Conducting a Medication Review
Published: 14 October 2020
Published: 14 October 2020
Medication reviews are integral in reducing the prevalence of adverse events and ensuring that medicines are being used safely and appropriately.
A medication review is a systematic evaluation of a patient’s medicines. It is an interprofessional process that aims to ensure medicines are being used safely and effectively at all times (CEC 2019).
During a medication review, a practitioner works together with the patient to assess the risks and benefits of all medicines being taken by the patient. This may lead to decisions being made about the patient’s medication regimen (PSA 2020).
The two main goals of a medication review are to:
Any issues or potential issues found during a medication review should be documented and addressed, and appropriate recommendations should be made to counter identified risks (CEC 2019).
Rather than solely being a pharmacist’s role, medication reviews are an interprofessional responsibility. Other members of the care team may conduct reviews when medicines are being prescribed, dispensed and administered, as long as they are appropriately trained to do so (ACSQHC 2019; CEC 2019). Ideally, a multidisciplinary collaborative approach is used.
This action states that medication reviews should be conducted and documented in order to ensure medicine use is optimised and the risk of medicine-related problems is reduced (ACSQHC 2019).
Health service organisations are required to:
Keep in mind that medication reviews and medication reconciliation are different, but related processes. While medication reviews focus on optimising medicine use, identifying issues and implementing recommendations, medication reconciliation is more related to interprofessional communication and resolving discrepancies (CEC 2019).
Generally, medication reconciliation should be undertaken prior to a review, as this will ensure the patient’s medication history is as comprehensive as possible, allowing for a more accurate review (CEC 2019).
There are a number of reasons why a medication review might be needed. The patient, their carers, medical practitioners, pharmacists or health professionals involved in the patient’s care are all able to indicate that a review may be necessary, but the medical practitioner is responsible for making the decision to refer (PSA 2020). In the community and in Aged Care homes, funding is available for General practitioners and accredited pharmacists under the Medical Benefits Scheme (MBS).
Every organisation should have risk assessment criteria for identifying patients who require a medication review. Priority should be given to patients who are at higher risk of experiencing medicine-related problems or ADRs (ACSQHC 2019).
Patients who meet any of the following risk factors are more susceptible to medicine-related problems and adverse events, and may benefit from a medication review:
(PSA 2020; SHPA 2015)
A structured medication review should comprise:
(ACSQHC 2019; NICE 2020)
Each medicine currently being taken by the patient (i.e. existing or newly prescribed) needs to be assessed for clarity, validity and appropriateness (ACSQHC 2019).
The following questions should be asked:
(CEC 2019; SHPA 2013)
With these points in mind, you should also consider:
Medication reviews should be patient-centred (WA DoH 2018), taking into account the patient’s experience with the medicines they are taking (ACSQHC 2019).
The patient should be supported to participate in the review process to the extent that they choose and provide input about the options, benefits and risks of their medicines (PSA 2020).
When conducting a medication review, the patient’s satisfaction with their medicines should be assessed to determine whether they are having a positive care experience (e.g. whether they are experiencing any medicine-related problems). If the patient has a chronic condition, their quality of life and life expectancy should be considered when making decisions (ACSQHC 2019).
Discussing when, how and whether the patient has been taking their prescribed medicines will provide a greater understanding of the patient’s experience and allow any issues to be identified and addressed (ACSQHC 2019).
Medication reviews can help ensure that medicines are always being used safely and appropriately while reducing the risk of medicine-related problems and ADRs. They are also a useful way of gauging patient experience and satisfaction so that the patient’s medicine regimen can be tailored to better suit their needs.
All reviews and recommendations that arise should be appropriately documented, and medicines should always be prescribed, dispensed and administered in consultation with the required information and patient records.
Question 1 of 3
True or false? The terms medication review and medication reconciliation are interchangeable.
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Ausmed’s Editorial team is committed to providing high-quality and thoroughly researched content to our readers, free of any commercial bias or conflict of interest. All articles are developed in consultation with healthcare professionals and peer reviewed where necessary, undergoing a yearly review to ensure all healthcare information is kept up to date. See Educator Profile
Jenny is a practicing pharmacist, a Teaching Associate at Monash University and Clinical Associate at RMIT university . She is a current member of the PSA Branch committee, Editorial Board Member of AUS-DI (Drug information), Guidelines Committee for the National Asthma Council Australian Asthma Handbook, and RACGP Silver book for Aged Care . Jenny is an accredited consultant pharmacist, and conducts her own company focussing on medication reviews in the home and Aged Care Facilities as well as Quality Use of Medicine consultancy. She works regularly in community pharmacy plus sessions in a GP clinic at a Community Health Centre. Jenny has published over 380 educational articles and presents hundreds of talks annually. In 2010 Jenny received the Sanofi-Aventis award by the University of Sydney, in 2013, PSA Australian Pharmacist of the Year and 2016 Jenny was the AACP-MIMs Consultant Pharmacist of the Year. See Educator Profile