These include allowing direct HMR referral from GP to accredited pharmacist (instead of via the community pharmacy as an intermediate channel) and imposing that RMMR has to be collaborative (involving the participation of both the GP and accredited pharmacist in the review process).[53,54] Medication reviews led by medical doctors or nurses have also been

explored. While disease management is the key focus in the studies, ambiguous results have been reported relating to management of adverse drug events or medication management plans.[26] Barriers to the implementation of pharmacist-mediated medication review services in rural areas have been reported, including travel costs for training and limited remuneration for travel to patients’ homes or aged-care facilities.[28] In addition, the need for a GP’s referral challenges the provision of such services in rural areas where access to a GP is often limited.[28] The inability to engage an accredited Selleckchem Afatinib pharmacist in a timely matter has also been reported.[19] This warrants further research to extend referral pathway to rural healthcare providers (e.g. nurses) and to explore remuneration framework or career

pathway for accredited pharmacists in rural areas. The transfer of medication information to relevant mTOR inhibitor healthcare providers is crucial to ensure optimal ongoing care and therapy for the patient.[2] Research suggests that medication errors in this step are common, as changes to patients’ medication regimens are often not communicated effectively between the hospital, specialist, GP, pharmacist, other healthcare provider(s),

carer(s) and patients themselves.[1,8,18,19,30,42,52,55,56] One such case highlighted the confusion of a rural patient about his medications, which resulted from ineffective information transfer and the inability for his various healthcare providers to provide comprehensive Nintedanib (BIBF 1120) care.[55] Information transfer is crucial during each transition in a patient’s care. A role has been proposed for pharmacists to act as a liaison between healthcare providers to facilitate medication reconciliation and information transfer between healthcare providers;[19,21,52,56] more research should be undertaken to explore this role to develop an appropriate framework to be implemented in rural areas. Some studies have explored information transfer and medication reconciliation processes (on admission and on discharge) between hospitals and the primary care setting.[18,19,42,56] Prior to the PBS Public Hospital Pharmaceutical Reforms, 3–7 days’ worth of discharge medications were supplied by Queensland public hospitals. During this period, the discharged patient was responsible to visit a GP to obtain new prescriptions for continuing therapy.[42] This was particularly challenging for patients in areas where timely access to GP services was lacking, resulting in patients potentially missing doses of medication(s).