Home Medicines Reviews
‘Know your patients, Know their medicines’
A Home Medicines Review is a collaborative, patient focused service designed to reduce the risk of medication-related problems. For GPs it provides comprehensive, up-to-date information about all the medicines, complementary products, devices and other prescriptions being used by patients at home. For patients it provides education and assistance with medications/ aids/ devices to help people get the best out of their medicines, and avoid medicine-related problems.
The Division supports the provision of HMRs for patients by working with practices to develop systems for conducting HMRs, facilitating links with pharmacies and providing consumer education and resources. Implementation of a practice nurse- led system can be a great way to streamline the provision of HMRs, and provide a proactive, systematic approach to providing this service.
Who is eligible for an HMR?
A HMR is available once in each 12 month period, except where there has been a significant change in the patient's condition or medication regimen requiring a new HMR. HMR is only available for patients living in the community and not for residents of Residential Aged Care Facilities.
What are good reasons for a HMR?
· Currently taking 5 or more regular medications
· Taking more than 12 doses of medication per day
· Significant changes made to medication treatment regimen in the last 3 months
· Medication with a narrow therapeutic index or medications requiring therapeutic monitoring
· Symptoms suggestive of an adverse drug reaction
· Sub-optimal response to treatment with medicines
· Suspected non-compliance or inability to manage medication related therapeutic devices
· Patients having difficulty managing their own medicines because of literacy or language difficulties, dexterity problems or impaired sight, confusion/dementia or other cognitive difficulties
· Patients attending a number of different doctors, both general practitioners and specialists
· Recent discharge from a facility / hospital (in the last 4 weeks)
*These are not strict criteria – a HMR can be done on an annual basis provided there is a clinical need.
The HMR Process
First consultation
- Patient is identified for HMR and gives consent
- Generate referral and send to patient’s preferred community pharmacy (patient can deliver form if appropriate)
- Pharmacist conducts home visit and prepares report for GP
- GP and pharmacist discuss report either by phone or email
- The GPs uses the information from the pharmacist report to draft a medication management plan.
Second (final) consultation
- The patient is recalled to discuss the plan
- Pharmacist and patient are provided with a copy of the plan
- Charge MBS Item 900 after final visit ($140.20 as of November 2008)
For assistance in coordinating Home Medicines Reviews, or for resources for your practice and patients, please contact Alice Windle.