Services & Programs

Home Medicines Review (HMR)

Overview

Home Medicines Reviews (HMRs) formerly known as Domiciliary Medication Management Reviews (DMMRs), are a way for General Practitioners and Pharmacists to help patients manage their medications at home.

Objectives

The aim of a HMR is to achieve safe, effective and appropriate use of medicines by solving or avoiding medication related problems that interfere with desired patient outcomes

Program Detail

The Home Medicines Review program was established as a result of earlier Australian studies which showed that a collaborative effort between a patient's GP and their pharmacist, including a pharmacist review of medications in the home and a medication management plan, would improve patient's management of their medicines.

A medication review is much more than simply a check for drug interactions. HMRs provide the opportunity to;

• Educate the patient about their medication,
• Assess the need for administration assistance (eg. nebulisers, blood glucose meters, dose administration aids) and
• Critically important improve compliance and concordance.

As the review is conducted in the patient's home appropriate storage, out-of-date medicines, medicines prescribed by specialists or hospitals and over the counter and complementary medicines can also be reviewed.

Steps in the HMR Process

• The patient’s regular GP identifies a patient at risk or suffering from medication related complications or injury.
• The GP explains the HMR process to the patient, and receives consent for conducting a HMR. 
  Download a Patient Information Brochure
• The GP uses the GP Referral Form, to refer an eligible patient to their preferred community pharmacy. Referral letter templates can be found in most common practice management software such as Medical Director, and provide a simple method for listing all your patient’s relevant medications and details. 
  Download a manual generic referral form
• This referral letter can then be faxed to the preferred community pharmacy, or given to the patient for deliver to the pharmacy. 
• The community pharmacy organises for a pharmacist to conduct the HMR in the patient's home. 
• The accredited pharmacist identifies and assesses the patient's medication management issues and writes a report for the GP.
• Following discussion with the pharmacist the GP generates a Medication Management Plan. Templates for this plan can be found in most common practice management software such as Medical Director. 
  Download a generic Medication Management Plan
• The GP discusses the Medication Management Plan with the patient, and instigates any changes. 
• The GP faxes a copy of the final plan to the pharmacy.
  

  The GP Easy HMR Flow Chart is a step-by-step guide to help you through the process.

Which patients can receive a Home Medicine Review?

Anyone living in their own home can have a Home Medicines Review if the General Practitioner thinks their condition or the medicines they are taking make a review worthwhile. Some situations are more likely to put patients at risk of medicine-related problems, such as:

•  Taking five or more regular medicines or taking more than 12 doses of medicine per day
• Recent significant changes to a patients medication routine in the last 3 months
• Attending a number of different doctors, both GP’s and specialists
• Recent discharge from hospital
• Medications with a narrow therapeutic window  or requiring regular monitoring
• Symptoms suggestive of an adverse drug reaction
• Suboptimal response to a treatment with medicine
• Patients having difficulty managing their medications because of literacy, confusion, impaired sight or cognitive problems
  

MBS Item Number 900