Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Sep 30.
doi: 10.1007/s11096-025-02018-7. Online ahead of print.

Impact of Australian home medicines reviews on continuous polypharmacy and associated costs among older women: a cohort study

Kaeshaelya Thiruchelvam  1   2 , Nicholas Egan  3   4 , Syed Shahzad Hasan  5 , Julie Byles  3   4
Affiliations

Impact of Australian home medicines reviews on continuous polypharmacy and associated costs among older women: a cohort study

Kaeshaelya Thiruchelvam et al. Int J Clin Pharm. .

Abstract

Introduction: Medication misadventure is associated with the use of polypharmacy and is highly prevalent in the older population living in the community, especially among women.

Aim: This study aimed to determine the impact of Home Medicines Reviews (HMRs) on continuous polypharmacy, the prevalence of continuous polypharmacy, and inflation-adjusted differences in costs among women who did and did not receive HMRs.

Method: The study included 9347 participants from the Australian Longitudinal Study on Women's Health who fulfilled the eligibility criteria from 77-82 years in 2003 to 91-96 years in 2017. Generalised estimating equations were used to estimate the association between HMRs and continuous polypharmacy. Out-of-pocket costs and benefits paid to government were presented as median costs for each participant from 2003 to 2017, alongside interquartile ranges.

Results: Only a small percentage of women received HMRs in 2003 (1.14%) but this percentage increased over time to 2017 (3.95%). The prevalence of continuous polypharmacy in 2017 was 39.06% amongst women who received an HMR and 28.05% amongst women who did not receive an HMR. There was evidence for an association between the use of HMRs and continuous polypharmacy in the following calendar year (OR 1.12; 95% CI 1.03, 1.21). There was an increase in out-of-pocket (OOP) medication costs in both women with and without HMRs, with the HMR group demonstrating higher OOP medication costs (AUD$26 to AUD$57) than the non-HMR group (AUD$22 to AUD$50).

Conclusion: HMRs were associated with a modest increase in the odds of continuous polypharmacy in the subsequent year. Increase in OOP medication costs over time highlights the need to further optimise cost-effective medications for individuals.

Keywords: Aged care; Australia; Costs; Health care costs; Home care services; Home medication review; Polypharmacy.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethics approval: This research was approved under the ALSWH, which has ongoing ethical approval from the Human Research Ethics Committees (HRECs) of the Universities of Newcastle and Queensland (approval numbers H-076-0795 and 2004000224, respectively) on 26 July 1995. The ALSWH also maintains institutional HREC approvals for record linkage (approval numbers H-2011-0371 and 2012000132, respectively). Access to national data collections is approved by the Australian Institute of Health and Welfare HREC. Consent to participate: For the ALSWH survey data, all participants consented to joining the study and are free to withdraw or suspend their participation at any time. For the linked data (PBS), ALSWH participants who explicitly decline health record linkage are excluded from linked data requests. Over 80 percent of all ALSWH participants have explicitly consented to record linkage. Since 2005, the responsible Human Research Ethics Committees have approved opt-out consent; in addition, a waiver applies to unconsented participants who were deceased or lost to follow up before 2005.

References

    1. Pharmaceutical Society of Australia. Guidelienes for pharmacists providing home medicines review (HMR) services [Internet]. Australia; 2011 [cited 2019 Aug 30]. Available from: https://www.ppaonline.com.au/wp-content/uploads/2019/01/PSA-Guidelines-f... . Accessed 17 January 2025
    1. Sarwar MR, McDonald VM, Abramson MJ, et al. Credentialed pharmacist-led home medicines reviews targeting treatable traits and their impact on health outcomes in people with chronic obstructive pulmonary disease: a pre- and post-intervention study. Int J Clin Pharm. 2025;47(1):157–65. https://doi.org/10.1007/s11096-024-01819-6 . 17 January 2025 - DOI - PubMed
    1. Pharmacy Programs Administrator. Program rules- home medicines reviews [Internet]. 2024 Jul [cited 2024 Dec 17]. Available from: https://www.ppaonline.com.au/wp-content/uploads/2019/01/HMR-Program-Rule... . Accessed 17 January 2025
    1. Pharmaceutical Society of Australia. Guidelines for comprehensive medication management reviews [Internet]. Australia: Pharmaceutical Society of Australia; 2020 Mar [cited 2020 Sep 14]. Available from: https://www.ppaonline.com.au/wp-content/uploads/2020/04/PSA-Guidelines-f... . Accessed 17 January 2025
    1. Australian Institute of Health and Welfare. Australian Institute of Health and Welfare. 2018 [cited 2020 Sep 22]. Older Australia at a glance, aged care. Available from: https://www.aihw.gov.au/reports/older-people/older-australia-at-a-glance... . Accessed 17 January 2025

LinkOut - more resources