ASPIRE Medication Safety Trial

Brisbane North PHN and the Royal Brisbane and Women’s Hospital (RBWH) have partnered to deliver ASPIRE in our region with the aim of reducing medication-related harm at transitions of care.

The transition of care from hospital to home is widely recognised as a period of increased risk for medication-related harm. Older people or those taking high-risk or multiple medications (polypharmacy) are typically more vulnerable.

The ASPIRE (A systems approach to enhancing community-based medication review) Trial is a multi-centre study, sponsored by the University of Sydney. It investigates a PHN-based model aiming to coordinate timely medication reviews for individuals at high risk of medication-related harm during their transition from hospital to home. North Brisbane is one of four trial sites across Queensland and New South Wales.

The trial, running until 2025, will evaluate the implementation of a health service intervention program designed to enhance both the uptake and effectiveness of Home Medicines Reviews (HMRs) after a hospital stay.

Brisbane North PHN in partnership with RBWH are planning to achieve this through:

• Implementing a Brisbane North PHN-based Medication Safety Hub with a Medication Safety Pharmacist who assists in coordinating timely medication management reviews.
• Engaging a hospital pharmacist at the Royal Brisbane and Women’s Hospital (RBWH) to identify patients at high risk of medication-related harm who are likely to benefit from a post-discharge medication review.
• Strengthening communication channels between local hospitals, primary care healthcare practitioners, and the PHN-based Medication Safety Pharmacist to improve medication safety and patient outcomes.
• Facilitating multi-disciplinary, PHN-led professional development activities focused on quality use of medicines for local healthcare practitioners.
• Developing a communication strategy to raise awareness among local healthcare practitioners about the new role of the PHN in coordinating medication reviews and medication safety initiatives.

Home Medicines Review: supporting quality use of medicines

A Home Medicines Review (HMR) is a government funded medication review service involving the patient, their general practitioner (GP) and an accredited (credentialed) pharmacist. HMRs employ a person- centred approach to increase patient involvement in making informed decisions about their medicines, aiming to improve health outcomes and quality of life.

HMRs conducted after a hospital stay enable accredited (credentialed) pharmacists to:

• enhance the patient’s understanding of their recently altered or new medication regimen
• assess whether the patient is tolerating and managing their new medication regimen at home
• review prescription and non-prescription medications the patient is using
• recommend interventions that ensure a patient’s medication use is safe, effective and appropriate
• identify and address actual or potential medication-related problems
• escalate concerns regarding medication-related harm to the referring practitioner.
  

General Practitioners

GPs are notified of their patients’ enrolment in the ASPIRE Trial via their hospital discharge summary. Patients are encouraged to schedule an appointment with their GP to initiate a HMR referral. The PHN Medication Safety Pharmacist communicates additional clinical information obtained during the patient’s handover with the hospital pharmacist to the GP.

Brisbane North Accredited Pharmacist Directory

Brisbane North PHN have created a local directory of accredited (credentialed) pharmacists who are available to conduct HMRs. This directory is available to General Practitioners via HealthPathways until the end of the trial.

Pharmacists interested in being involved in ASPIRE or connecting with the PHN for Continuing Professional Development events can provide consent via the Accredited Pharmacist Registration Form to be listed on the Brisbane North PHN Accredited (Credentialed) Pharmacist Directory.

Home Medicines Review Resources for GPs and Consumers

A Home Medicines Review (HMR), also known as a Domiciliary Medication Management Review (DMMR), is billed under MBS Item 900, after a written Medication Management Plan is developed in accordance with MBS requirements.

To support the Home Medicines Review process, a suite of practice software resources is now available. The cheat sheets help GPs streamline HMR referrals and Medication Management Plans in Best Practice and Medical Director, making referrals easier. Additionally, the DMMR Form 1 in Best Practice can be updated to enable access to the practice address book and to include the option of adding credentialed pharmacists' details.

Refer to the consumer information for essential details on the HMR process and its role in optimising medication management.