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An online education package for pharmacists delivering a home medication review service to patients following acute coronary syndromes

Daniel Bernal, Leanne Chalmers, Luke R.E. Bereznicki, Ronald L Castelino, Patricia M Davidson, Gregory M Peterson


Rationale, aims and objectives: To develop and evaluate a person-centered online education package to facilitate the delivery of a Home Medicines Review system following acute coronary syndromes (ACS).

Methods: An education package of 5 online lectures, an assessment quiz and an evaluation questionnaire was developed to increase the skills and capacity of pharmacists. Course material was generated from a targeted appraisal of literature and reviewed by expert pharmacists. Kirkpatrick’s 4-level model for evaluating training programs was applied as an international standard for measuring the quality of the material developed. The evaluation questionnaire measured the dimension of reactions to the material and the assessment quiz measured the dimension of learning.

Results: From a pool of 91 accredited pharmacists, 36 registered an interest in the education package and completed the online enrolment. Of those who enrolled, 27 completed the package. Twenty-two pharmacists passed the quiz on their first attempt and 3 passed on their second attempt. Analysis of the evaluation questionnaire consistently showed pharmacists’ reactions to the material were positive.

Conclusion: In Australia, Home Medicines Reviews are endorsed by policy and reimbursed. Providing resources to increase the knowledge and confidence of pharmacists will potentially improve their ability to address specific issues with adherence and medication use following ACS.


Acute coronary syndromes, home medicines review, medication adherence, professional education and training

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Holland, R., Desborough, J., Goodyer, L., Hall, S., Wright, D. & Loke, Y.K. (2008). Does pharmacist-led medication review help to reduce hospital admissions and deaths in older people? A systematic review and meta-analysis. British Journal of Clinical Pharmacology 65 (3) 303-316.

Holland, R., Lenaghan, E., Harvey, I., Smith, R., Shepstone, L., Lipp, A., Christou, M., Evans, D. & Hand, C. (2005). Does home based medication review keep older people out of hospital? The HOMER randomised controlled trial. British Medical Journal 330 (7486) 293.

Stewart, S., Vandenbroek, A.J., Pearson, S. & Horowitz, J.D. (1999). Prolonged beneficial effects of a home-based intervention on unplanned readmissions and mortality among patients with congestive heart failure. Archives of Internal Medicine 159 (3) 257-261.

Castelino, R.L., Bajorek, B.V. & Chen, T.F. (2009). Targeting suboptimal prescribing in the elderly: a review of the impact of pharmacy services. Annals of Pharmacotherapy 43 (6) 1096-1106.

Agreement Management Committee, Australian Association of Consultant Pharmacy. Framework document for Domiciliary Medication Management Reviews. Australian Association of Consultant Pharmacy (AACP). (2001). (Accessed: 23/03/2011). Available from:

Kalet, A.L., Gillespie, C.C., Schwartz, M.D., Holmboe, E.S., Ark, T.K., Jay, M., Paik, S., Truncali, A., Hyland Bruno, J., Zabar, S.R. & Gourevitch, M.N. (2010). New measures to establish the evidence base for medical education: identifying educationally sensitive patient outcomes. Academic Medicine 85 (5) 844-851.

Poole, P. & Shulruf, B. (2013). Choosing study outcomes: keeping an eye on the big picture. Medical Education 47 (7) 645-648.

Benbassat, J. & Taragin, M. (2000). Hospital readmissions as a measure of quality of health care: advantages and limitations. Archives of Internal Medicine 160 (8) 1074-1081.

Emblen, G. & Miller, E. (2004). Home medicines review. The how and why for GPs. Australian Family Physician 33 (1-2) 49-51.

The Pharmacy Guild of Australia. (2012). Program specific guidelines: Home Medicines Review. Department of Health and Ageing. Canberra: Australian Government.

Campbell Research & Consulting. Home medicines review program: qualitative research project final report. (2008). (Accessed 22/03/2011). Available from:$File/HMR%20Final%20Report.pdf.

Turnbull, G. (2013). Urgent action needed on Home Medicines Review Program. The Pharmacy Guild of Australia. (Accessed 31/01/2013). Available from: The_Guild/tabNews_and_events/Guild_News_Centre/2013 /MR_HMRs_31Jan13.pdf

Turnbull, G. (2013). Guild welcomes support for medicines reviews. The Pharmacy Guild of Australia. (Cited 2013 8/Mar). Available from: The_ Guild/tab-News_and_ events/ Guild_News_ Centre /2013 /MR_HMR_Minister_8Mar13.pdf.

Ho, P.M., Spertus, J.A., Masoudi, F.A., Reid, K.J., Peterson, E.D., Magid, D.J., Krumholz, H.M. & Rumsfeld, J.S. (2006). Impact of medication therapy discontinuation on mortality after myocardial infarction. Archives of Internal Medicine 166 (17) 1842-1847.

Peterson, G.M., Thompson, A., Pulver, L.K., Robertson, M.B., Brieger, D., Wai, A., Tett, S.E. & the Dmacs Project Group. (2011). Management of acute coronary syndromes at hospital discharge: do targeted educational interventions improve practice quality? Journal for Healthcare Quality 34 (1) 26-34.

Chew, D.P., Huynh, L.T., Liew, D., Astley, C., Soman, A. & Brieger, D. (2009). Potential survival gains in the treatment of myocardial infarction. Heart 95 (22) 1844-1850.

Ali, R.C., Melloni, C., Ou, F.S., Schmader, K., Ohman, E.M., Roe, M.T., Peterson, E.D. & Alexander, K.P. (2009). Age and persistent use of cardiovascular medication after acute coronary syndrome: results from medication applied and sustained over time. Journal of the American Geriatrics Society 57 (11) 1990-1996.

Lemmens, K.M.M., Nieboer, A.P., van Schayck, C.P., Asin, J.D. & Huijsman, R. (2008). A model to evaluate quality and effectiveness of disease management. Quality and Safety in Health Care 17 (6) 447-453.

Stafford, L., Peterson, G.M., Bereznicki, L.R., Jackson, S.L. & van Tienen, E.C. (2010). Training Australian pharmacists for participation in a collaborative, home-based post-discharge warfarin management service. Pharmacy World and Science 32 (5) 637-642.

Kirkpatrick, D. (1996). Revisiting Kirkpatrick's four-level model. Training & Development 50 (1) 54-57.

Bernal, D., Stafford, L., Bereznicki, L., Castelino, R., Davidson, P. & Peterson, G. (2012). Home medicines reviews following acute coronary syndrome: study protocol for a randomized controlled trial. Trials 13 (1) 30.

Acute Coronary Syndromes Guidelines Working Group. (2006). Guidelines for the management of acute coronary syndromes 2006. Medical Journal of Australia 184 (Supplement 8) S9-S29.

Chew, D., Aroney, C., Aylward, P., Kelly, A.M., White, H.D., Tideman, P.A., Waddell, J., Azad, L., Wilson, A.J. & Ruta, L.A. (2011). 2011 Addendum to the guidelines for the management of acute coronary syndromes 2006. Heart, Lung and Circulation 20 (8) 487-502.

National Heart Foundation of Australia (Aslani, P., Krass, I., Bajorek, B., Thistlethwaite, J., Tofler, G., on behalf of the Heart Foundation Pharmaceutical Roundtable). (2011). Improving adherence in cardiovascular care. A toolkit for health professionals. Available from:

Sabaté, E. (2003). Adherence to long-term therapies. Evidence for action. Geneva: World Health Organization.

Morisky, D.E., Green, L.W. & Levine, D.M. (1986). Concurrent and predictive validity of a self-reported measure of medication adherence. Medical Care 24 (1) 67-74.

Steptoe, A., Kerry, S., Rink, E. & Hilton, S. (2001). The impact of behavioral counseling on stage of change in fat intake, physical activity, and cigarette smoking in adults at increased risk of coronary heart disease. American Journal of Public Health 91 (2) 265-269.

Parrott, A. (1996). Smoking cessation counselling: the stages of change model. Florence, KY: Taylor & Frances/Routledge.

Formea, C.M., Nicholson, W.T., McCullough, K.B., Berg, K.D., Berg, M.L., Cunningham, J.L., Merten, J.A., Ou, N.N. & Stollings, J.L. (2013). Development and evaluation of a pharmacogenomics educational program for pharmacists. American Journal of Pharmaceutical Education 77 (1) 10.

Stafford, L., Peterson, G.M., Bereznicki, L.R., Jackson, S.L., van Tienen, E.C., Angley, M.T., Bajorek, B.V., McLachlan, A.J., Mullan, J.R., Misan, G.M. & Gaetani, L. (2011). Clinical outcomes of a collaborative, home-based postdischarge warfarin management service. Annals of Pharmacotherapy 45 (3) 325-334.

Bhatt, D.L., Cryer, B.L., Contant, C.F., Cohen, M., Lanas, A., Schnitzer, T.J., Shook, T.L., Lapuerta, P., Goldsmith, M.A., Laine, L., Scirica, B.M., Murphy, S.A., Cannon, C.P. & COGENT Investigators. (2010). Clopidogrel with or without omeprazole in coronary artery disease. New England Journal of Medicine 363 (20) 1909-1917.

Juurlink, D.N., Gomes, T., Ko, D.T., Szmitko, P.E., Austin, P.C., Tu, J.V., Henry, D.A., Kopp, A. & Mamdani, M.M. (2009). A population-based study of the drug interaction between proton pump inhibitors and clopidogrel. Canadian Medical Association Journal 180 (7) 713-718.

Cuisset, T., Frere, C., Quilici, J., Poyet, R., Bali, L., Brissy, O., Morange, P.E., Alessi, M.C. & Bonnet, J.L. (2009). Comparison of omeprazole and pantoprazole influence on a high 150-mg clopidogrel maintenance dose: The PACA (Proton Pump Inhibitors And Clopidogrel Association) prospective randomized study. Journal of the American College of Cardiology 54 (13) 1149-1153.

Everly, M.J., Heaton, P.C. & Cluxton, R.J., Jr. (2004). Beta-blocker underuse in secondary prevention of myocardial infarction. Annals of Pharmacotherapy 38 (2) 286-293.

Eckel, R.H. (2010). Approach to the patient who is intolerant of statin therapy. Journal of Clinical Endocrinology and Metabolism 95 (5) 2015-2022.



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