Home Medicines Review (HMR)
Overview
Home Medicines Review (HMR) was introduced to prevent medication related morbidity and mortality. CWDGP 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. Annually 140,000 hospital admissions and 400,000 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 a 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 recieving a HMR, for example, children taking multiple medications can also benefit.
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 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 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. The process consists of two consultations for the GP and patient.
- The first consultation involves the identification of a patient with the potential to benefit from a HMR. A referral is generated for the patient's chosen community pharmacy then faxed or given to the patient to deliver. The Accredited Pharmacist and GP discuss the clinical report where appropriate.
- The second consultation to the GP takes place upon receipt of the pharmacist's report of the visit to the patient's 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. Item 900 is claimed at this consultation, current benefit $140.20
To view the easy to follow GP HMR flowchart follow this link.
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
Pharmacists
Pharmacies must be registered with Medicare Australia in order to provide this service to their patients and to receive remuneration. Medicare Australia will direct debit the nominated account monthly. As of 1 July 2009 the Pharmacy Fee for HMR is $190.64
A once only payment of $1500.00 is available to pharmacists who have received their accreditation. A second payment of $750 is an annual payment that is available to accredited pharmacists on renewal of a valid accreditation. An accredited pharmacist can only claim the second payment once per 12 month period.
HMR information for Pharmacies
Accredited Pharmacists in Central West (List)
Stage 1 Medication Review Accreditation Workshop for Pharmacists
The Division will be holding a Stage 1 workshop on the weekend of 20th and 21st March 2010. The workshop will be held in the Division Board Room at 265 Durham Street Bathurst. Please complete the registration form to ensure your position at the workshop.Consumers
The Dangers of Mixing Medicines
The CHOICE website has an article on the risk of adverse events from medicines which may result in hospitalisation. The article explains what can happen to the older patient on medicines for various disease states. Please follow the link to read more.
HMR Education
HMR Case Study Modules provide an opportunity for general practitioners and pharmacists to work together in a collaborative environment. The structured case studies have a clinical focus and are built around HMR. They are interactive and provide opportunity for discussion, interview role play and HMR Plan report writing. The Division offers HMR Case Study modules on a variety of topics.
In the 2008-2010 Triennium, the HMR Case Studies have been allocated as an Active Learning Module with 40 CAT-1 points if GPs attend 3 modules and complete:
- Predisposing activity: HMR Referral, Item 900 Checklist and Evidence
- Attendance at Case Study, interactive with discussion, role play, written HMR Plan and evaluation
- Reinforcing Activity: Start 2 HMRs and send copies to MMR Facilitator
If GPs attend less than 3 modules they will be awarded Cat-2 points
Pharmacists will be allocated 6 CPD points for each 2 hour case study, provided the pre-case study quiz, assessment quiz and evaluation are completed and given to the facilitator.
The case studies can also be used to provide peer support for all pharmacists, as well as those pharmacists becoming accredited.