Home Medicines Review (HMR) Services

(also known as Domiciliary Medication Management Review (DMMR) services)


Overview of the Program

The Medication Management Review (MMR) Facilitator scheme was introduced into the Medical Benefits Scheme in October 2001 to increase the appropriate use of medications and improve patient health outcomes. The MMR Facilitator scheme is a Pharmacy Guild of Australia initiative, working in partnership with Health Workforce Queensland the Far North Queensland Rural Division of General Practice and is funded by the Australian Government Department of Health and Ageing. The Home Medication Review (HMR) is a consumer-focused, structured and collaborative health care service provided in the community setting, to optimise quality use of medicines and consumer understanding. The Goal of the HMR is to maximise an individual patient’s benefit from their medication regimen, accomplished through a team approach involving the GP and the patient’s preferred community pharmacy, with the patient as the central focus.

The Home Medication Review Process

  1. The need for an HMR is identified by a member of the health care team, consumer or patient's carer
  2. The general practitioner undertakes a consultation assessing the patient's clinical need from a quality use of medicines perspective
  3. During the consultation the GP obtains the patient's consent, documents this in the medical record and requests the patient nominate a community pharmacy to participate in the HMR
  4. The GP refers the consumer to their preferred community pharmacy providing relevant clinical information
  5. Community pharmacy co-ordinates delivery of the HMR service, arranging the venue and time for the HMR with the consumer and notifying the GP of the details
  6. An accredited pharmacist conducts the HMR and prepares a report
  7. The GP and reviewing pharmacist discuss the report and clinical findings and develop medication management strategies
  8. A second consultation with the consumer and GP is undertaken so the medication management plan can be discussed with the patient (and their carer where appropriate)
  9. The consumer and/or members of the health care team implement the plan with follow up and monitoring

Criteria for a Home Medication Review

The general practitioner is the key component of the HMR process and a referral from the GP is essential. The patient should meet one of the following criteria:

  • 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
  • Recent discharge from a facility or hospital (in the last four weeks)

Information for GP's

  • Anyone can request a referral.
  • It is the patient who chooses which community pharmacy to be referred to. This is a requirement for claiming the HMR item.
  • A registered pharmacist must conduct the HMR interview.
  • Referrals must be actioned within 2 weeks of receipt.
  • The interview is preferably conducted in the patient's home.
  • The registered pharmacist is involved in the post-interview discussion with the GP.
  • General practitioners must supply the patient and community pharmacy with a copy of the medication plan, even if there is no change in the medication regime.
  • There are monitoring and follow-up requirements of the community pharmacy.

Resources

General

GPs and Practice Staff

Consumers/Carers

If you have any further queries regarding the Medication Management Review program please contact Isabel Mazgay at the Division office on (07)40965046 or email eso@fnqrdgp.org.au.