Medication safety has become both a national and PHN (Primary Health Network) health priority. Problems with medications are common at transitions of care, for example, when patients move between hospital and home. Medication-related problems result in a significant number of hospital re-admissions and emergency department visits each year.
ASPIRE to improve medication safety
The ASPIRE (A Systems approach to enhancing community-based medication review) Trial seeks to reduce the incidence of medication-related problems by improving the uptake and effectiveness of community-based home medication or medicines reviews (HMRs).
HMRs employ a person-centred approach to increase patient involvement in making informed decisions about their medicines – they are funded by the Australian Government but are underutilised post-hospital discharge.
The trial will focus on the high-risk transition period from hospital to home, with Northern Sydney PHN (Primary Health Network) and the Royal North Shore Hospital (RNSH) working in partnership to improve communication and coordination between hospital and primary care settings for patients leaving RNSH. It aims to reduce unplanned readmissions by providing a GP-initiated HMR to those patients who are at higher risk of medication-related problems – typically older people, or those taking multiple medications (polypharmacy).
Patients identified by the RNSH as likely to benefit from a timely HMR are enrolled into the program. The patient’s GP can initiate an HMR referral to an accredited pharmacist or their community pharmacy, who will then perform an HMR in the patient’s home in collaboration with their GP. A dedicated Medication Safety Pharmacist at the PHN, funded through the trial, will support the process, GPs, pharmacists and patients.
This is an ideal opportunity to discuss the patient’s personal goals, concerns and preferences and see how they manage their medication at home. An HMR supports quality use of medication, and this in turn supports quality of life.
Co-adaptation Workshops at Northern Sydney PHN
At Northern Sydney PHN, there will be two co-adaptation Workshops running in October and November 2023, which will inform the implementation of the ASPIRE Trial. At these workshops, we discuss how to best support patients in our practices through Home Medicines Reviews through collaboration between geriatricians, general practitioners, pharmacists and community members.
About the trial in our region
The ASPIRE trial is a multi-centred investigation whether a PHN-based implementation model for improving access to a timely post- discharge medication review reduces unplanned readmissions for patients leaving hospitals. Northern Sydney PHN together with Royal North Shore Hospital (RNSH) is one of four trial centres in the study. Assoc Prof Fiona Robinson is the Principal Investigator for the trial at SNHN and Prof Sarah Hilmer is the Principal Investigator at RNSH. The study is being run by a multi-disciplinary team of researchers from the University of Sydney, Northern Sydney PHN, RNSH and other leading institutions.
The aim of this study is to investigate whether an implementation model for reducing medication harm post-discharge reduces unplanned hospital readmissions. The model will involve a timely post-discharge Medication Management Review supported by the establishment of Medication Safety Hub within the participating Primary Health Networks.
Northern Sydney PHN and RNSH will be the second sites to transition to the active intervention phase, commencing February 2024. The trial is scheduled to run until June 2025, pending further extensions.
Facilitating the ASPIRE Trial at Northern Sydney PHN is Medication Safety Pharmacist Georgette Yassa whose role includes establishing communication channels between the PHN, RNSH, GPs and accredited pharmacists, supporting GPs in the coordination of a medication review service for their patient and gathering data for analysis by the lead research agency the University of Sydney.
Medication Safety Hub
As part of this study a Medication Safety Hub will be established at the Northern Sydney PHN area which will facilitate the development and delivery of education events around medication safety.
The ASPIRE trial is funded by the Medical Research Future Fund (MRFF) under the Australian Government’s MRFF 2020 Quality, Safety and Effectiveness of Medicine Use and Medicine Intervention by Pharmacists grant.
If you have questions about the ASPIRE Trial, please contact Georgette via email at gyassa@snhn.org.au
Find out more about WHO’s Medication Without Harm.
Credentialed list of pharmacists for ASPIRE Trial: click here