Home Medicines Reviews
Home Medicines Reviews (also known as Domiciliary Medication Management Reviews) assist people of any age to manage their medicines more effectively. If you are using multiple medications, have difficulty managing your medication, or have been recently discharged from hospital or other care facility, you may benefit from a Home Medicines Review.
This involves your medical practitioner and pharmacist working together to review all the medicines you are taking, including prescription medicine, over-the-counter and complementary medicines. Your doctor will use the results of this review to develop a medication management plan for you.
Speak with your GP or Phone: 13 20 11 (Medicare services)
Do be aware that under the Medscheck program, where chemists check the medicines of multiple prescription users, that there is no program requirement to provide a written report of the medicine review, and the review is not required to be conducted in collaboration with the patient's GP or other health professionals (Australian National Audit office).
However, the Pharmacy Guild says the patient gets a report.
Website explaining the Home Medicines Reviews
---------
My Health Record:
My Health Record opt-out dates announced:
The Australian Government has announced that every Australian will be offered a My Health Record by the end of 2018, unless they choose not to have one. The opt out period was extended until the 31st January 2019. However, even after that date, you can still choose to opt out if you want. My Health Record enables important health information including allergies, medical conditions, treatments, medicines, and test reports to be securely shared between clinicians and their patients, meaning that doctors, pharmacists and authorised healthcare providers will be able to access a person’s My Health Record to assist in their future treatment of patients and issues such as prescription of medicines and advance care planning.
My Health Record legislation changes
On Monday 26 November 2018, The Australian Digital Health Agency announced that the Australian Parliament passed legislation to strengthen privacy protections in My Heath Records Act 2012. The changes include:
A My Health Record will be created for all Australians after 31 January 2019 unless they tell the Australian Digital Health Agency that they do not want one.
26 November 2018
My Health Record: A stronger My Health Record
7 November 2018
The Morrison Government will introduce further legislative amendments to ensure the safety and privacy of health information in the My Health Record system including provisions to protect people against domestic violence and tougher penalties for those that misuse the system. We have examined the recommendations from the Senate Inquiry, we have listened to concerns…
Health Minister Greg Hunt announced on 10 August that the My Health Record opt-out period has been extended until 15 November 2018. This will ensure all Australians have an opportunity to make an informed decision as the government strengthens the 2012 My Health Record legislation. To read the full media release, click here. Visit the My Health Record website for more information on supporting and informing patients during the My Health Record opt-out period.
As of July 1, more than 5.9 million Australians and nearly 13,000 healthcare professional organisations were registered with My Health Record. By the end of the year, a record will be created for every Australian who decides not to opt out.
The opt-out period has been extended until the 31st January 2019. Note that consumers can continue to do so at any time in the future.
To learn more about My Health Record.
https://www.myhealthrecord.gov.au/
What is it?
https://www.myhealthrecord.gov.au/for-you-your-family/what-is-my-health-record
What’s in it?
The My Health Record is an online summary of an individual’s health information that can be shared securely between the patient and authorized healthcare providers involved in their care. Individuals control what goes into their My Health Record, and who can access it. Registered and authorized healthcare providers such as general practitioners, specialists, pharmacists, allied health professionals and hospital staff can access it online from anywhere at any time when they need to, like in an accident or emergency.
https://www.myhealthrecord.gov.au/for-you-your-family/what-is-in-my-health-record
My Health Record:
Individuals have a number of mechanisms available to them to manage the content of, and to control access to, their and/or their dependent's My Health Record(s).
These include - Limiting access
Access to the record or documents can be changed to restrict access to information they consider sensitive.
My Health Record and pathology request forms
Over the past few months you may have noticed pathology request forms now have a check box with the wording ‘do not send to My Health Record’. If a patient has a My Health Record and does not wish for their pathology results to be uploaded, this check box will need to be ticked by either the health provider or patient. If you have older forms that do not have this check box, hand writing ‘do not send to My Health Record’ is accepted. When the check box is ticked or consent is withdrawn through writing, this is applied to all tests requested on the form. A patient will need to withdraw consent for each instance they do not want their results uploaded.
If the check box is left unticked and the patient has a My Health Record, the results will be uploaded. The upload of results to a patient's My Health Record will not replace current forms of communication or correspondence. Please also note that some Queensland Health facilities are now uploading pathology results to the My Health Record system. For more information, you can also visit the My Health Record website.
This is the final week for Australians to opt-out of having a secure My Health Record created for them by the end of 2018. Any Australian that doesn’t want a record has the opportunity to register their choice by visiting MyHealthRecord.gov.au or calling 1800 723 471 by 15 November 2018.
What is in My Health Record?
By default, when an individual registers for a My Health Record they give standing consent for all registered healthcare provider organisations to access and upload information to their My Health Record. Learn more here.
Every time your My Health Record is accessed, it is recorded in an audit log which you can view by logging into your My Health Record. The System Operator cyber security team constantly monitors system access. There are strict penalties for unlawful access. If you have concerns about who has accessed your My Health Record, contact us immediately on 1800 723 471.
07 September 2018
The Australian Institute of Health and Welfare is proud to have been selected to manage and release My Health Record data for secondary purposes. The announcement reinforces our position as trusted, experienced managers of and leaders in data.
Using My Health Record for secondary purposes will open a range of possibilities to fill data gaps by allowing the health sector to better understand how Australia’s health system is used—as well as gaining valuable insights into the health outcomes for patients.
It is a significant new role for the AIHW, and we look forward to working closely with the Department of Health, the Australian Digital Health Agency and other stakeholders to build the evidence base and contribute to better health and wellbeing for all Australians, while upholding the strictest data quality and privacy standards.
For more information on the use of My Health Record data for secondary purposes: Framework to guide the secondary use of My Health Record system data.
20 December 2018
----------
Pharmacist review, home checks part of medication strategy for people with dementia
By: Dallas Bastian in News, Top Stories August 4, 2017
Australian researchers are hoping to improve outcomes for people with dementia after they are discharged from hospital through a medication strategy that starts in the lead-up to discharge and continues into the home.
Associate professor Ashley Kable, from the University of Newcastle, said medication generally changes for people once they’ve been treated in hospital, which makes self-administration even harder for people with dementia, and added the responsibility often falls back on carers.
Kable said currently, home medication reviews can be requested by a general practitioner following a patient’s discharge from hospital, but are not always done. She said the safe medication strategy will include clinical pharmacist review of medications and communication with the carer, training in hospital to use medication dose administration aids and provision of a discharge medication plan and explanation.
The discharge summary will include a note for general practitioners to request a home medicines review. These will be conducted by community pharmacists who will aim to identify any prescribed medications that may be a risk for people with dementia, such as those that may cause confusion or result in falls, any potential drug interactions or contraindicated medications, any adjuvant medications being used in addition to prescribed medications that may be a risk, and any modifications to medications that may be required for a person with dementia.
SO, when your loved one is discharged from hospital, do make sure to go to your usual Pharmacist and ask for a Home Medicines Review. Many of the usual medications may have been changed, upped in dosage, or Brand altered in the hospital. YOU, need to know as the result can be most serious for your loved one. YOU, as a Carer, can do this. Alternatively, have a chat with your loved one's GP and have him write a note to your Pharmacist to do this.
How the pharmacist can simplify a dosing schedule during an Home Medicines Review:
• Reduce dosing frequency and recommend long-acting dosage forms where possible
• Recommend a higher strength to reduce the number of dosage units for a specific medicine where two tablets of the same medicine are taken at different times in a day
• Recommend a lower strength product where the person is cutting tablets in half or into quarters
• Consolidate dosing times to fit in with the patient’s lifestyle
• Recommend a combination product if suitable to reduce the number of medicines being used
• Recommend a suitable adherence aid for the patient with cognitive or dexterity issues
for a closer look:
https://www.veteransmates.net.au/documents/10184/38810/Nov_2016_GP_Insert.pdf/e9b3126e-bf0e-4238-bd74-8cdd617458d0
"With the focus on medicines and older Australians in these lists, we urge people to consider if they are on the right medicine, or whether they could be taking too many medicines and if you are due for a review. It’s always timely to check with your doctor or pharmacist to see if any medicines are unnecessary and if they could cause harm if taken together."
----------------------
It is always a good idea to keep a Medicines List
BE AWARE: of holding on to expired medicines and keeping these in the home which increases your risk of misadventure. It is a good idea to regularly clean out your medicines cabinet and check the expiry date on all of your medicines.
Professor Jennifer Martin from the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists (ASCEPT) (experts in the use and toxicity of medicines) says, "Many of our recommendations today will help patients avoid unnecessary tests and procedures and lead to discussions on reducing waste and overuse of medicines.
"One of our recommendations is to reduce the use of multiple medicines, common in older patients. Hyperpolypharmacy is where people may be on as many as 15 to 20 medicines at a time. Research has confirmed a significant association between polypharmacy and adverse outcomes among older people and an association with decreased physical and social functioning; increased risk of falls, delirium, hospital admissions and death. With an ageing population, use of many medicines at the same time is something we need to be having conversations about to avoid potentially harmful implications."
Older Australians may not be aware that they are on a ‘prescribing cascade’, where they take one medicine and have an adverse reaction, so are put on another medicine. One common example is when a patient is prescribed a nonsteroidal drug for pain, and is then prescribed a proton pump inhibitor (PPI) to reduce the risk of stomach side effects caused by the first prescribed medicine.
The new recommendations on appropriate use and prescribing of medicine include:
Dr Lynn Weekes, CEO of NPS MedicineWise who facilitate Choosing Wisely Australia says, "We are delighted to launch two more lists of Choosing Wisely Australia recommendations today. Choosing Wisely Australia is all about kick starting conversations about unnecessary tests, treatments and procedures, and that more is not always better. The adoption of these recommendations by health professionals will improve care.
"With the focus on medicines and older Australians in these lists, we urge people to consider if they are on the right medicine, or whether they could be taking too many medicines and if you are due for a review. It’s always timely to check with your doctor or pharmacist to see if any medicines are unnecessary and if they could cause harm if taken together."
http://www.nps.org.au/
Pain Australia has great professional resources to help very Australian access the best possible treatment without delay, to reduce long-term disability, improve work retention rates, and help people and their families live better lives: www.painaustralia.org.au
Australian Pain Management Association works with health clinicians, researchers, government and the community to deliver evidence-based pain management services: www.painmanagement.org.au
NPS MedicineWISE has free and evidence-based information on medicines, health conditions and medical tests for both health professionals and consumers:
https://www.nps.org.au/search?q=Pain&scope=all&age=any&category=all&sort=most-relevant
Chronic Pain Australia can help you improve your knowledge and understanding about chronic pain across Australia
http://chronicpainaustralia.org.au/index.php
08 August 2021
Home Medicines Reviews (also known as Domiciliary Medication Management Reviews) assist people of any age to manage their medicines more effectively. If you are using multiple medications, have difficulty managing your medication, or have been recently discharged from hospital or other care facility, you may benefit from a Home Medicines Review.
This involves your medical practitioner and pharmacist working together to review all the medicines you are taking, including prescription medicine, over-the-counter and complementary medicines. Your doctor will use the results of this review to develop a medication management plan for you.
Speak with your GP or Phone: 13 20 11 (Medicare services)
Do be aware that under the Medscheck program, where chemists check the medicines of multiple prescription users, that there is no program requirement to provide a written report of the medicine review, and the review is not required to be conducted in collaboration with the patient's GP or other health professionals (Australian National Audit office).
However, the Pharmacy Guild says the patient gets a report.
Website explaining the Home Medicines Reviews
---------
My Health Record:
My Health Record opt-out dates announced:
The Australian Government has announced that every Australian will be offered a My Health Record by the end of 2018, unless they choose not to have one. The opt out period was extended until the 31st January 2019. However, even after that date, you can still choose to opt out if you want. My Health Record enables important health information including allergies, medical conditions, treatments, medicines, and test reports to be securely shared between clinicians and their patients, meaning that doctors, pharmacists and authorised healthcare providers will be able to access a person’s My Health Record to assist in their future treatment of patients and issues such as prescription of medicines and advance care planning.
My Health Record legislation changes
On Monday 26 November 2018, The Australian Digital Health Agency announced that the Australian Parliament passed legislation to strengthen privacy protections in My Heath Records Act 2012. The changes include:
- allow Australians to permanently delete their records, and any backups, at any time
- explicitly prohibit access to My Health Records by insurers and employers
- provide greater privacy for teenagers 14 years and over
- strengthen existing protections for people at risk of family and domestic violence
- clarify that only the Agency, the Department of Health and the Chief Executive of Medicare (and no other government agency) can access the My Health Record system
- explicitly require law enforcement and other agencies to produce a court order to access information in My Health Records
- make clear that the system cannot be privatised or used for commercial purposes.
A My Health Record will be created for all Australians after 31 January 2019 unless they tell the Australian Digital Health Agency that they do not want one.
26 November 2018
My Health Record: A stronger My Health Record
7 November 2018
The Morrison Government will introduce further legislative amendments to ensure the safety and privacy of health information in the My Health Record system including provisions to protect people against domestic violence and tougher penalties for those that misuse the system. We have examined the recommendations from the Senate Inquiry, we have listened to concerns…
Health Minister Greg Hunt announced on 10 August that the My Health Record opt-out period has been extended until 15 November 2018. This will ensure all Australians have an opportunity to make an informed decision as the government strengthens the 2012 My Health Record legislation. To read the full media release, click here. Visit the My Health Record website for more information on supporting and informing patients during the My Health Record opt-out period.
As of July 1, more than 5.9 million Australians and nearly 13,000 healthcare professional organisations were registered with My Health Record. By the end of the year, a record will be created for every Australian who decides not to opt out.
The opt-out period has been extended until the 31st January 2019. Note that consumers can continue to do so at any time in the future.
To learn more about My Health Record.
https://www.myhealthrecord.gov.au/
What is it?
https://www.myhealthrecord.gov.au/for-you-your-family/what-is-my-health-record
What’s in it?
The My Health Record is an online summary of an individual’s health information that can be shared securely between the patient and authorized healthcare providers involved in their care. Individuals control what goes into their My Health Record, and who can access it. Registered and authorized healthcare providers such as general practitioners, specialists, pharmacists, allied health professionals and hospital staff can access it online from anywhere at any time when they need to, like in an accident or emergency.
https://www.myhealthrecord.gov.au/for-you-your-family/what-is-in-my-health-record
My Health Record:
Individuals have a number of mechanisms available to them to manage the content of, and to control access to, their and/or their dependent's My Health Record(s).
These include - Limiting access
- Limiting access to the whole of their record and having a Record Access Code that needs to be given to healthcare provider organisations who they wish to grant access and/or;
- Limiting access to specific documents in their My Health Record, and having a Document Access Code to give to select healthcare provider organisations for them to gain access to the restricted set of documents;
- Turning off automatic checking for a My Health Record, which will prevent a healthcare provider organisation being automatically notified via their local clinical software if a person has a record.
Access to the record or documents can be changed to restrict access to information they consider sensitive.
My Health Record and pathology request forms
Over the past few months you may have noticed pathology request forms now have a check box with the wording ‘do not send to My Health Record’. If a patient has a My Health Record and does not wish for their pathology results to be uploaded, this check box will need to be ticked by either the health provider or patient. If you have older forms that do not have this check box, hand writing ‘do not send to My Health Record’ is accepted. When the check box is ticked or consent is withdrawn through writing, this is applied to all tests requested on the form. A patient will need to withdraw consent for each instance they do not want their results uploaded.
If the check box is left unticked and the patient has a My Health Record, the results will be uploaded. The upload of results to a patient's My Health Record will not replace current forms of communication or correspondence. Please also note that some Queensland Health facilities are now uploading pathology results to the My Health Record system. For more information, you can also visit the My Health Record website.
This is the final week for Australians to opt-out of having a secure My Health Record created for them by the end of 2018. Any Australian that doesn’t want a record has the opportunity to register their choice by visiting MyHealthRecord.gov.au or calling 1800 723 471 by 15 November 2018.
What is in My Health Record?
By default, when an individual registers for a My Health Record they give standing consent for all registered healthcare provider organisations to access and upload information to their My Health Record. Learn more here.
Every time your My Health Record is accessed, it is recorded in an audit log which you can view by logging into your My Health Record. The System Operator cyber security team constantly monitors system access. There are strict penalties for unlawful access. If you have concerns about who has accessed your My Health Record, contact us immediately on 1800 723 471.
07 September 2018
The Australian Institute of Health and Welfare is proud to have been selected to manage and release My Health Record data for secondary purposes. The announcement reinforces our position as trusted, experienced managers of and leaders in data.
Using My Health Record for secondary purposes will open a range of possibilities to fill data gaps by allowing the health sector to better understand how Australia’s health system is used—as well as gaining valuable insights into the health outcomes for patients.
It is a significant new role for the AIHW, and we look forward to working closely with the Department of Health, the Australian Digital Health Agency and other stakeholders to build the evidence base and contribute to better health and wellbeing for all Australians, while upholding the strictest data quality and privacy standards.
For more information on the use of My Health Record data for secondary purposes: Framework to guide the secondary use of My Health Record system data.
20 December 2018
----------
Pharmacist review, home checks part of medication strategy for people with dementia
By: Dallas Bastian in News, Top Stories August 4, 2017
Australian researchers are hoping to improve outcomes for people with dementia after they are discharged from hospital through a medication strategy that starts in the lead-up to discharge and continues into the home.
Associate professor Ashley Kable, from the University of Newcastle, said medication generally changes for people once they’ve been treated in hospital, which makes self-administration even harder for people with dementia, and added the responsibility often falls back on carers.
Kable said currently, home medication reviews can be requested by a general practitioner following a patient’s discharge from hospital, but are not always done. She said the safe medication strategy will include clinical pharmacist review of medications and communication with the carer, training in hospital to use medication dose administration aids and provision of a discharge medication plan and explanation.
The discharge summary will include a note for general practitioners to request a home medicines review. These will be conducted by community pharmacists who will aim to identify any prescribed medications that may be a risk for people with dementia, such as those that may cause confusion or result in falls, any potential drug interactions or contraindicated medications, any adjuvant medications being used in addition to prescribed medications that may be a risk, and any modifications to medications that may be required for a person with dementia.
SO, when your loved one is discharged from hospital, do make sure to go to your usual Pharmacist and ask for a Home Medicines Review. Many of the usual medications may have been changed, upped in dosage, or Brand altered in the hospital. YOU, need to know as the result can be most serious for your loved one. YOU, as a Carer, can do this. Alternatively, have a chat with your loved one's GP and have him write a note to your Pharmacist to do this.
How the pharmacist can simplify a dosing schedule during an Home Medicines Review:
• Reduce dosing frequency and recommend long-acting dosage forms where possible
• Recommend a higher strength to reduce the number of dosage units for a specific medicine where two tablets of the same medicine are taken at different times in a day
• Recommend a lower strength product where the person is cutting tablets in half or into quarters
• Consolidate dosing times to fit in with the patient’s lifestyle
• Recommend a combination product if suitable to reduce the number of medicines being used
• Recommend a suitable adherence aid for the patient with cognitive or dexterity issues
for a closer look:
https://www.veteransmates.net.au/documents/10184/38810/Nov_2016_GP_Insert.pdf/e9b3126e-bf0e-4238-bd74-8cdd617458d0
"With the focus on medicines and older Australians in these lists, we urge people to consider if they are on the right medicine, or whether they could be taking too many medicines and if you are due for a review. It’s always timely to check with your doctor or pharmacist to see if any medicines are unnecessary and if they could cause harm if taken together."
----------------------
It is always a good idea to keep a Medicines List
BE AWARE: of holding on to expired medicines and keeping these in the home which increases your risk of misadventure. It is a good idea to regularly clean out your medicines cabinet and check the expiry date on all of your medicines.
- Pay attention to what is in your medicine cabinet and always check the expiry date.
- Most medicines will slowly deteriorate over time, which can make them less effective and in some cases harmful.
- Australians can take their unwanted, unused or expired medicines to their local pharmacy for safe disposal. Disposing of medicines with their local pharmacist will ensure medicines do not end up in waterways or landfill.
- After checking the expiry dates on medicines in the home, it’s a good time to start a medicines list. A medicines list allows you to record all your medicines, the reason you are using the medicine, and the dose.
Professor Jennifer Martin from the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists (ASCEPT) (experts in the use and toxicity of medicines) says, "Many of our recommendations today will help patients avoid unnecessary tests and procedures and lead to discussions on reducing waste and overuse of medicines.
"One of our recommendations is to reduce the use of multiple medicines, common in older patients. Hyperpolypharmacy is where people may be on as many as 15 to 20 medicines at a time. Research has confirmed a significant association between polypharmacy and adverse outcomes among older people and an association with decreased physical and social functioning; increased risk of falls, delirium, hospital admissions and death. With an ageing population, use of many medicines at the same time is something we need to be having conversations about to avoid potentially harmful implications."
Older Australians may not be aware that they are on a ‘prescribing cascade’, where they take one medicine and have an adverse reaction, so are put on another medicine. One common example is when a patient is prescribed a nonsteroidal drug for pain, and is then prescribed a proton pump inhibitor (PPI) to reduce the risk of stomach side effects caused by the first prescribed medicine.
The new recommendations on appropriate use and prescribing of medicine include:
- recognising and stopping the prescribing cascade, to avoid adverse drug reactions in older people
- reducing the use of multiple medicines
- to not prescribe medicines without conducting a drug review, to avoid adverse outcomes for people on 5 to 20 medications, and
- to stop medicines when no further benefit will be achieved, particularly for older patients with a limited life expectancy where the treatments are unlikely to prevent disease.
Dr Lynn Weekes, CEO of NPS MedicineWise who facilitate Choosing Wisely Australia says, "We are delighted to launch two more lists of Choosing Wisely Australia recommendations today. Choosing Wisely Australia is all about kick starting conversations about unnecessary tests, treatments and procedures, and that more is not always better. The adoption of these recommendations by health professionals will improve care.
"With the focus on medicines and older Australians in these lists, we urge people to consider if they are on the right medicine, or whether they could be taking too many medicines and if you are due for a review. It’s always timely to check with your doctor or pharmacist to see if any medicines are unnecessary and if they could cause harm if taken together."
http://www.nps.org.au/
Pain Australia has great professional resources to help very Australian access the best possible treatment without delay, to reduce long-term disability, improve work retention rates, and help people and their families live better lives: www.painaustralia.org.au
Australian Pain Management Association works with health clinicians, researchers, government and the community to deliver evidence-based pain management services: www.painmanagement.org.au
NPS MedicineWISE has free and evidence-based information on medicines, health conditions and medical tests for both health professionals and consumers:
https://www.nps.org.au/search?q=Pain&scope=all&age=any&category=all&sort=most-relevant
Chronic Pain Australia can help you improve your knowledge and understanding about chronic pain across Australia
http://chronicpainaustralia.org.au/index.php
08 August 2021