New report affirms potential of hospital-initiated meds review pathways

New report affirms potential of hospital-initiated meds review pathways

The Society of Hospital Pharmacists of Australia (SHPA) has entrenched its position as the leading voice on safe medicines management across all-important transitions of care, with senior members publishing expert opinion on barriers and enablers to implementation of hospital-initiated post-discharge medication reviews in Australia. 

The report, published in the latest issue of SHPA’s flagship Journal of Pharmacy Practice and Research (JPPR) – available free to SHPA members – identified barriers in both hospital and primary care, including time pressures, limited resources and low awareness of Home Medicines Review (HMR) and Residential Medication Management Review (RMMR) programs in the Seventh Community Pharmacy Agreement (7CPA) and updated program rules, while enablers included facilitation of hospital initiated medication reviews (HIMRs) via GP referral pathways, educational visiting, and onsite GP and aged care pharmacist roles. 

The authors propose trial funding of Transition of Care Stewardship (ToCS) pharmacists in hospitals as a key driver of increased access to timely HIMRs, with additional funding forecast to build capacity of primary care pharmacists and maximise their role in improving medication safety of high-risk patients at care transitions. 

‘The role of a ToCS pharmacist working collaboratively with hospital doctors and GPs could ensure a safe discharge as bed pressures increase. 

‘Our vision is that a ToCS pharmacist will facilitate HIMRs and a ‘warm handover’ of the medication-related information for at-risk patients transitioning from hospital to either home or residential aged care (including respite care).’ 

Report authors include current and past members of SHPA Specialty Practice Leadership Committees, including Transitions of Care and Primary Care (Dr Manya Angley, Deirdre Criddle, Katie Phillips, Joy Gailer, Horst Thiele, Dr Amy Page and Carly Pauw) as well as Geriatric Medicine (Dr Rohan Elliott) and Research (Dr Amy Page and Dr Jonathan Penm). 

The report follows SHPA’s 2020 release of a framework to support the identification and referral by hospital-based clinicians of high-risk patients to HMR, RMMR and Hospital Outreach Medication Review (HOMR) pathways, after successful advocacy resulted in changes to the 7CPA program rules which broadened the referral base to include specialist medical practitioners. 

SHPA’s Hospital-initiated medication reviews (HIMR): Hospital pharmacy practice update brings together the work of hospital, community and accredited pharmacists for more effective medicine management across transitions of care.

SHPA President Tom Simpson says the practice update and subsequent expert report is emblematic of the organisation’s core focus on advancing expert, specialised pharmacist care that places the patient at the centre of collaborative care teams.

‘SHPA looks forward to working with partners in government, pharmacy and primary care to improve medication safety outcomes for aged care patients after they have been admitted to hospital.

‘In particular, we look forward to ensuring implementation of hospital-initiated medication review (HIMR) pathways, and that ToCS pharmacists have appropriate and seamless touchpoints with the upcoming on-site Aged Care pharmacist program, so that we can fully realise wrap-around, patient-centred care.

‘We’re proud to advance pharmacist specialisation in Australia.

‘HIMRs are a timely example of how SHPA’s advances to ensure medicines safety and optimal outcomes for patients who have acute care touchpoints, can ripple outward to benefit those who don’t.’