Retrospective Evaluation of Home Medicines Review by Pharmacists in Older Australian Patients Using the Medication Appropriateness Index

Abstract

The study demonstrates that the provision of medication reviews by accredited pharmacists can improve the appropriateness of prescribing as demonstrated by the change in MAI score and, hence, has the potential to improve patient outcomes. Pharmacists who perform medication reviews could also consider including the systematic approach of applying the MAI to assist in optimizing prescribing in older people.

Medication management among home-dwelling older patients with chronic diseases: Possible roles for community pharmacists

“…However, community pharmacy-based studies investigating medication management of home-dwelling elderly are rare. The already published pharmacy studies report on home-based medication reviews aimed at improving the appropriateness of prescribing (7)(8)(9)(10)(11).…”

The True Impact of Changes to Professional Services Program in Australian Pharmacy

“…3,4 It has taken a generational shift over a period of nearly 20 years to begin the processes whereby these services have become inculcated in pharmacy practice outside of hospitals. It has been necessary to re-engineer the profession, creating models of advanced practice to allow skilled practitioners to deliver the services and educating pharmacists to develop the skill sets required to do so.…”

Time to Rethink the Funding Model for Home Medicines Review

“…MedsChecks, Diabetes MedsChecks and Clinical Interventions by pharmacists), none of which is supported by any evidence in the context of the Australian healthcare setting. Conversely, there is evidence on the value of HMRs to consumers, 2,5,6 a demonstration of cost savings of up to $550 per HMR to the health system, 7-10 and a demonstrable track record that clearly illustrates the delivery of a truly collaborative service between GPs, patients, independent accredited pharmacists and other community or hospitalbased pharmacists [11][12][13][14][15][16][17][18] (Fig. 1).…”

“…Australian studies have demonstrated that HMRs can resolve, manage or reduce medicine-related problems for a wide range of patients. [11][12][13][14][15][16][17][18][19][20][21] In addition, HMRs improve health outcomes; for example, in patients receiving betablockers for heart failure, an HMR resulted in a 45% reduction in likelihood of hospitalisation for heart failure at any time. 18 Another study found that an HMR in patients taking warfarin resulted in a 79% reduced likelihood of bleeding-associated hospitalisation 2-6 months after the HMR.…”

“…21 Research conducted across Australia has consistently demonstrated that HMRs are a cost-effective way to identify and resolve medicine-related problems and improve health outcomes. [11][12][13][14][15][16][17][18][19] Based on Australian data, [7][8][9][10][11][18][19][20] approximately 25 000 out of every 100 000 HMRs conducted are provided to patients with high-cost medical conditions (diabetes, heart failure and atrial fibrillation). Cost savings to the health system arising from HMRs for those 25 000 Australians can be estimated at approximately $550 per person for each HMR (from hospital costs and length of stay), totalling $13.75 million per year.…”