In Australia, an estimated 140,000 people are admitted to hospitals each year because of medication-related problems. More than two-thirds of these problems are avoidable. In addition, an unknown — but probably much larger — number of people have medication-related problems that do not require hospitalisation. Having a Home Medicines Review is one way to avoid becoming one of these statistics.

Home Medicines Reviews (HMRs) are comprehensive reviews of all your medicines, including any non-prescription medicines bought at pharmacies, supermarkets and health-food shops. They are conducted by a specially trained pharmacist, usually in your own home. Although your GP and specialists may review your medicines periodically, it is often beneficial for a pharmacist to come in and have a fresh look at them and talk to you about how you’re managing them.

HMRs were introduced two years ago, but already over 40,000 people have benefited from them.

What’s involved in an HMR?

An HMR involves your GP and a community pharmacist of your choice. Your GP sets up the review by writing a referral to the pharmacist.

An accredited pharmacist will do the review in your own home at a mutually agreed time. If you do not want to be interviewed at home, the HMR can be done elsewhere, but it is best done at home. Family or friends can be present if you wish.

The pharmacist will ask you to find all your medicines. They will then check them, ask a few questions, and talk to you about them. You will be encouraged to ask any questions you may have. As part of this process, they may:

• explain why, when and how to take your medicines
• show you how to use your medicines correctly
• explain where your medicines should be stored
• check that your medication equipment, e.g. asthma puffer, is in good working order and is being used correctly
• help you make a list of all your medicines.

A pharmacist conducting a Home Medicines Review. 

The pharmacist will then write a report for your GP. The report will note any problems you are experiencing and suggest solutions. The solutions may involve:

• giving you more information about your medicines: what they are for, what to expect when taking them, and what problems you should report to the GP
• giving you some help so you can remember to take your medicines, e.g. recommending a Webster pack (see Need Help Keeping Track? in the November 2002 MedicinesTalk)
• changing your medicines.

Benefits of HMRs

HMRs have helped many consumers better understand and manage their health problems. In particular, they have taught them why and how to use their medicines. After having an HMR, many consumers feel more confident about managing their medicines because they know what ‘problems’ to expect, and which ones to report to their GP.

Some consumers have found that having an HMR solved some of the problems they were experiencing with their medicines. One real-life example was a woman who had been prescribed a strong, sustained-release (long-acting) painkiller twice daily. The pharmacist doing the HMR discovered the woman was crushing the tablets because they were ‘too big to swallow whole’. As a result, she was unwittingly destroying the coating that made them long-acting tablets. This meant that instead of having steady pain-relief for about 12 hours, the pain-relief lasted for only 4 – 6 hours, leaving her with no relief for the remaining 6 – 8 hours until she took the next tablet. The high dose in the first few hours also increased her chances of having side effects. When the pharmacist told the GP about the problem in her report, the GP solved it by prescribing a tablet that was easier to swallow.

HMRs are conducted by a specially trained pharmacist, usually in your own home.

Who should have an HMR?

HMRs are particularly useful for people who:

• take more than five medicines a day
• have recently spent time in hospital
• are concerned about their medicines
• are confused about their medicines
• do not always remember to take their medicines.

Older people are particularly susceptible to developing medication-related problems because they are more likely to have several medical conditions and therefore be taking several medicines. Taking multiple medicines greatly increases the chances of developing medicationrelated problems because of interactions between the medicines. In addition, people metabolise medicines less effectively when they age, which increases their chances of developing medication related problems.

Organising an HMR

If you (or someone you care for) might benefit from having an HMR, talk to your GP or pharmacist about organising one.

HMRs are available in all states and territories. The pharmacist’s review and report is paid for by the Australian Government so it will not cost you anything. Your GP may bulk-bill or charge you for the GP consultations.

More information

Each state has its own Medication Management Review Facilitator who can give you and your group information about HMRs, and put you in touch with the relevant HMR people in your area.

A brochure about HMRs is available in English, Arabic, Chinese, Croatian, Dutch, German, Greek, Hungarian, Italian, Korean, Macedonian, Maltese, Polish, Russian, Serbian, Spanish, Turkish, Ukrainian  and Vietnamese. Copies of the English-language brochure are available from the state Medication Management Review Facilitators.

Copies of the non-English language brochures can be downloaded from www.guild.org.au.

State Medication Management Review Co-ordinators