Health Care Professionals

MedsCheck

Frequently Asked Questions: MedsCheck at Home

Patient Eligibility

Conducting the MedsCheck at Home



Patient Eligibility

Who is eligible to receive a MedsCheck at Home?

Ontarians who hold a valid Ontario health card, living in Ontario, taking a minimum of 3 chronic prescription medications and who are not otherwise able to attend the community pharmacy are eligible for the MedsCheck at Home. These patients are typically frail and elderly; home bound and/or living in isolated conditions or with a relative; however, they may also be non-Ontario Drug Benefit recipients and/or under the age of 65 years depending on individual circumstances. In addition, these patients will not have benefited from a MedsCheck service that is otherwise available at the pharmacy in person. 

Residents of Retirement Homes or Group Homes are not eligible for the MedsCheck at Home; should such residents require a home visit, provided they meet the respective program criteria and agrees to a home visit, may be eligible to receive a MedsCheck Annual, MedsCheck Follow-up or a MedsCheck for Diabetes Annual.

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Can a family member ask if a MedsCheck at Home can be arranged for their mother who is not able to come to the pharmacy in person?

Yes. A pharmacist may arrange a MedsCheck at Home at the request of a family member provided the patient meets the program criteria and has provided consent to the home visit by the pharmacist.

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How often can I conduct a MedsCheck at Home for a patient?

Patients are eligible for a MedsCheck at Home service once per year based on the date that the recipient had their previous MedsCheck at Home service or other ‘annual’ medication review service (with the exception of the MedsCheck LTC). Should a patient require another pharmacist’s visit or follow-up communication, the pharmacist will accommodate the need as per the best interest of the patient, plan the visit with patient approval and document accordingly. Subsequent home visits within the year are not reimbursed as MedsCheck at Home; however, the patient may qualify under the MedsCheck Follow-up program.

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What if the patient receiving a MedsCheck at Home needs another visit during the same year; will I be compensated?

The MedsCheck at Home service is reimbursed at $150 per year based on the date that the recipient had their previous MedsCheck at Home service (or other annual MedsCheck service with the exception of MedsCheck LTC). Pharmacists may visit the patient more than once during the same year as part of a MedsCheck Follow-up provided the patient meets the program criteria.

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Does the reimbursement for the MedsCheck at Home cover the pharmacist’s traveling expenses?

Yes. The reimbursement for the MedsCheck at Home of $150 per year is intended to include travel. There is no additional reimbursement for traveling to the patient’s home.

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How do I determine whether a patient has already had a MedsCheck at Home medication review conducted at another pharmacy?

Pharmacists are required to plan the ‘at home visit’ with patient permission and to schedule a time to visit that is agreeable to the patient. In so doing, it is important to ask the patient whether or not they have participated in the MedsCheck at Home service (or other MedsCheck service) with another pharmacy in the past year.

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How will the ministry address patients who receive a MedsCheck at Home medication review more than once within the year?

Pharmacies are reimbursed for one MedsCheck at Home claim per year based on the date that the recipient had their previous MedsCheck at Home service or other ‘annual’ service with the exception of MedsCheck LTC. A patient who receives a MedsCheck at Home is not eligible for a MedsCheck service that may otherwise take place within the community pharmacy including the MedsCheck Annual or a MedsCheck for Diabetes.

Ministry inspectors will monitor the claims and will follow up with pharmacies if there are concerns regarding claims submissions including missing or incomplete documentation records. All MedsCheck claims are subject to audit and claims may be recovered if deemed appropriate.

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Conducting the Medscheck at Home

As a pharmacist, do I require specific training and education to conduct a MedsCheck at Home?

Pharmacists are required to be registered to practice direct patient care with the Ontario College of Pharmacists (OCP) (Part A of the Register, OCP).

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Can the pharmacist conduct the MedsCheck at Home service in a community center or other meeting place?

No. The MedsCheck at Home is designed as a pharmacist’s one-on-one consultation to occur in the patient’s private home; this could include circumstances when a patient is living with a relative or friend and is not able to attend the pharmacy.

Residents of Retirement Homes or Group Homes are not eligible for the MedsCheck at Home; should such residents require a home visit, provided s/he meets the respective program criteria and agrees to a home visit, may be eligible to receive a MedsCheck Annual, MedsCheck Follow-up or a MedsCheck for Diabetes Annual service.

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Is the patient required to sign the MedsCheck at Home medication reviews along with the pharmacist?

No. Effective October 1, 2016 the ministry implemented the MedsCheck Patient Acknowledgment of Professional Pharmacy Services form and process. This annual process outlines the MedsCheck services that are funded by the Ontario government, that they occur at the pharmacy (unless the program specifies otherwise) where there is sufficient privacy and that the MedsCheck patient personal medication record will be shared with the patient’s primary prescriber.

The final MedsCheck at Home medication review must be signed and dated by the pharmacist – patients are not required to sign the completed MedsCheck form. It must also indicate that the mediation review took place in the patient’s home and documentation must include that a medication cabinet cleanup was conducted and documentation thereof.

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Can the pharmacist conduct the MedsCheck at Home with the caregiver?

Yes. A caregiver may be present for the MedsCheck at Home however, as the patient will already be at home, it will be conducted with both. If the patient is unable to sign the appropriate consent / annual acknowledgment form, the caregiver may sign.

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Can the pharmacist make a claim for the MedsCheck at Home if the patient forgot about the visit and sends the pharmacist away?

No. Pharmacy staff need to develop a system of scheduling and reminding the patient of the MedsCheck appointments, including the MedsCheck at Home at a time that is convenient for the patient. A mechanism should be in place whereby the pharmacy contacts the patient to ensure the visit is still on schedule as agreed.

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What is included in the MedsCheck at Home medication review?

The MedsCheck at Home review includes a medication review as in the MedsCheck Annual program as well as observed medication-taking behaviour. Any real or potential drug therapy problems and recommendations need to be documented and shared with the appropriate health-care professional. In addition, any education, advice, follow-up measures and referrals need to be documented. All MedsCheck medication reviews require the use of professional pharmacist notes +/or the use of a pharmacist’s worksheet. The ministry provides a template of minimum fields for this purpose that pharmacists can adapt. The review also requires documentation of the medication storage areas including a list of expired or unused medication that the pharmacist returns to the pharmacy.

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Are there specific drugs that require monitoring by pharmacists when conducting the MedsCheck at Home?

While the MedsCheck program is not considered a “monitoring” service as in “monitoring INR (international normalized ratio) levels,” when conducting any medication review pharmacists are reviewing all drugs and combinations of drugs towards optimizing a patient’s drug therapy and improving quality of life. However, specific to the MedsCheck at Home, pharmacists are evaluating / monitoring the effectiveness and safety of medications that may cause or aggravate common drug –related problems for the elderly if appropriate including drugs listed on the Beers criteria.

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Are there procedures a pharmacist should take when transporting a patient’s expired / unused medications back to the pharmacy?

In cases where a pharmacist is accepting a patient’s expired / unused prescription and non-prescription medication for disposal at the community pharmacy, the pharmacist should document the service provided, along with an inventory list including name, strength and quantity of the drug to be disposed at the community pharmacy. Along with the inventory list, the patient must provide written consent whereby the patient requests the pharmacist to destroy the drugs as listed at the community pharmacy; the inventory list documentation must be signed and dated by the parties involved. Both the patient and the pharmacist receive a copy of the list; the pharmacist must keep the list with the MedsCheck at Home medication review.

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What is the process for unserviceable drugs that are taken away by the pharmacist to be destroyed?

With appropriate documentation and patient consent, any drugs transported by the pharmacist will stay in the possession of the pharmacist until returned to the pharmacy; the transport process should be completed as soon as possible. Pharmacists should dispose of the drugs in accordance with the standards of practice and the disposal must be in an environmentally appropriate manner.

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Is there a standardized form that pharmacists must use for the MedsCheck at Home?

Yes. Pharmacists are required to use the MedsCheck Personal Medication Record standardized form and pharmacist worksheet. The completed form is signed and dated by the pharmacist and a copy is provided to the patient when all potential drug therapy problems have been resolved to the best ability of the pharmacist. The completed form is also shared with the primary prescriber using the standard fax/letter template.

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How long should a MedsCheck at Home review take?

Time required to conduct the MedsCheck at Home will vary from patient to patient depending on the degree of their chronic condition; it is estimated that the visit portion will take approximately 1 ½ to 2 hours.

Registered pharmacy technicians can assist in the administrative work required to prepare for any MedsCheck program including identifying patients, organizing appointments, collecting reference information and accompanying the pharmacist on the visit.

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Where can I find contact information regarding the closest Community Care Access Centre should my patient require a referral to that service?

Pharmacy staff can access the Local Health Information Network (LHIN) website for more information on contact information for area hospitals, community care access centres and other community support services. To access information use the LHIN website at: www.lhins.on.ca.

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For More Information

To learn more about MedsCheck talk to your Pharmacist or contact ServiceOntario, INFOline 1-866-255-6701 or TTY 1-800-387-5559