Pharmacy
Residential Medication Management Reviews Program - Fact Sheet
Fact Sheet on the Residential Medication Management Reviews Program available under the Fourth Community Pharmacy Agreement.
The Fourth Community Pharmacy Agreement (Fourth Agreement) includes funding of up to $150 million for a range of Medication Management Review Programs. As part of this, $66.75m is allocated to the Residential Medication Management Reviews (RMMR) Program.
The RMMR Program was established in 1997 and aims to promote safe effective and appropriate use of medicines particularly for residents of Aged Care Facilities who are often taking multiple medications. The program helps reduce the risk of medication misadventures and optimise the benefits achieved from medication treatment through the quality use of medicines. .
What is a RMMR?
Aged care facilities engage an accredited pharmacist to conduct medication management reviews to eligible residents of aged care facilities. There are two types of medication reviews under this program:Pharmacist only; and
Collaborative RMMRs
The pharmacist only review is undertaken by the accredited pharmacist in the aged care facility and, although the recommendations may be forwarded to the resident’s GP, does not require referral from a GP. The accredited pharmacist is able to conduct one (1) pharmacist only review per eligible resident within a 12 month period.
A collaborative review is undertaken by the accredited pharmacist on referral by the resident’s GP. There are specific reasons why a collaborative RMMR is conducted, such as a change in the number or type of medications taken, or if the resident has had an adverse event such as hospitalisation. There is no limit on the number of collaborative RMMR’s undertaken within a 12 month period so long as they are deemed necessary by the GP.
Should all new residents receive a RMMR?
Generally an initial RMMR service should be conducted for all new eligible residents as soon as possible and ideally within 6 to 12 weeks of admission into the aged care facility. Guidelines from the Pharmaceutical Society of Australia recommend that this initial medication review be conducted as a collaborative review where possible.Can all pharmacists provide a RMMR?
No. Only those pharmacists who have undertaken specified education programs orexaminations through the Australian Association of Consultant Pharmacy or the Society of Hospital Pharmacists of Australia, and have been accredited to provide medication reviews, can conduct RMMR’s.
The accredited pharmacist must ensure Quality Use of Medicine (QUM) services are provided to the aged care facility. QUM is an important arm of Australia’s National Medicines Policy. It recognises that in order to achieve quality use of medicines, consumers must be provided with the most appropriate treatment and have the knowledge and skills to use medicines to their best effect.
Pharmacists have a particularly important role to play in promoting the quality use of medicines, through promoting good treatment choices, good communication with consumers and collaboration with other health practitioners including GPs. Top of page
These services can be performed by the accredited pharmacist or they can sub-contract the services to an alternate QUM provider. Approved RMMR Service Providers and QUM Service Providers are required to work closely with the aged care home in ensuring optimal health outcomes for residents.
Examples of QUM activities may include:
- Medication advisory activities
- Education activities; and
- Continuous improvement activities
Can RMMRs be provided to patients in the community?
No. A similar program, Home Medicines Reviews program, conducts medication reviews in the community. These reviews require referral from a GP and an accredited pharmacist is engaged through a community pharmacy to conduct the review.What patients are eligible for this service?
All residents living permanently in an aged care facility who hold a current Medicare or DVA card are eligible to receive RMMR services.Who may benefit from a RMMR?
Priority should be given to eligible residents with the following characteristics:- taking five or more regular medications,
- taking more than 12 doses of medication per day,
- suffering from multiple medical conditions,
- admitted to the facility in the last four weeks,
- had significant changes made to their medication regimen in the last three months,
- on medication with a narrow therapeutic index or requiring therapeutic monitoring,
- with symptoms suggestive of adverse drug reaction,
- with a sub-therapeutic response to treatment,
- suspected of non-compliance or not managing drug related therapeutic devices,
- self managing medications that are at risk due to language difficulties, dexterity problems, impaired sight or cognitive difficulties, increasing frailty; or
- changes in health status.
What is the current rate of remuneration?
From July 2007, RMMR providers/accredited pharmacists are paid on a fee-for-service basis. The current rate as at April 2008 is $130 per service.GPs who participate in a collaborative RMMR service are eligible to claim under Item 903 of the MBS. The current rate as at April 2008 is $93.85.
