to GPs are medication related. 70% of these are thought to be preventable.
HMR provides an opportunity for patients living in the community to benefit from a team approach to their care. Through improving understanding and compliance, a medication review can optimise the patient's benefit from their medication regimen and reduce the risk of medication mishaps.
Patients most likely to benefit from HMR are:
- patients at risk of medication related problems because of their co-morbidities, age or social circumstances
- the characteristics of their medicines (e.g. Warfarin)
- the complexity of their medication treatment regimen
- patients recently discharged from hospital or patients discharged from hospital with multiple medicines or changes in therapy
- suspected non-compliance or difficulties managing medication related therapeutic devices
- patients on multiple medications
There is no age limit or barrier to HMRs, and in fact HMRs are not restricted to adult patients, for example children taking multiple medications can also benefit from a HMR.
Home Medicines Review involves a GP consultation - to generate a referral to the patient's chosen Community Pharmacy. The Pharmacy will either have an Accredited Pharmacist on staff or access to one who will contact the patient to arrange an interview (preferably in the patient's home). A comprehensive and up-to-date written report containing information about all medicines, complimentary products, devices and other prescriptions being used by the patient at home is provided back to the referring GP.
General Practitioners
GPs are encouraged to participate in the Home Medicines Review program designed to improve the quality use of medicines by patients in the community. Click here to review the GP HMR flowchart.
The process consists of two consultations for the GP and patient. The first consultation involves the identification of a patient with potential to benefit from a HMR, and generates a referral to the patients choice of pharmacy. The Accredited Pharmacist and GP discuss the clinical report, where appropriate. The second consultation to the GP takes place upon receipt of the pharmacist report of the visit to the patients home where an assessment has been made on the patient's medications and medication regimen. During this consultation the GP and the patient can discuss the findings and implement any action, including review of a Medication Management Plan. A copy of the plan is offered to the patient.
GPs can access the Pharmacy Guild links below to obtain up to date information and resources to assist in the HMR process.
Practice Staff
Practice staff can play a vital role in the identification of patients for the HMR program. Practice staff can identify which patients would benefit from a HMR and be able to assist the GP in the HMR process. Click on the links below for more information on the role of practice staff. Your Division facilitator is able to visit your practice and help in the training and understanding of HMR.
Information for Practice Staff
Incentive payment informationNational Prescribing Service (NPS)Overview
The NPS is aimed at General Practitioners but Practice Nurses are welcome to participate in self directed medication research. The National Prescribing Service provides independent evidence-based information, services and resources to health professionals and the community on Quality Use of Medicines (QUM). NPS aims to provide quality communications in the prescribing process that is independent of the government and the pharmaceutical industry. NPS in a non-profit organisation funded by the Department of Health and Ageing.
Quick quiz:
Write a short response to the question in the provided answer sheet.1. Which cohort of patients in your practice may be eligible for and benefit from a Home Medication Review (HMR)?