What Home Medicines Reviews could look like in the future

Credentialed Pharmacist of the Year Angus Thompson MPS reflects on the importance of Home Medicines Reviews (HMRs) and how he would like to see the service develop.

Why choose pharmacy?

I was initially thinking of studying food science, but following a school careers evening featuring a local community pharmacist, my appetite for pharmacy was whet when I spent a morning with him in the pharmacy. The die was then cast by conversations with a family friend who was a hospital pharmacist. I first heard about HMRs from an Australian-trained colleague back in the United Kingdom who said, ‘I can see you enjoying doing HMRs’. He was spot on, it is immensely professionally rewarding!

Tell us about your advocacy work around HMRs?

I first became involved in advocacy for HMRs back in 2014, a year after I started offering the service and saw first-hand the impact HMRs can make. I co-authored an article in The Conversation, spoke on local radio and used social media to raise awareness of issues – including the introduction of the cap on how many reviews we can provide per month. After the Australian Association of Consultant Pharmacy (AACP) ceased operations at the end 2022, many credentialed pharmacists saw threats to the service looming – particularly with the decision to commence negotiations for the 8th Community Pharmacy Agreement early. Consequently, I was particularly keen to try and raise awareness of the service, its benefits and the potential threats to its future among those outside our profession; and harness their support for our cause. Many responded indicating their support and some relayed this via letters to federal ministers. I’m confident our voice has been heard and remain optimistic.

Your hopes for the future of HMRs?

We really need the currently over-restrictive HMR program rules to be overhauled, particularly the cap which should – at the very least – be relaxed. What other health professional is restricted to how many patients they can see each month by an arbitrary limit? When patients and prescribers first hear about the cap, they are incredulous. I know many of us would also welcome permission to conduct some reviews outside the patient’s home without prior approval, a more realistic travel allowance for servicing rural and remote patients, and an uplift to payments which have not increased since 2019. These changes are desperately needed to make the program fit for service in 2025 and beyond, enabling credentialed pharmacists to meet the needs of patients in a timely fashion – irrespective of where they live.

Your key advice for pharmacists interested in pursuing credentialing?

Go for it! Many of the 3,000+ pharmacists in the Consultant Pharmacists Australia Facebook group demonstrate an amazing passion for patient-centred care. Once you get into this area of practice, you’ll see why. If you’re unsure, approach a local credentialed pharmacist, ask if you can spend some time with them on the job. Pick their brains.

But be realistic. Just because there are hundreds of thousands of Australians who could benefit from a medication review, it doesn’t mean work will fall into your lap. It can take time and hard work to build up a steady flow of referrals and even then, they will ebb and flow. In my experience, one thing you can guarantee is that there’ll be a flood just before you head away on holiday.

What’s on your bucket list?

Cuba, Slovenia, Botswana … oh sorry, you meant professionally? Top of my list is to see general practice pharmacists become the norm rather than the exception. Working in this space in the UK 20 years ago, I saw first-hand the impact we can make. With the manpower crisis now engulfing Australian general practice, the time is right to accelerate the expansion of such pharmacist roles. I also see this practice setting as ideal for pharmacist prescribing, working collaboratively as part of the practice team.

And finally, what’s your perfect ride and cafe order?

Along the gorgeous coast road to Verona Sands in the Huon Valley and over the hill to Cygnet for an oat cappuccino and almond croissant.