Home Medicines Review

A Home Medicines Review (HMR), also known as a Domiciliary Medication Management Review (DMMR), is a comprehensive review for patient’s living in the community. It is designed to optimise patient health outcomes through a person-centred, collaborative approach involving the patient, their GP, a credentialed pharmacist, and their regular community pharmacy. 

The objectives of an HMR are to ensure the safe, effective, and appropriate use of medicines, prevent medication-related problems, and improve the patient’s quality of life through a coordinated team effort. 

Step 1. Prepare your practice 

• Discuss HMRs at practice meetings. You may like to invite your Brisbane North PHN Quality Improvement Engagement Officer.
• Refer to Home Medicines Review - Practice Support - Brisbane North PHN
• Access clinical guidelines and other resources
  • Medicines Advice Initiative Australia: addressing the hidden risk of cumulative medicines load to reduce harm
  • Video: HMR community service announcement
  • Brisbane North HealthPathways: medication management review
• Provide education resources to all staff: HMR fact sheet for GPs,
• Display patient brochures throughout practice
• Engage a local credentialed pharmacist

Step 2. Patient demographics- Identify patients who are eligible and would benefit from a home medicine review 

1. Identify patients eligible for an HMR using the Primary Sense High Complexity 4 & 5 report.  Export report to excel for further filtering if required.
2. Check patient has not had an HMR elsewhere via HPOS or My Health Record
3. Invite GP to review patient list

Step 3. Offer HMRs to patient

• Opportunistically offer HMR to eligible patients at existing appointment by using the Primary Sense –High Complexity 4&5 report – filter for existing appointments.
• Export filtered Primary Sense High Complexity report to CSV file and recall patients for an HMR via SMS. Alternatively you may like to phone patients or mail an invitation to discuss.
• Add HMR to care plan and health assessment templates to prompt discussions
• Complete the HMR process.
• Put a recall in place for another HMR in 12 months. You may like to review the recall process for care planning so that HMR compliments this process.
• Record the progress of HMR on the activity tracking spreadsheet. 

Step 4. Access clinical guidelines and other resources 

1. Review tracking spreadsheet and identify areas for improvement
2. Update team with progress and outcomes
3. Collect team feedback
4. Contact credentialled Pharmacist to discuss progress and outcomes. Establish a relationship with the credentialed pharmacist to facilitate improved processes.
5. Continue to document PDSA cycles