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Abstract: Aim: We evaluated the impact of quality improvement interventions at different time points on the uptake of collaborative Home Medicines Reviews (HMRs). Methods: National interventions to promote HMRs, comprising patient‐specific prescriber feedback and tailored educational materials for patients and clinicians, were conducted in 2004, 2006 and 2011 through the Veterans’ Medicines Advice and Therapeutics Education Services (Veterans’ MATES) program. Primary care patients taking multiple medicines were targeted in each intervention, while primary care patients taking multiple medicines who did not receive the intervention served as comparisons. Monthly HMR rates among targeted patients and a comparison group in the 9 months post‐intervention were determined using health claims data from the Australian Government Department of Veterans’ Affairs and compared using log binomial regression models. Overall trends in the rate of HMRs between November 2001 and December 2016 were also determined. Results: Over 40 000 patients were targeted in each HMR intervention. Relative increases in HMR uptake were observed among patients targeted in the 2004 intervention (rate ratio (RR) 1.76 (1.39, 2.22), p < 0.0001), the 2006 intervention (RR 1.45 (1.19, 1.76), p = 0.0002) and the 2011 intervention (RR 2.81 (2.34, 3.37), p < 0.0001) compared to the comparison group. Overall, the monthly HMR rate increased from 0.2 per 1000 patients in November 2001 to 2.7 per 1000 patients in December 2012. Conclusion: Regular repetition of quality improvement messages has led to sustained increases in HMR uptake among Australian veterans over the last decade. [ABSTRACT FROM AUTHOR]

Background: Problems with achieving the continuum of medicines management are long-standing. Audits are valuable in improving medication management and the quality and safety of healthcare systems. Aim: To evaluate the accuracy and timeliness of electronic discharge summaries (EDS) provided to patients and their primary care providers at discharge. This was a forerunner to the study hospital's National Accreditation Examination and for routine safety and quality evaluation. Methods: This study was a retrospective audit using an adaptation of the NSW indicator 5.3, 'Percentage of discharge summaries that include medication therapy changes and explanations for changes' (National quality use of medicines indicators for Australian Hospitals. ACSQHC, Sydney, NSW, 2014). The additions to the NSW tool included: assessing the completion and timeliness of delivery to primary health care providers, and the accuracy of the information. Results: In patients leaving hospital, 75% had a hospital EDS completed, with 46% completed within the recommended 48 h from discharge. For an EDS to be delivered, a primary healthcare provider must be nominated by the patient. This occurred in 53% of our sample. Accuracy of information on what medicines patients should use post-discharge was also assessed. It indicated 46% accuracy, with the majority of errors being omissions of required medicines. None of the EDSs included documented reasons for changes to medicines, in the provided table, to the primary healthcare provider. In patients on a short-term therapy, such as antibiotics, 71% of EDSs had documented a plan for short-term therapies to be completed in the community. Conclusion: The lack of information on the primary care provider recorded in the patient' s clinical system and discharge summaries, limited the timely transfer of essential information on post-discharge medicine management to the patient's primary care provider. Work has commenced on an educational program to improve data entry of the patient's primary care provider when they are admitted, and plans to improve compliance with the EDS policy. [ABSTRACT FROM AUTHOR]

The author reflects on the factors to be considered for pharmacy practice to change in Australia. He perceives that the approach can be modeled on re-professionalisation experiences in nursing and medicine and the significant work done in the area by the Canadian Pharmacists Association. He also views that it is the responsibility of every member of the profession, from students to elders, to contribute to the sector.