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For General Practitioners
Thrive, Proactive Medication Service
Thrive is an ongoing support service to enable you to deliver exceptional patient care.
Stages of Services
How Ward MM Thrive works with you to provide the best health results.
How does testing DNA help find the right medication?
Our DNA testing partner, MyDNA conduct a pharmacogenomic test which identifies variations in a number of genes that affect medication response. These variations have been shown to affect either the blood levels or the therapeutic response/side-effects to a number of medications.
If you can't find an answer to your question here please contact Ward MM directly on 1800 927 366.
- Thrive is designed to collaborate with you to improve your patient’s quality of life. The purpose of the new service is to aid in reducing the risk of medication related harm.
- We will work closely with you, your patient, their specialists and their relatives to ensure that we have an understanding of their needs and concerns. We will then work collaboratively with you to provide a truly tailored personalised medication management plan which we will consistently monitor and revise through regular follow up.
- Insight into the impact of your patient’s DNA on their ability to metabolise their current and future medications.
- Access to a collaborative clinical pharmacist partner to help determine, support and monitor a long term proactive medication plan for your patient.
- Supported clinical clerking activities to free up your time for patient facing tasks.
- Regular case conferencing.
- Insight into any non-prescription medications or supplements being taken by your patient to gain a full understanding of their medication profile.
- Insight into potential additional goals and concerns faced by your patient and their relevant family members.
- Benchmarked data insights on your prescribing practices.
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- Booking appointments for your patients to see you.
- Blood glucose testing.
- Blood pressure monitoring and recording.
- Support medication dosing changes and adherence.
We know that people taking 5 or more medications are at an increased risk of medication related harm. There has been some published evidence of the advantages of medication management reviews identifying that they help reduce drug burden, drug costs and improve quality of life.
In the MJA in 2002 Gilbert et al evaluated a collaborative medication management service model which concluded that using case conferencing, a home visit and then a second case conference would be beneficial in engaging GPs and pharmacists and in assisting in the resolution of medication related problems.
The benefits that can be gained from RMMRs in the aged care home are difficult to ignore. They are delivered in a setting where almost all of the residents are elderly, where medication use is complex and fraught with risk, and where the acuity of care is progressively increasing overtime, these services have great potential to deliver improved outcomes and a decrease in drug related morbidity. It is apparent that by delivering these services more frequently will only improve on these benefits.
Pharmacogenomics aims to support a personalized prescribing approach to reduce the risk of adverse drug reactions. Many publications have identified this as one of the main advantages of using DNA testing for individuals to guide prescribing. The Ubiquitous Pharmacogenomics Consortium in Europe are commencing their first international implementation project to determine the impact of pre-emptive testing on ADR frequency, severity and associated costs.
- Gilbert AL, Roughead E, Beilby J, Mott K, Barratt J Collaborative Medication Management Services- Improving Patient Care. MJA 2002;177:189-192
- Nishtala PS, McLachlan AJ, Bell JS, Chen TF. A retrospective study of drug-related problems in Australian aged care homes: medication reviews involving pharmacists and general practitioners. J Eval Clin Pract 2011;17:97- 103.
- Nishtala SP, Hilmer SN, McLachlan AJ, Hannan P, Chen TF. Impact of Residential Medication Management Reviews on Drug Burden Index in Aged-Care Homes - A Retrospective Analysis. Drugs Aging 2009;26:677- 686.
- Kapoor R, Tan-Koi WC, Teo YY. Role of pharmacogenetics in public health and clinical health care: a SWOT analysis. Eur J Hum Genet 2016;24(12):1651–1657
- van de Wouden CH, Cambon-Thomsen A, Cecchin E et al.; Ubiquitous Pharmacogenomics Consortium. Implementing Pharmacogenomics in Europe: Design and Implementation Strategy of the Ubiquitous Pharmacogenomics Consortium. Clin Pharmacol Ther 2017;101(3):341–358.
- NHS England. Improving outcomes through personalised medicine. Available
at: https://www.england.nhs.uk/wp-content/uploads/2016/09/improving-outcomes-personalised-medicine.pdf (accessed May 2018)
- At the moment the government fund one RMMR (aka DMMR) or HMR to be conducted by an accredited clinical pharmacist every two years, or more frequently if there is a clinical need such as unexpected hospitalization, falls or changes in cognition. Although this service provides valuable support to general practitioners when considering prescribing regimens, it does not fully take into account the potentially harmful impact medications can have in causing a clinical need.
- In order to learn from other models, such as the role of a clinical pharmacist in the Australian hospital system, Ward MM have developed the Thrive service to truly consider the complexity and acuity of people being admitted to aged care homes and living in the community with chronic conditions. The service takes into consideration a number of factors not included in an RMMR or HMR, such as DNA results and family concerns, and creates a proactive long-term plan for your patient.
- This plan is created in collaboration with you and, going beyond a basic RMMR or HMR, is regularly reviewed to ensure it continues to meet the current needs of your patient. The objective of this plan is to support you to make the best decisions for your patient with as much information and scientific rigor as possible.
This service is akin to what currently happens in the hospital system where the clinical pharmacists are able to be part of a multidisciplinary team. Working collaboratively in this way will allow us to identify medication related issues and ensure they are acted upon in a timely manner. We will also be able to provide you with feedback on your patient. The other difference is the provision of DNA testing which allows us to assess the metaboliser status of your patient. We can then discuss the implications of the test results with you to ensure that any potential medication changes can be acted upon during the case conference.