Personal Medication Review Protocol

The following flowchart provides an overview of the protocol. To view the associated documentation, click upon the links.

For further information on the protocols, contact DIRC at (800) 268-8058 or This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Download Protocol and All Forms  - [ pdf ]
Download Forms for Customisation

Download Adobe Acrobat Reader (a Free download)

The protocol outlined below and the associated documentation is provided as a guide to pharmacists. The use of these practice tools is not mandatory. You are free to customize these tools for your own practice, or develop your own tools.

To review the Ontario College of Pharmacists Framework to Support Comprehensive Medication Consultation Services, click here.

For clinical and practice support, contact the Drug Information and Research Centre at This e-mail address is being protected from spambots. You need JavaScript enabled to view it , or (800) 268-8058 or (416) 385-DIRC. 
 

Prepare for Medication Review - Identify Patients

Determination of eligibility:

MedsCheck Annual

  • Taking 3 or more chronic prescription medications, and
  • Ontario resident with an OHIP card, and
  • No MedsCheck review in previous 365 days

MedsCheck Follow-up

      During the annual time-frame of a MedsCheck, a patient may benefit from a MedsCheck follow-

      up if they meet one of the following criteria:

  • A patient is discharged from hospital, or
  • A pharmacist's documented decision, or
  • A physician or nurse practitioner request, or
  • A planned hospital admission


Promotion of service by:

 

Scheduling of Appointment:
  • Indicate that patients should budget 30 minutes of time
  • Provide appointment card (front page, back page)
  • Remind patient to bring all medications to appointment (including prescriptions from other pharmacies, OTC, herbal supplements etc.)

 

Step 1: Download and review Data Collection Form  - [ pdf ]
Step 2: Complete as much information as possible in Patient Background Form (Form1)  - [ pdf ]
Step 3: Complete columns A-D in Table 1 (Patient Medication History Form-Prescription only) (Form2)  - [ pdf ]

 

Review Medications with Patient

Step 1: Complete Patient Background Form (Form1)  - [ pdf ]
Step 2: Complete Table 1 (prescription) of the Patient Medication History Form) (Form2)  - [ pdf ]
Step 3: Complete Table 2 (otc/herbal) of the Patient Medication History Form) (Form2)  - [ pdf ]

 

Complete Documentation and Follow-Up

Step 1: Address issues that were identified and document them in the Action Plan form (Form 3)  - [ pdf ] 
Step 2: Complete the Personal Medication Record (Form 4) for the patient.  - [ pdf ]   
Step 3: Ask the patient if they have any further questions or concerns. 
Step 4: Ask the patient to complete the Personal Medication Review Satisfaction Survey  - [ pdf ] 
Step 5: Follow up with the patient as necessary on issues outlined in the Action Plan. Contact physician, if necessary, using the Physician Letter (Form 5). You may wish to include the Action Plan along with the Personal Medication record. - [ pdf ] 
Step 6: Document the completion of the Medication Review in the Patient Profile in your computer system.

 

Reimbursement

Submit claim electronically to ODB for reimbursement.



Comments and feedback on these tools are welcomed at This e-mail address is being protected from spambots. You need JavaScript enabled to view it . Future changes to the protocol and tools will be communicated through DIRC's eDIRC bulletin. To subscribe to the eDIRC bulletin, click here.



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