Home Medicines Review (HMRs), also known as Domiciliary Medication Management Review (DMMR)

• Aims to enhance an individual patient's benefit from their medications and reduce adverse medication events. The patient must be living at home in the community.
• HMR/DMMR is a Medicare Item 900 for GPs. All three elements of the HMR need to be completed before claiming.

The three steps in the HMR/DMMR process are:

1. GP prepares HMR/DMMR Referral for patient and send referral to patient's preferred community pharmacy or accredited pharmacist
2. Accredited pharmacist visits patient in their home and prepares HMR Report and sends to GP. GP then discusses results of the HMR Report with the reviewing pharmacist
3. GP prepares a written HMR/DMMR Medication Management Plan in consultation with patient. GP sends a copy of Plan to pharmacy/ pharmacist. GP can now claim MBS Item 900 ($154.80; if DVA patient: $174.55- benefits as at 14/6/16)

• Medical Director and Best Practice users can find the above templates within their software. Please see related documents for a step by step guide in accessing the templates in pdf Medical Director (666 KB)  and  pdf Best Practice (615 KB) .
• Go to the 6cpa website, then Promotional Resources to print the Home Medicine Review consumer brochure for your patients.

Residential Medication Management Reviews (RMMRs) for aged in RACFs

• Aim is to enhance an individual patient's benefit from their medications and reduce adverse medication events. The patient must be a permanent resident of a residential aged care facility (RACF)
• RMMR is a Medicare Item 903 for GPs. All three elements of the RMMR need to be completed before claiming by the GP.

The three steps in the RMMR process are:

1. GP prepares RMMR Referral for patient and send referral to RACF's contracted accredited pharmacist
2. Accredited pharmacist visits patient in the RACF and prepares RMMR Report and sends to GP. GP then discusses results of the RMMR Report with the reviewing pharmacist
3. GP prepares a written RMMR Medication Management Plan in consultation with patient. GP sends a copy of Plan to the RACF and accredited pharmacist. GP can now claim MBS Item 903 ($106.00; if DVA patient: 115% Benefit- benefits as at 14/6/16)

Please note the hyperlinks attached to the RMMR Referral and Plan are the same sample document which combines both GP referral, pharmacist report and GP Plan.

• GPs can assist in detection of fraudulent prescriptions (including Schedule 8 medications and benzodiazepines) by ensuring their medical software has enabled the electronic Prescription functionality in their User settings. Then a barcode is printed on the bottom of each prescription generated, enabling pharmacists to scan the scripts and detect any fraudulent scripts. Fraudulent Schedule 8 scripts have been detected after being scanned within the CESPHN locality. For more information on enabling ePrescriptions go to Medisecure or eRx.

• The Prescription Shopping Information Service is a 24 hour, 7 days a week telephone service. GPs can access this service on phone 1800 631 181 to find out if a patient is unknowingly or deliberately gets more PBS medicine than they need.

• Royal Australian College of General Practitioners (RACGP) has two relevant Guidelines:

  • Part A: Prescribing drugs of dependence in general practice: Clinical governance framework
  • Part B: Prescribing drugs of dependence in general practice: Benzodiazepines

• NSW Therapeutic Advisory Group Inc. - Preventing and managing problems with opioid prescribing for chronic non-cancer pain. NSW TAG: Sydney, 2015

• NSW Health Guide for Medical Practitioners: Criteria for issuing non-handwritten (computer generated) prescriptions

• GPs who are interested in finding out more about this topic are encouraged to read the National Pharmaceutical Drug Misuse Framework for Action 2012-2015

• The Pain Management Network has useful chronic pain assessment, management and resource tools for GPs, such as the Quick Steps to Manage Chronic Pain in Primary Care. The Brief Pain Inventory, can be edited online and saved, and consumer resources are available.

• NPS MedicineWise offers free CPD on chronic pain:

  • for GPs for the 2014-2016 triennium, which is recognised for the Practice Incentive Program Quality Prescribing Incentive (PIP QPI). Find out more about the Clinical eAudit and the case study.

  • for pharmacists: the Pharmacy Practice review "Chronic pain: opioids and beyond, supporting a multimodal approach" provides up to 8 hours of Group 2 CPD (or 16 CPD credits)

• NSW Health Chronic Pain Management – information for medical practitioners and pharmacists

• Educational videos for understanding pain
  • English
  • Arabic, Chinese, French, German, Hebrew, Italian, Japanese, Norwegian, Portuguese, Spanish

• CALD Communication tool for pain: Afghan, Burmese, Indian, Iraqi, Sri Lankan, Sudanese, Vietnamese. Assists healthcare providers with assessing pain patients who have low literacy levels, who are Non-English speaking, the aged community and those with disabilities.