HMR – Home Medication Review
The Home Medication Review (HMR) is a consumer-focused, structured and collaborative service offered to consumers living at home in the community. The goal of HMR, as a consumer focussed service, is to maximise an individual consumer's benefit from their medication regimen, and prevent medication-related problems. It involves a team approach, with the consumer, their general practitioner, their pharmacy, and other relevant members of the health care team in a comprehensive review of medications in the home setting.
How often - Who qualifies - Required criteria - The process of completion - Accredited Pharmacists - HMR templates - Subsidised dose Administration Aids (Veteran Affairs Clients)
How often can a HMR be conducted?
A patient may have a HMR once every twelve months or sooner if there has been a significant change in the patient's condition or medication regimen and the general practitioner decides that a new HMR is warranted.
Who can have a HMR?
People living in the community setting who meet the criteria for a HMR. The review is not available for in-patients of a hospital, day hospital facility, or care recipients in residential aged care facilities.
What are the criteria for a HMR?
The patient's regular general practitioner must assess that a review is clinically necessary to ensure quality use of medicines or to address the needs of patients living at homeExamples of risk factors known to predispose people to medication related adverse events are:
- 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;
- patient's having difficulty managing their own medicines because of literacy or language difficulties, dexterity problems or impaired sight, confusion or dementia or other cognitive difficulties;
- patients attending a number of different doctors, both general practitioners and specialists; and
- recent discharge from a facility or hospital (in the last four weeks).
What is the process for completion of a HMR?
General practitioners will refer patients who need a HMR to their patient's preferred community pharmacy which coordinates the pharmacy component of the HMR service. Accredited Pharmacists The referral will contain relevant medical information including information about the patient's medications. An accredited pharmacist employed by an approved community pharmacy is always responsible for producing the HMR clinical assessment of information and the resulting recommendations and report. The community pharmacist coordinating the service will either be an accredited pharmacist themself, or otherwise employ or contract an accredited pharmacist.The community pharmacy coordinates the HMR, letting the general practitioner know the arrangements for the HMR and the contact details of the accredited pharmacist. The pharmacist conducts the HMR including an examination of all the patient's medications and related devices. The pharmacist also identifies any issues the patient may have with their medications, for example, compliance, storage and administration techniques. They write a report that includes their findings and recommendations. The reviewing pharmacist will then discuss the report either face-to-face or by phone, with the general practitioner, who decides on a course of action. The general practitioner arranges a consultation with the patient to discuss the results and develop a written medication plan for agreement with the patient. The process of completion of a HMR.
- Assessment by general practitioner of clinical need for service from a quality use of medicines perspective with the patient as the focus and formal initiation of HMR if appropriate
- Informed consent obtained by the general practitioner during consultation
- Referral by general practitioner to patient's preferred community pharmacy
- Community pharmacy coordinates service delivery on receipt of referral and notifies the general practitioner of details of the service provider
- The preferred venue and time for medication review are arranged with consumer
- Appropriately accredited pharmacist conducts HMR
- Review of information by appropriately accredited pharmacist and development of suggested management strategies
- Preparation of report by appropriately accredited pharmacist
- Report provided to and discussed with general practitioner and community pharmacist
- Medication management plan agreed between patient and general practitioner
- Implementation of agreed actions with appropriate follow up and monitoring
Subsidised Dose Administration Aids - All veterans patients are able to have weekly dose administration aids (Websterpak) prepared by their community pharmacy and paid for by the DVA as long as this has been recommended as part of the HMR. The Residential Medication Management Reviews (RMMR) is a mirror service provided to Commonwealth funded residents of Aged Care facilities.
Links and Resources
| Pharmacy Guild Australia |
| < Prev | Next > |
|---|