Study finds room for improvement in medication review process

A first-of-its-kind study of Australia’s Home Medicines Review service has found a disconnect between the information provided by GPs and what is required by pharmacists.

"We recommend that medical practitioners consider providing more clinical information in their referrals to facilitate a more comprehensive review."

Dr Kenneth Lee

Home Medicines Review is a service provided by pharmacists at the request of a GP to ensure patients who are taking multiple prescription medications – about a third of older Australians – are doing so safely.

The study, published in the Archives of Gerontology and Geriatrics, was done by a national research group that includes three researchers from The University of Western Australia and is the first to characterise the types of information provided, collected and reported.

Lead researcher Dr Kenneth Lee, from UWA’s School of Allied Health, said there seemed to be a mismatch between the information the system provided to pharmacists and what they actually need to minimise medication-related harm.

“In particular, hospital admissions/discharge summaries and letters from specialists were rarely included in referrals from GPs,” Dr Lee said.

“Pharmacists can of course go back and request this sort of information from GPs, but having to do so does affect the efficiency of the service.

“We recommend that medical practitioners consider providing more clinical information in their referrals to facilitate a more comprehensive review.”

Image: Dr Kenneth Lee.

The questionnaire-based study involved 179 participants, all consultant pharmacists actively delivering the service.
Dr Lee said the findings also suggest a need to look beyond clinical outcomes as the most important end result of a Home Medicines Review.

“We would like more studies to look at quality of life and whether consumers feel like their personal goals and wishes are being taken into account,” he said.

“Medication reviews focused on consumer goals can improve quality of life, as well as various health issues such as pain and dizziness.”

Previous research in this area has shown that GPs and pharmacists often have differing views on the role of the service, with GPs seeing them as a way to mitigate polypharmacy while pharmacists are motivated to identify medication errors.

“The findings of this new study can serve to bridge the information gap by raising awareness of the common information types required by consultant pharmacists when delivering a Home Medicines Review service,” Dr Lee said.