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The Australian Model for Home Medicines Review Dr Tim Chen Faculty of Pharmacy timchen@pharm.usyd.edu.au. 9 th Commonwealth Pharmaceutical Association Conference and MPS Pharmacy Scientific Conference 2007 1 st -5 th August 2007. Overview. Background Information – Australia
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The Australian Model for Home Medicines Review Dr Tim Chen Faculty of Pharmacy timchen@pharm.usyd.edu.au 9th Commonwealth Pharmaceutical Association Conference and MPS Pharmacy Scientific Conference 2007 1st-5th August 2007
Overview • Background Information – Australia • Medicine use in Australia • National Medicines Policy • Model for Home Medicines Review in Australia • Selected studies • Concluding comments • Supplementary materials
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
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
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
Australia’s 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
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
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
Objectives of HMR • Achieve safe, effective and appropriate use of medicines • Improve quality of life and health outcomes • Improve patient’s and health professional’s knowledge and understanding about medicines • Facilitate cooperative working relationships between members of the health care team Medicare Australia
PHILOSOPHICAL SHIFT:from Product to Patient Supply role Product Patient Cognitive Service QUM
Randomised Comparative Study Chen, Bennett, Smith et al., 2000 http://www.guild.org.au/public/dmmrfiles/report_stgeorge.pdf
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
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
Impact on Use of Medicines N=362 cases Chen, Bennett, Smith et al., 2000 http://www.guild.org.au/public/dmmrfiles/report_stgeorge.pdf
Impact on Use of Medications Chen, Bennett, Smith et al., 2000 http://www.guild.org.au/public/dmmrfiles/report_stgeorge.pdf
Progress to DateHome Medicines Review Quarterly Statistical Bulletin • March Quarter 2007 • From www.guild.org.au
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
Summary: Philosophical Shift From Product to Patient Supply role Product Patient Cognitive Service HMR QUM
Concluding Comments • HMR has been successfully implemented in Australia • Funded by Commonwealth Government • Collaborative medication team approach • Sustainability of HMR = Support for Implementation
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
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 Acknowledgements
Thank you Comments … Questions …