Development and trial of an instrument to evaluate accredited pharmacists' clinical home medicines review reports in Australia

Abstract

In Australia, clinical reports are written by an accredited pharmacist following in-home patient consultations as part of a home medicines review (HMR). These reports communicate clinical findings and recommendations to the patient's general practitioner to optimise medicines and improve patient health. However, it is unknown if clinical HMR reports adhere to practice guidelines. This study aimed to develop an instrument from Australian practice guidelines, and then test the instrument by evaluating a small sample of clinical HMR reports written by accredited pharmacists. An instrument was developed from a consolidation of HMR practice guidelines and then applied to a small sample of de-identified clinical HMR reports provided by accredited pharmacists. The instrument developed contained 30 criteria for clinical HMR report writing, and 20 HMR reports were evaluated from 12 accredited pharmacists. Seven of the 30 criteria were met by all clinical HMR reports evaluated (were consumer-focused, documented a medicines list, medicines strengths, medicines directions, medication-related problems, and included both evidence-based and clinical recommendations for optimising medicines management). However, of the 20 HMR reports evaluated only 30% (n = 6) documented the general practitioner's reason for HMR referral, 60% (n = 12) detailed allergies/adverse drug reactions, 50% (n = 10) documented an adherence statement, and 20% (n = 4) documented vaccination status. Clinical HMR reports evaluated in this small study were aligned with practice guidelines for some criteria. Future research is warranted in a larger study to further investigate clinical HMR report writing adherence to practice guidelines in Australia.