Managing the Mental Health Merry Go Round Karalyn Huxhagen B Pharm FPS AACPA

2 8/10/2014 Home Medicine Review (HMR) Item 900 Called DMMR in the schedule Can be claimed after the medication management plan is completed Use the Item 900 General Practitioner checklist

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Item Number 900 Can be claimed once yearly per patient unless there are significant changes to the medication or condition GP can initiate for a patient if they Have supplied the majority of services over the last 12 months OR Will provide majority of services over the next 12 months IDENTIFY PATIENT GP, specialist, patient, carer or other health care professional may identify a patient Patient must be living at home, can be non-funded self care (not in Hospital or Residential Care), Patient is at risk of medication misadventure Useful for elderly patients, with multiple physical/mental conditions GP ASSESSES THE CLINICAL NEED Examples of known risk factors that may lead to medication misadventure in patients Taking 5 or more medications Taking more than 12 doses per day Many changes to their medication regimen Taking medications with a narrow therapeutic index Symptoms suggestive of an adverse drug reaction Suspected non-compliance Difficulty managing their medications because of literacy, language, dexterity, impaired vision confusion or cognitive difficulties Attending multiple doctors Recent discharge from hospital ( 4 weeks) Other, (eg loss of spouse, different health care professional involved in treatment) 4 8/10/2014

Item Number /10/2014 GP INITIATES THE HOME MEDICINES REVIEW GP to obtain and document informed consent for Conducting the Home Medicines Review The exchange of information between the pharmacist and the GP The pharmacist to conduct an interview, preferably at the patient’s home Patient aware that they will have to return for the second visit Patient aware of any costs involved if there is no bulk billing GP to send information to the pharmacy that includes Diagnosis, current medications, relevant test results and medical history, also include allergies, smoking and alcohol history GP REFERS TO THE PATIENT’S PREFERRED COMMUNITY PHARMACY OR INDEPENDENT CONSULTANT PHARMACIST The pharmacy or consultant pharmacist is responsible for co-ordinating the Home Medicines Review. They will organise the interview, the assessment of the information and the mechanism of reporting back to the GP

Item Number 900 REPORT AND DISCUSSION The accredited pharmacist will submit a written and verbal report. The discussion may help the GP develop a new Management Plan GP DEVELOPS A MANAGEMENT PLAN To be prepared in consultation with the patient at the return visit Document patient agreement to implement the plan Make copies of the Plan for patient file and pharmacy Patient to be offered a copy GP CLAIM FOR HOME MEDICINES REVIEW Make the Item 900 claim after Management Plan complete ( item covers identifying the patient, initiating the HMR, preparation of information for the pharmacy, development of the Management Plan) This Checklist was designed to be used in conjunction with Item 900, not to replace it 6 8/10/2014