HMR: Refining Patient Eligibility Criteria

Project Details
Project ID: RFT2013-01
Type: Commissioned
Status: Completed
Institution: Healthcare Management Advisors
Chief Investigator: Wayne Kinrade

Project Summary

The Home Medicines Review (HMR) Programme aims to enhance the quality use of medicines and reduce adverse medicines events. This is undertaken through a comprehensive medication review conducted by an accredited pharmacist in the patient’s home.

The HMR Programme was introduced in October 2001. Demand for HMRs was low in the initial years after introduction of the Programme. Data on the number of HMR services claimed since the commencement of 5CPA highlights significant growth in demand has occurred over the life of the agreement.

At present there are two sources that specify criteria affecting eligibility for a HMR: the Medical Benefits Schedule (MBS) definition for Item 900,Domiciliary Medication Management Review; and the Home Medicines Review Programme Specific Guidelines. An examination of their contents identified issues with how these criteria operate.

The project methodology was guided by a needs assessment framework. This sought to collect information on relative benefits from a HMR for different patient cohorts using a range of information sources – the literature, consumers, peak bodies, clinicians ‘on the ground’ and HMR Programme operational data.

The project team examined three options for revising criteria affecting eligibility for a HMR. Two of the options were based on findings from the national survey conducted for the project.

Further issues that require examination before revised eligibility criteria can be implemented were identified. These include:

  • refinement of definitions around inclusion and exclusion criteria, linkages between MBS definitions and the Programme Specific Guidelines, enhancing quality assurance, the relationship of HMRs to other medication management services, and
  • assessing the impact of the proposal on demand for HMRs.