New hospital-initiated medication review pathways to help close safety gaps

The Society of Hospital Pharmacists of Australia (SHPA) has unveiled a new framework to support the identification and referral by hospital-based clinicians of high risk patients to Home Medicines Review (HMR), Residential Medication Management Review (RMMR) and Hospital Outreach Medication Review (HOMR) pathways.

Released five months after the HMR and RMMR Program Rules were changed to broaden the referral base beyond General Practitioners (GPs) and fund up to two follow-up encounters after initial medication review, 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 Transitions of Care and Primary Care Chair Deirdre Criddle says the HIMR Practice Update provides practical information enabling hospital-based doctors to harness the April policy changes, which were recommended in the Interim Report of the Royal Commission into Aged Care Quality and Safety.

‘Safe transitions of care start in the hospital. With Medication Safety now Australia’s 10th National Health Priority Area, we want to help drive the conversation around pharmacist-led models of care targeting timely post-discharge medication management services for high-risk patients. 

‘It is important to note these pathways do not replace pathways for services already in place. They are additional or complementary pathways so more people can access medication review, especially when poor resourcing or a lack of time may prevent effective referral.

‘We feel the SHPA HIMR Practice Update is the beginning of an overdue conversation between hospital and primary care, to change the culture from discharge to handover and make a real difference for our most vulnerable patients.’

Every year in Australia 250,000 hospital admissions are a result of medication-related problems, costing $1.4 billion, and the transition of care between the hospital and the community remains a known challenge.

SHPA Transitions of Care and Primary Care Leadership Committee member Dr Manya Angley, who provided testimony on inappropriate prescribing and use of antipsychotic medicines to the Disability Royal Commission in September, says the document supports hospitals to integrate new referral pathways into patient care according to their local workforce and community needs.

‘This Practice Update provides a long-awaited framework for authentic collaboration between health professions to achieve our common goal – the best outcomes for patients at risk of medication-related harm – and the Leadership Committee acknowledges and thanks the work of experts who have advocated for these interventions over many years.

‘Every sector of our profession now has a responsibility to engage with the HIMR Practice Update, and ensure the protocols effectively address this long-standing gap in care; we encourage Australian hospitals to embrace this complex area.’

Download the media release.