Why do HMRs?
The benefits of HMR for you and your patients
The prevalence of polypharmacy (defined as five or more medications taken in 24 hours) identified in a survey published in the MJA (MJA 2012; 196: 50-53) found that 66% of participants aged 75 years and older were taking five or more medications. Another study also associated polypharmacy with an increased risk of adverse drug reactions requiring medical attention compared with those seniors only taking one or two medications. Every year more than 200,000 Australians are admitted to hospital due to medication related problems. At least half of these admissions could be avoided with better medication management.
Apart from a profitable revenue stream, there is overwhelming evidence that Home Medicines Review (HMR) can improve a patient's knowledge, skills and confidence in using medicines. It is a simple and effective tool to identify, manage and resolve medication-related problems, improving health outcomes and increasing the willingness of a patient to discuss their medicines with their GP. It also helps make your patients feel valued and cared for and more in control of their medications.
Home medication reviews (HMR) can be of significant benefit considering patient medication compliance rates are reported to be as low as 50-60%. This is compounded by factors such as dementia, vision or hearing problems and those with multiple chronic health problems.
Identification of eligible patients for HMR
Potentially any patient with chronic disease taking multiple medications may be eligible and are likely to benefit from a Home Medicines Review.
The patient eligibility criteria are reproduced here from the Medicare Benefits Schedule:
Patient eligibility
The item is available to people living in the community who meet the criteria for a DMMR. The item is not available for in-patients of a hospital, or care recipients in residential aged care facilities.
DMMRs are targeted at patients who are likely to benefit from such a review: patients for whom quality use of medicines may be an issue or; patients who are at risk of medication misadventure because of factors such as their co-morbidities, age or social circumstances, the characteristics of their medicines, the complexity of their medication treatment regimen, or a lack of knowledge and skills to use medicines to their best effect.
Examples of risk factors known to predispose people to medication related adverse events are:
- currently taking five or more regular medications;
- taking more than 12 doses of medication per day;
- significant changes made to medication treatment regimen in the last three 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;
- patients having difficulty managing their own medicines because of literacy or language difficulties, dexterity problems or impaired sight, confusion/dementia or other cognitive difficulties;
- patients attending a number of different doctors, both general practitioners and specialists; and
- recent discharge from a facility / hospital (in the last four weeks).”
If you are ready to incorporate Home Medicines Reviews (HMR)
in your practice or clinic click here.
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