A Home Medicines Review (HMR) is a comprehensive clinical review of a patient’s medicines in their home by an accredited pharmacist on referral from the patient’s general practitioner (GP). It is also called as Domiciliary medication management review. It is designed to enhance the quality use of medicines and reduce the number of adverse medicine events, by assisting consumers to better manage and understand their medicines through a medication review conducted by an accredited pharmacist in the patient’s home.
There are different problems due to irrational medications or medication errors. Irrational medication may lead to hospital admissions, increased morbidity & mortality. These medication errors are due to lack of knowledge about the diseases or ailments & medications. These problems are high in geriatrics with chronic illness, patients on polypharmacy & patients with multiple co-morbidities. These patients require regular monitoring & medication management at home and for that purpose, we take home medication review program. Pharmacist and medical professional provide HMR program, they review the patient, diseases & drug treatment.
HMR involve estimation of disease, evaluating the therapeutic efficacy of each drug, adverse effects, adherence medication & drug interaction. HMR includes a thorough check of medicines taken by patients, prescription drugs & non-prescription drugs.
AIM: To prevent problems related to medication & provide individual drug regimen through the team.
HMR program consists of four steps. They are
1. Assessment of clinical need & referral
2. Interview, review & report
3. Medication management plan
4. Payment (or) Continuity of patient care
1. ASSESSMENT OF CLINICAL NEED & REFERRAL
2. INTERVIEW, REVIEW & REPORT
3. MEDICATION MANAGEMENT PLAN
4. PAYMENT (OR) CONTINUITY OF PATIENT CARE
Participation in HMR program
1. Requirements of participation in HMR program: Patient need to accept all the terms and conditions of the program.
2. Patients eligibility criteria: Patients with chronic diseases should go for HMR program.
3. Identifying patients for HMR: The patients with the risk of medication mis-adventure, co-diseases, complex treatment regimens should be selected for HMR program.
4. Patient consent (Acceptance): Patient should accept for the HMR program.
5. Patient interview: Patients interview must occur face-to-face at the patients home except in some circumstances like cultural reasons & safety concerns associated with a visit to the patients home.