Home medicines review (Australia)

Figure 1: The Home Medicine Review process

Pharmacists usually assist the patient with reviewing the medication needed. Credit: Bill Branson (Photographer)

Home Medicines Review (HMR) is a service provided in Australia aimed at enhancing the safe, effective, and appropriate use of medicines by individuals in their own homes. Through a collaborative approach, it involves the patient, their general practitioner (GP), and a pharmacist to ensure that all medications are being used optimally to achieve the best possible health outcomes.

Overview

The HMR process is initiated by a GP who identifies patients who could benefit from a review of their medications. This is particularly important for patients who are taking multiple medications, have recently changed their medication regimen, have been recently discharged from a hospital, or have conditions that could be influenced by their current medication management. The GP then refers the patient to an accredited pharmacist who conducts a comprehensive review of all the patient's medicines, including prescription drugs, over-the-counter medications, and herbal supplements.

Process

1. Referral: The process begins with a referral made by the patient's GP to an accredited pharmacist. This referral is based on the GP's assessment of the patient's need for a medication review.
2. Interview: The pharmacist schedules a visit to the patient's home to discuss their medication regimen. This allows the pharmacist to assess how the patient is managing their medicines and to identify any issues such as difficulties with adherence, side effects, or drug interactions.
3. Report: After the home visit, the pharmacist prepares a comprehensive report detailing their findings and recommendations for optimizing the patient's medication regimen. This report is then sent back to the referring GP.
4. Follow-up: The GP reviews the pharmacist's recommendations and discusses these with the patient. Together, they agree on a medication management plan. The GP may make changes to the patient's medications based on the pharmacist's recommendations.

Benefits

The HMR program offers several benefits, including:

• Improved patient understanding of their medications, leading to better adherence and outcomes.
• Identification and resolution of potential drug interactions and side effects.
• Enhanced communication between the patient, GP, and pharmacist.
• Reduction in hospital admissions due to medication-related issues.

Eligibility

Patients are eligible for an HMR if they are at risk of medication-related problems. This includes patients with multiple medical conditions, those taking multiple medications, patients with recent significant changes to their medication regimen, individuals with language or literacy issues affecting their understanding of medication instructions, and patients who have been recently discharged from a hospital.

Funding

The HMR program is funded by the Australian Government through the Pharmaceutical Benefits Scheme (PBS), ensuring that the service is provided at no direct cost to eligible patients.

Challenges and Considerations

While the HMR program has been successful in improving medication management for many Australians, there are challenges in ensuring that all eligible patients can access the service. These include awareness among patients and healthcare providers, the availability of accredited pharmacists, and geographical limitations, especially in rural and remote areas.

Conclusion

The Home Medicines Review is a critical component of Australia's healthcare system, aiming to improve the quality of care for patients by ensuring their medications are used safely and effectively. By fostering collaboration between patients, GPs, and pharmacists, the HMR program addresses the complex needs of individuals with multiple health conditions and medications, ultimately contributing to better health outcomes and quality of life.