Thursday, August 07, 2008

Home Medicines Review


As part of the hospital placement, I went on for a Home Medicines Review (HMR) today and found it to be very inspiring.

HMR is basically a service where a pharmacist will go to the home of a discharged patient and assess all the meds he/she is taking and also his/her competency in taking them.

I was often taught in Uni that patient's adherence in taking medications is often the biggest problem in a successful treatment. I was blissfully unaware of the magnitude of the problem until I saw it first hand today.

Today we went to visit an elderly patient who had congestive heart failure and diabetes. He had 10 medications on his list. It was assumed that all these while, he was compliant with his medication and understands what they are for.

During the course of the interview, it was then found out that he only took the meds when he remembered about them, which is around 3-4 times per week. What's more, he selects which medication to take, and stops them if he felt better. He had no idea what some of the medications are for, and there are even medications which expired 6 years ago!

I found the role of the pharmacist in this case very meaningful. Like a detective, he made the patient felt comfortable and slowly plodded and prodded to gain information about the medications the patient is taking and also his knowledge of the drugs. He then patiently inform the patient about the importance of taking each medication and how they can help him. He also thought about ways to make the patient remember how and when to take the medication.

After that, the pharmacist liaised with the patient's doctor to figure out exactly what medications the patient is on. He even helped in negotiating with the patient's local pharmacy to do a Dosett box (pic below) for the patient and deliver it to him free of charge!


It was a great feeling to see the patient so relieved that his problems are being sorted out and that this intervention is likely to prolong his life for a few more years. I was glad to find out that there's so much a pharmacist can do to make others feel better. This really inspired me to be a pharmacist who can make a difference in the lives of others in the near future.

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