A study to identify the issues and barriers experienced when changes to a patient medication regimen are recommended by pharmacists in the community setting in Australia

Abstract

Background: In Australia, 10-16% acute hospital admissions is related to medication. Home medication review is offered to patients using multiple medications, those with narrow therapeutic-index. It is also recommended for people with recent changes to their medication, who were recently discharged from hospital or who have difficulties with their medication. Objectives: The aim of this study was to identify issues that arise during the process and explore the barriers experienced when changes to patient medication regimen are recommended. Setting: All interviews were conducted in Australia in patients’ homes in accordance with the appropriate guidelines. Method: This study used historical data from past consultations conducted in Australia. The audit was approved by the University of Wolverhampton Human Research Ethics Committee. It is based on anonymised historical data. Main outcome measure: This audit explored improvement in patient health outcomes and service satisfaction Results: Out of 28 home medication reviews, only two occasions were the pharmacist’s recommendations, actioned. On eight occasions, the clinic receptionist acknowledged the receipt of the report but it was not actioned and on 18 occasions no response was received from the doctor or the clinic receptionist. Conclusion: This audit suggests four important areas in the home medication review process require review; the initiation of home medication review, the requirement for diagnostics and recent history to be provided prior to the review, the need to for discussion between the doctors and pharmacists around the recommendations and whether they will be actioned or the reason if they will not be actioned.