What is a HMR?

Home Medication Review or Home Medicines Review (HMR) is a program funded by the Australian Government Department of Health & Ageing under the 5^th Community Pharmacy Agreement

 

A HMR involves the patient, their general practitioner, an accredited pharmacist and regular community pharmacy. In some cases other relevant members of the healthcare team, such as nurses in community practice or carers, are included.

Accredited Pharmacists are qualified to undertake medication management review.  This involves visiting patients at their homes, reviewing their medicine routines & providing their GP with a detailed report.

The HMR program aims to increase quality use of medicines and reduce adverse medicine events by conducting a comprehensive review of a patient’s medicine in the patient’s home.

The objective of a HMR is to:

• achieve safe, effective and appropriate use of medicines by detecting and addressing medicine related problems that interfere with desired patient outcomes
•  improve the patient's quality of life and health outcomes using a best practice approach, that involves cooperation between the GP, accredited pharmacist, other relevant health professionals
• improve the patient's knowledge and understanding of medicine
• facilitate cooperative working relationships between a patient’s health professionals to improve their health and wellbeing
• provide medicine information to the patient and other health professionals involved in the patient’s care.

If a HMR cannot be conducted in the home the accredited pharmacist must get prior approval from the Department of Health and Ageing (DoHA) before the review takes place.

The GP may refer directly to an accredited pharmacist, or the patient’s preferred community pharmacy.

Benefits of HMRs include:

• reduce the risk of ploypharmacy
• improve patient awareness of their medicines
• provide a better understanding of patient medication and lifestyle issues
• assist to determine if a patient is seeing other health care professionals and acquiring medicine for other sources
• ensure patient continuity of care
• fulfills medico legal requirements (WorkCover)

A GP determines if a patient is eligible for a HMR.  Eligibility includes:

• takes more than 12 doses of medicine per day
• have difficulty managing their own meds because of illiteracy or language barriers or impaired sight 
• attend a number of different doctors, both GPs and specialists
• have been discharged from hospital in the previous four weeks
• have had a significant change to their medication regimen in the past three months
• have experienced a change in their medical condition or abilities – e.g. falls, cognition, physical function
• use prescription medicine with a narrow therapeutic index or medicine that needs therapeutic monitoring
• have symptoms of an adverse drug reaction
• have a sub-therapeutic response to therapy
• have problems managing medication devices, e.g. does administration aids, or
• are at risk or can’t manage their own medicine due to changes in dexterity, confusion or impaired vision.
  

Cost of HMRs:

There is no cost to the patient.

Accredited pharmacists are reimbursed by Medicare.

GPs are able to claim $151.75 for a fully completed MBS Item 900. 

As an example of revenue growth over a 12 month period, just five HMR referrals per week will generate around $40,000 in additional income for the referring GP.

 

Confidentiality:

All information relating to a HMR is confidential. Information from the patient’s record can only be given to the accredited pharmacist conducting the review, with the patient’s consent. Input from each person involved in the review process is documented in the review report, as well as the recommendations and management plan.