Home medicines reviews: a qualitative study of GPs’ experiences
Kristie Rebecca Weir A B H , Vasi Naganathan C D , Debbie Rigby E , Kirsten McCaffery A B , Carissa Bonner A B , Lyndal Trevena F , Andrew J. McLachlan C G and Jesse Jansen A BA Wiser Healthcare, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia.
B Sydney Health Literacy Lab, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia.
C Centre for Education and Research on Ageing (CERA), Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW 2006, Australia.
D Ageing and Alzheimer’s Institute, Concord Repatriation General Hospital, NSW 2139, Australia.
E DR Pharmacy Consulting, Brisbane, Qld 4001, Australia.
F Ask Share Know Centre for Research Excellence, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia.
G Faculty of Medicine and Health, Sydney Pharmacy School, University of Sydney, NSW 2006, Australia.
H Corresponding author. Email: kristie.weir@gmail.com
Australian Journal of Primary Health 26(1) 24-30 https://doi.org/10.1071/PY19072
Submitted: 02 April 2019 Accepted: 23 August 2019 Published: 18 November 2019
Abstract
This qualitative study explored GPs’ experiences with pharmacist-led home medicines reviews (HMRs) and the barriers and facilitators to GPs using HMRs to optimise medicines for older people. Semi-structured interviews were conducted with 32 GPs Australia-wide. Purposeful sampling was undertaken to obtain a representative group in terms of age, gender and location. Data were analysed using framework analysis. Overall, GPs found HMRs useful for educating patients about their medicines, improving adherence and understanding the patient’s home environment. Barriers to effective use of HMRs included patient resistance to having medicines reviewed and limited access to HMRs in regional or rural areas. GPs differed in the extent and way they use HMRs. One group found HMRs very useful, wanted more access to HMRs and reported frequent interactions with pharmacists. A second group was ambivalent, and perceived HMRs could be useful but had limitations in what they can achieve. A third group was sceptical, and reported HMRs rarely provide new insights, and recommendations were not clinically relevant to patients. Understanding GPs’ expectations and preferences through interprofessional communication and partnerships are ways to address these barriers. Future improvements to the HMR program may include incentives and resources that promote collaboration between GPs and pharmacists.
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