Home Medicines Review (HMR), the Hospital Community Link
Purpose of the study: To identify if the process of facilitation was useful in helping general practitioners and pharmacists to implement Home Medicines Review and if the actual process of HMR help the patients from the Heartlink Program at Prince of Wales Hospital (POWH) to better medication management.
Method: The general practitioners of patients with heart failure who have been discharged from POWH, via Heartlink were requested to make a referral for an HMR. HMR was used as an enabler to cross the interface between hospital and community. Tools were developed to survey pharmacists, general practitioner and patients.
Results: Of the 134 referrals to 72 GPs, 63 HMRs were conducted. Of the 71 that were not conducted, 8 were declined by the patient, 1 where the pharmacy was not a service provider and 49 were declined by the GP.
The study of the program showed that 84% of general practitioners surveyed found an improved link between hospital and community. 72% thought that the Heartlink Program identifying patients for HMR made the process easier. 86% of general practitioners and 93% of pharmacists indicated that HMRs improved medication use.
Conclusion: The Facilitator provided very useful training for GPs and pharmacists to become involved in HMR. Patients were surveyed after the HMR and 89% said they learned something new at the HMR interview and felt more confident about their medications. From the patient’s view, having an HMR to explain change to regimen, reinforce lifestyle changes and make sure they are taking the medicines as ordered, supports the changes in treatment made at the hospital. The HMR process reports back to the GP so the link from hospital to community was strengthened.
From Heartlink’s view, HMR acted as a successful enabler to cross the hospital community interface. As the pharmacies became more aware of the actual treatment of these patients they were able to be even more supportive.