The UMORE group have considerable medication review expertise, and as such are a valuable source of knowledge in areas such as advice, accreditation and mentoring.
The Home Medicines Review (HMR) and Residential Medication Management Review (RMMR) schemes are critical to both the safe use of medicines and the future of the pharmacy profession in Australia. The RMMR program was implemented in 1997, whilst the HMR program has been funded since 2001. While these schemes have been reasonably successful, there is significant room for their expansion. One of the early impediments was the relative difficulty in assessing accredited pharmacists around the country. Related to this, there appeared to be a great number of pharmacists commencing the accreditation process but failing to complete it.
The team at UMORE proposed to develop an online accreditation procedure for AACP. This online system would improve access to the accreditation process, assist in improving the accreditation completion rate, and hence improve access to accredited pharmacists across Australia. A database of 150 validated multiple choice questions was initially created, and this has now been expanded to include an additional 200 questions. Analysis of the pass / fail rate of this process has also been undertaken, and discussions are currently underway to further build on the accreditation process.
Members of UMORE have extensive experience of HMRs and RMMRs and have conducted over 5000 medication reviews. Currently, six members of UMORE are accredited to perform medication reviews. Dr Shane Jackson and Dr Peter Tenni are recognised leaders in Medication Management Reviews (MMR) and conduct training and accreditation sessions across the country. In addition, Dr Jackson and Dr Tenni are very active in clinical practice and conduct RMMRs in over 40 facilities across Tasmania. |
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The data collected during medication reviews is an extremely valuable resource to enable the review and assessment of prescribing practices.
UMORE has been involved in a retrospective review of HMR and RMMR reports submitted to AACP. The main aim of the work undertaken to this point was to determine the nature of DRPs identified by the accredited pharmacists. This was facilitated by the construction of an extensive database containing 234 de-identified case reports.
There has been considerable concern raised about the high use of psychotropic drugs in residential care facilities to treat characteristic behavioural and psychological symptoms of dementia. UMORE has proposed to develop, trial and evaluate approaches by pharmacists to ensure psychotropic drugs are used appropriately in people with dementia residing in the residential care environment. The medication review case notes of 2500 patients residing in 40 care facilities in Tasmania throughout 2006, will be analysed to determine what psychotropic drugs and doses were prescribed, the indications they were prescribed for and the usage rates of these medications. This project will form the basis of the PhD for Juanita Westbury , titled Roles for Pharmacists to improve the QUM to treat behavioural and psychological symptoms of dementia in residential care facilities.
Further analysis of medication reviews is being undertaken by clinical and consultant pharmacist and honours candidate Andrew Stafford. In a project titled The development of a documentation system to facilitate the analysis of pharmacist conducted medication reviews in Australia, Andrew will explore the factors which trigger pharmacists to identify drug-related problems in medication reviews, and from where the information is sourced. The other main objectives of the project are to explicitly define the criteria that need to be recorded to analyse each component of the RMMR and HMR processes, and then to test the system with a number of reviews already performed.
VALMER - The Value of Home Medicines Reviews |
