The 2014 Act came into effect in July 2014. It introduced new principles to support people experiencing mental illness to make and participate in treatment decision (shared decision making) and to have their views and preferences considered and respected.
Ask for a Home Medicines Review (HMR)
A Home Medicines Review (HMR) is a clinical process that considers a person’s medicines, and their wishes to help them manage their medicines in their own home. This service is free and is carried out in the person’s own home at a time that is convenient to them. It is an opportunity to ask questions, check for adverse reactions or side effects and discuss any medication options available. Family members can be present if desired.
Types of questions that are asked include:
- What is my medication for?
- How do I take it?
- When do I take it?
- How often do I take it?
- How long do I have to take it for?
- Side effects?
- What are the side effects I should watch out for?
- Will this medicine make me put on weight?
- How does it affect my driving?
- Will it increase my risk of falls?
- What do I do if a side effect occurs?
- Are there any interactions with other medications?
- Can I safely take these vitamins, minerals or herbal product with my prescribed medicines?
- What happens if I miss a dose? Can I stop taking them?
- What is a generic medicine?
- I cannot swallow this medicine- what can I do? Can I crush it?
- Can you give me written information that I can understand?
- Can you give me a list of my medicines with the brand names?
- How can I remember to take my medicines?
- Which inhaler do I take when?
- Is there an inhaler that is easier for me to use?
- What else can I do to help me with my pain?
How do I get a Home Medicines Review?
Ask your General Practitioner (GP) for a referral. They will either send it to your usual community pharmacy or refer directly to an accredited pharmacist. In addition, Pain Medicine specialists, Physicians, Psychiatrists or Palliative Medicine specialists may generate HMR referrals for you.
During the HMR Interview process, the Accredited Pharmacist will aim to improve the patient and the carer ’s understanding of the medicines. They then produce an HMR Report that outlines their findings and send that to the referrer. On the next visit to the referrer the doctor will discuss the findings of the report with the patient and develop a mutually agreed plan based on patient needs. This may be referral to other agencies, the use of Dose Administration Aid, slowly ceasing medications, trialling a different medication or checking pathology tests.
If necessary, if clinically indicated, up to two follow-up service(s) can be conducted, with a focus on the resolution of medication-related problems identified at the initial Interview. A full interview can be requested every two years – or if medically indicated every year.
There are many examples of where the HMR has helped people. For example
- Doubling up of medicines with confusion of brand name and generic
- Crushing medicines
- Missed allergies
- Unwanted side effects e.g., sleepy, dry mouth, constipation, confusion, memory loss, weight gain
- Increased falls due to medicines
- Taking night-time tablets during the day and vice versa
- Sleeping problems
- Reducing the number of tablets taken
The Home Medicine Interview offers you the luxury to discuss your concerns about your medicines in the privacy of your own home to enable you to manage your medicines safely and know when to call for assistance.
Dr Jenny Gowan PhD Consultant pharmacist