Exploring accredited pharmacists' work processes during Home Medicines Reviews

Introduction. The Home Medicines Review (HMR) Programme in Australia aims to enhance quality use of medicines and improve patient health via collaboration between accredited pharmacists (APs) and general practitioners (GPs). Little is known about APs’ perspectives of work processes during the various stages of HMRs. Aims. The aim of this project is to evaluate APs' perspectives of HMR work processes e.g. time spent on HMRs, use of technology, and adverse drug reaction (ADR) reporting. Methods. An online national survey was distributed to APs via three key professional pharmacist organisations. The survey explored APs’ opinions relating to the three key stages of HMR processes: (a) pre-interview i.e. preparation prior to the patient interview, (b) home interview, and (c) post-interview i.e. HMR report preparation and provision. Results. Most survey respondents were female, graduated in 2000-2009, and were from community pharmacy background. They were accredited for 11-15 years, had conducted 100-499 HMRs and were not integrated into GP clinics. They spent an average of 0-30 minutes pre-interview, 45-60 minutes during the home interview, and 1-2 hours post-interview. The majority did not use a laptop for information gathering during the home interview, and did not use devices/technology to educate patients and provide information. Most APs asked the patient to sign the Privacy Notification Form at the end of the home interview. A minority of APs have reported an ADR detected from a home interview to the health authorities or drug sponsor. Most APs spent 1-2 hours around HMR report preparation and on average, HMR reports were 2 pages in length. Discussion. Deeper insight into APs’ work processes will improve quality use of medicines in patients. Additionally, this valuable gain in knowledge around pharmacy practice issues, and health care workforce issues linked with patient home visits can inform future potential funding models. In taking a team-based approach, the perspectives of other health professionals regarding HMR work processes e.g. GPs could also be explored.