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HOME MEDICINES REVIEW Home Medicines Review (HMR) for Mrs Miller, a regular customer of your pharmacy. In the referral from Dr Tayler, they mention Mrs Miller has been experiencing recurrent UTIs and would benefit from a HMR. They have also requested you to simplify her medication regimen, screen for drug interactions, check for potential medication-related adverse effects and assess her compliance. The referral from Dr. Tayler includes the following information: Patient Medical Conditions Other relevant information Mrs Ruth Miller Type 2 Diabetes Weight: 65kg 19 Armitage Av. Hypertension Blood Pressure: 155/92 mmHg Granville NSW 2142 Dyslipidaemia Age: 48 years Depression Allergies: Penicillin Insomnia Non smoker Non-drinker Medicines Drug Dosage Indication Atorvastatin 40mg 1 N Dyslipidaemia Perindopril 2mg 1 M Hypertension Aspirin 100mg 1 M Primary Prevention Citalopram 40mg 1 N Depression Onset after husbands passing Metformin 1000mg + 1 BD Type 2 diabetes vildagliptin 50mg Dapagliflozin 10mg 1 N Type 2 diabetes Trimethoprim 300mg 1 D for 3 days Urinary Tract Infection (recurring) Domperidone 10mg 1 TDS Gastroparesis Oxybutynin 5mg 1 BD Urinary incontinence (urge) Tramadol SR 100mg 1 BD PRN Hip Replacement During the interview, you gather the following information from Mrs Miller: She has commenced Dapagliflozin 2 months prior to your home visit – she was not keen on injectable insulin (doctor said to trial this first) Ruth has completed 2 courses of Trimethoprim within the last 6 weeks. She reports each course had successfully treated the infection; however she is unsure why the infection keeps reoccurring. She finds herself having trouble sleeping most nights Her current fluid intake is not optimal as she is currently having plumbing issues at home which is making the water at home taste ‘funny’. Her neighbour has recommended cranberry juice to treat her UTIs She has been quite forgetful and confused lately and acknowledges that she has been missing doses of her medicines. She also feels like she is taking “too many pills” 4.1 Now that your interview with Mrs Miller has concluded, outline at least three (3) counselling points/lifestyle advice that you would give Mrs Miller as the Pharmacist before leaving her home and reporting back to the Doctor? 4.2 There are a number of important medication issues to address with Dr Tayler. List the issues you have identified in order of highest to lowest priority and the recommendations you would give. Complete the table below – Please identify and list at least FOUR (4) issues regarding Mrs Miller’s medicines. Issue identified Medication (s) Recommendations 1. 2. 3. 4. 5. 6. 4.3 Using the breakdown of issues you have identified in question 4.2 above, a letter to Dr Tayler about Mrs Miller’s medication management outlining your findings and recommendations for the HMR. Ensure you use appropriate communication and justify any recommendations you make with appropriate resources and references. Remember, Dr Tayler requested:interactions and; A simplified medication regimen (Identify the issues and suggest your recommendations) Poor standards in spelling and grammar will affect your credibility with other health professionals, so ensure that your report is well formatted and contains no spelling or grammatical errors. You may like to consider the format of your letter – adding in subheadings or tables with your recommendations to ensure your recommendations to the Doctor are clear. (approx. one page)

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