The Australian Model for Home Medicines Review

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• The Australian Model for Home Medicines Review
• Dr Tim Chen
• Faculty of Pharmacy
• timchen_at_pharm.usyd.edu.au

9th Commonwealth Pharmaceutical Association
Conference and MPS Pharmacy Scientific Conference
2007 1st-5th August 2007
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Overview

• Background Information Australia
• Medicine use in Australia
• National Medicines Policy
• Model for Home Medicines Review in Australia
• Selected studies
• Concluding comments
• Supplementary materials

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Introduction Some Key Statistics

• Australian Bureau of Statistics
• Population 20,502,720
• Number of Approved Pharmacies (June 2002)
• n 4,926
• Approximate Average population per pharmacy
• n 4150

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Key Statistics Ageing Population
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Scope of Medicine Use and Medication
IncidentsSafety and Quality Council. Second
National Report on Patient Safety. Improving
Medication Safety, July 2002

• About 200 million prescriptions dispensed per
  year by community pharmacy (780
  Rx/week/pharmacy)
• Top 10 Prescription Medicines Dispensed through
  Community Pharmacy

• Atorvastatin
• Simvastatin
• Salbutamol
• Celecoxib
• Frusemide

• Omeprazole
• Ranitidine
• Ramipril
• Amlodipine
• Ipratropium bromide

Statistics on Drug Use in Australia 2002
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Scope of Medicine Use and Medication
IncidentsSafety and Quality Council. Second
National Report on Patient Safety. Improving
Medication Safety, July 2002

• HOSPITAL 2-3 of all hospital admissions are
  medication related - 140,000 pa
• COMMUNITY 400,000/100 million GP consultations
  pa for ADEs (0.4 of all GP visits)
• Estimated cost AUD 380 million pa

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Australias National Medicines Policy

• Timely access to medicines
• Appropriate standards of medicines quality,
  safety, efficacy
• Quality use of medicines
• Responsible and viable medicines industry

www.health.gov.au
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Policy on Quality Use of Medicines (QUM)

• Judicious, appropriate, safe and efficacious use
  of medicines
• Medication Team doctors, pharmacists, nurses,
  consumers

www.health.gov.au/hbd/qum/overview.htm
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Home Medicines Review (HMR)

• HMR is a service designed to assist consumers
  living at home to maximise the benefit of their
  medication regimen and prevent medication related
  problems

Medicare Australia
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Objectives of HMR

1. Achieve safe, effective and appropriate use of
   medicines
2. Improve quality of life and health outcomes
3. Improve patients and health professionals
   knowledge and understanding about medicines
4. Facilitate cooperative working relationships
   between members of the health care team

Medicare Australia
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PHILOSOPHICAL SHIFTfrom Product to Patient
Product
Patient
Cognitive Service

• Supply
• role

QUM
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Australian Model for HMR
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Key Elements of HMR Intervention
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Interprofessional Collaboration inMedication
Review
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(No Transcript)
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Randomised Comparative Study
Chen, Bennett, Smith et al., 2000 http//www.guild
.org.au/public/dmmrfiles/report_stgeorge.pdf
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Key Stakeholders

• Research Team
• The University of Sydney
• Local Practitioners
• St George Canterbury Divisions of General
  Practice
• National Organisations
• Pharmaceutical Society of Australia
• Pharmacy Guild of Australia
• Royal Australian College of General Practitioners
• Australian Medical Association
• Consumer Health Forum
• Royal College of Nursing

Chen, Bennett, Smith et al., 2000 http//www.guild
.org.au/public/dmmrfiles/report_stgeorge.pdf
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Structure for Collaboration

• Organisational level -Top down
• International policy
• National policy
• Practice level Bottom up
• Local practice-based research
• Division of GP
• Local Government Area
• Guild Zone

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Impact on Use of Medicines
N362 cases
Chen, Bennett, Smith et al., 2000 http//www.guild
.org.au/public/dmmrfiles/report_stgeorge.pdf
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Impact on Use of Medications
Chen, Bennett, Smith et al., 2000 http//www.guild
.org.au/public/dmmrfiles/report_stgeorge.pdf
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Progress to DateHome Medicines Review
Quarterly Statistical Bulletin

• March Quarter 2007
• From www.guild.org.au

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Chart 3
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Chart 14
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Chart 6a
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• Summary

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Summary HMR Process
Referral from GP
Case conference with GP
Treatment goals clinical information
Comprehensive Medication Review
Patient Interview (in home)
Complete medication medical history
Chen, Bennett, Smith et al., 2000 http//www.guild
.org.au/public/dmmrfiles/report_stgeorge.pdf
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Summary Philosophical Shift From Product to
Patient
Product
Patient
Cognitive Service HMR

• Supply
• role

QUM
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Concluding Comments

• HMR has been successfully implemented in
  Australia
• Funded by Commonwealth Government
• Collaborative medication team approach
• Sustainability of HMR Support for
  Implementation

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Concluding Comments

• HMR has been successfully implemented in
  Australia
• Funded by Commonwealth Government
• Collaborative medication team approach
• Sustainability of HMR Support for
  Implementation
• Infrastructure support local facilitators
• Professional organisation support
• Continuing professional education
• Liaison with government
• On-going multi-disciplinary approach
• Evaluation of programme
• Accreditation education

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Acknowledgements

• Funding Bodies
• PHARM
• Commonwealth Department of Health and Aged Care
• Pharmacy Guild of Australia

• Key collaborators
• Dr Simon Bell
• Dr Paula Whitehead
• Dr Parisa Aslani
• Prof Andrew McLachlan
• Dr Alison Roberts
• Prof Charlie Benrimoj
• A/Prof Ines Krass
• Mrs Carlene Smith
• Mrs Alexandra Bennett
• Dr Abilio de Almeida Neto

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• Thank you
• Comments
• Questions