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Why Pharmika Consulting?

Pharmika Consulting has been providing Home Medication Review services for over 5 years.
 
With regular dialogue over the journey, strong relationships with General Practitioners have developed. 
 
These relationships have become the foundation of our unique understanding and appreciation of General Practice Profession.
 
With this in mind, we have developed a series of protocols and strategies that can make integrating Home Medication Reviews into your daily practice seem effortless.  
 
Some key components of our streamlined process that are available include;
  • Assistance with screening and identification of eligible patients using software programs and your existing practice staff
  • Utilising encrypted paperless communication systems
  • A style of reporting that will be tailored to your individual expectations and will make formulation of your Management Plan simple and efficient
  • A recall system
 
 
 

Benefits of a Home Medication Review to the GP;

A more thorough understanding of your patients circumstances
The HMR report is a concise synopsis of up-to-date information about the medicines, complementary products, over-the-counter medicines, devices and other prescriptions being used by  your patient. 
 
Often, this kind of information is not easily obtainable from the confines of your consulting room or the time constraints of a standard consultation.
 
The coupling of information presented in the HMR report with your existing data will provide you with a more holistic grasp of your patient and leave you better equipped to make considered decisions about their health.
 
Medico-Legal safeguard
Just by engaging a consultant pharmacist to review your patients medications you are demonstrating an attentive approach to your patient's health.
 
Issues detected by a consultant pharmacist can sometimes help avert potentially serious consequences. In a majority of situations, where this is not that case, you will still have a document, in your possession, that verifies and reinforces your prescribing choices.
 
Financial
GPs that are able to successfully integrate streamlined HMR processes into their daily practice are able to derive a very healthy supplementary income stream.
 
 
 
 

The HMR process

 
What is a Home Medication Review (Medicare Item 900)
A Home Medicines Review is a consumer-focused collaborative service used to assist the quality use of medicines.  
 
The process involves an initial GP consultation to generate the referral, a pharmacist interview with the patient (preferably in the patient's home), a clinical assessment by the pharmacist and a written report back to the GP. 
 
nullWhich patients are eligible
The eligibility criteria for a Home Medication Review is broad and encompasses effectively all patients at risk of medication misadventure.
 
Some examples include patients that;
  • are currently taking 5 or more regular medications;
  • are taking more than 12 doses of medication per day;
  • have had significant changes made to medication treatment regimen in the last 3 months;
  • are taking medication with a narrow therapeutic index or medications requiring therapeutic monitoring;
  • are experiencing symptoms suggestive of an adverse drug reaction;
  • have had a sub-optimal response to treatment with medicines;
  • are suspected of non-compliance or inability to manage medication related therapeutic devices;
  • are having difficulty managing their own medicines because of literacy or language difficulties, dexterity problems or impaired sight, confusion/dementia or other cognitive difficulties;
  • are attending a number of different doctors, both general practitioners and specialists; and have recently been discharged from a facility / hospital (in the last 4 weeks).
 
  1. Step 1: Identify eligible patient
  • A HMR can be suggested by any member of the healthcare team of by an associate of the patient or even by the patient themselves
  • Authority to initiate the process however is that of the patients GP only. 
  • A GP must review the case and be satisfied that it is indeed indicated.
 
  1. Discuss the HMR with the patient
  • Inform the patient about the process and obtain patient consent to proceed with the item number.
 
  1. Prepare a referral
  • Can be done automatically with most Prescriber Software programs
 
  1. Send the referral to the pharmacist and save it in patient history
  • Under the current model, this referral is to be forwarded to the Community Pharmacy that your patient nominates
  • Changes proposed in the Firth Community Pharmacy Agreement may allow GP discretion and the forwarding of the referral directly to a Consultant Pharmacist. Information about this will be posted here as it becomes available.
 
  1. Once the DMMR has been performed, you will receive a HMR report from the pharmacist.
 
  1. Discuss any issues arising from the HMR with the patient
  • Once the HMR report has been received, the patient can be called for a follow up visit.
  • At this visit issues arising from the HMR should be discussed. Any changes that are to be made as a result of the HMR can be recorded in a HMR plan (a copy of the plan can be accessed through Prescriber software programs)
 
  1. Mark patient history for a reminder prompt once 12 months has elapsed
  • Patients are eligible for a HMR every 12 months
 
  1. Claim Item 900
  • Item 900: $143.40
 
 
What is the consultant pharmacists role?
 
Once a GP referral for a HMR is received, the consultant pharmacist will organise a time to visit the patient in their home, to conduct an interview. 
The interview has 3 main objectives:
  1. Asses;
  • Patient understanding. How is the patient coping with their medication regimen? Are the necessary lifestyle adjustments associated with their ailments understood and being adhered to?  eg diet in the case of Diabetes.
  • Patient compliance. Which medications are physically on hand? What is the patient's attitude towards their medications? Do any barriers exist which may be jeopardising  optimal compliance (eg the existence of adverse drug reactions or misconceptions)
  1. Educate:
  • Each medication is thoroughly discussed with the patient, its indication, intended dosing regimen, common adverse effects etc (The patient may also be provided with pamphlets/ information sheets about their illnesses).
  • During the interview, the patient is given a unique opportunity to ask questions in the comfort and privacy of their own home.      
  1. Investigate;
  • The patient may be acquiring and/or using additional medications that you may be unaware of; medications prescribed by another GP or specialist, or obtained without a prescription from a pharmacy, a health food shop, a supermarket or even from a friend?
 
At the completion of the patient interview, a report will be prepared, containing a summary of relevant information obtained from the interview.
 
The report may also contain some recommendations on how the current regimen may be modified or some pathology testing which may be applicable.
 
 
Engaging pharmika consulting to conduct the HMR

HMR referrals can be forwarded to pharmika consulting by;
 
Mail: PO BOX 227 Moonee Ponds VIC 3039
Fax: 03 9375 7655
Email: referrals@pharmika.com.au
Argus PKI encrypted Email: medicationreviews@pharmika.com.au

 

Presentations & Articles composed by Pharmika Consulting

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