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4 June 2018
If nurses are of the belief a person would benefit from a medicines review then they can speak to the relevant medical practitioner who is the prescriber or encourage patients and their carers/spouses or family to enquire about this valuable service[i].
Nurses frequently encounter and identify patients who would benefit from a medicines management review when performing health assessments, care planning and other nursing activities. Nurses are then able to coordinate arrangements for follow up discussions with the patient’s general practitioner.
With medicines use increasing and polypharmacy common in older people with multiple co-morbidities we now have a situation where many more of hospital admissions of older people are drug-related compared with younger adults.
There is now overwhelming evidence that older people are at increased risk of medication-related problems and adverse medication events.[ii]
Reasons for these are:
Medicines reviews are a cornerstone method to improve a person’s safe use of medicines.[iii] Whilst reviews are sometimes undertaken as part of normal care, if a patient consents, they can be referred for a DMMR, which is conducted by accredited pharmacists. These reviews are subject to guidelines on the MBS items for medication management.
An overview of requirements are outlined below:
The benefit is not claimable until all the above components have been completed, i.e. after the second patient consultation.[iv]
Further information and links are provided below:
Overall, nurses play a really important role in early identification of those in need for a DMMR which may assist in early intervention of those at risk of complications due to (often inadvertent) medication mismanagement.
References
[i] Medicare Benefits Schedule – Item 900 – Associated notes. http://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&qt=ItemID&q=900
[ii] Elliott RA & Booth JC. Problems with medicine use in older Australians: a review of recent literature. Journal of Pharmacy Practice and Research. 2014 : 44: 258-271.
[iii] Roughhead L, Semple S & Rosenfeld E. Literature review: Medication safety in Australia. Australian Commission on Safety and Quality in Health Care. (ACSQHC) .August. 2013
[iv] Department of Health. Medication management reviews. http://www.health.gov.au , http://www.health.gov.au/internet/main/publishing.nsf/Content/medication_management_reviews.htm
This article was featured in APNA Connect – 4 June 2018.