EmailHospital Circular 14/2007
Date Issued: 11 July 2007
Distribution: Public hospitals
Subject: National Guidelines - Patient's Use Of Own Medications
Purpose: To advise hospitals of new national guidelines relating to patients using their own medications while admitted.
Using a patient's own medications
A patient's own medications can be used without breaching the Australian Health Care Agreement where:
- the medication is unrelated to the condition for admission; or
- the medication has been chronically used by the patient, and is required to be continued at the time of admission.
Example 1:
A patient is admitted for bowel cancer and has insulin dependant diabetes. The patient's own insulin can be used during their admitted episode. Medications relating to the treatment of the cancer such as chemotherapy painkillers and antiemetics will need to be provided by the health service.
Example 2:
A patient aged 65 was on the waiting list for an elective hip replacement. The patient also has congestive cardiac failure and arthritis and is on more than 4 medications, including a b blocker, ace inhibitor, diuretic, lipid lowering medication and a non-steroidal anti-inflammatory. The patient's own medications can be used during their admitted episode, however painkillers for post-operative pain and antithrombotics will need to be provided by the health service, as these items relate to the condition of admission.
When a patient's own medications must not be used
A patient's own medication must not be used in the health service where:
- pre-admission clinics for elective cases predict and facilitate supply of future admitted episode pharmaceutical use
Example:
A patient is being treated for breast cancer and the doctor at the pre-admission clinic writes a prescription for paclitaxel for the patient. The patient has their medication supplied at a community pharmacy. This medication is not to be used for the patient during their admitted episode, as this would be a clear breach of the Australian Healthcare Agreement.
Implementation
The decision to use a patient's own medications during their admitted stay will be made by the individual health service, taking into consideration any resource implications and ensuring that these guidelines are adhered to completely.
It is the responsibility of the admitting institution to ensure the development and coordination of a medication plan for each patient. This plan should take into consideration a number of factors including medication checking, supply and information. The people responsible for coordinating the medication plan will need to assess the viability of using a patient's own medications against the following.
Individual health service responsibilities
- Determine hospital policy on using a patients own medications (ensuring compliance with these guidelines)
- Ensure that the patient's medications are not related to the reason of admission
- Ensure that consent of the patient/carer is obtained for the health service to utilise the patient's own medication during their admitted episode
- Ensure that the patient's medication is thoroughly examined for suitability by appropriately qualified health service staff, checking:
- Original packs only and/or original strip packs only
- Expiry date checking
- Identify the appropriateness and effectiveness of current medication, paying particular attention to any problems associated with current drug therapy including any possible relationship with current medical condition
- Document allergies and any previous adverse drug reactions
- Ensure appropriate mechanisms are in place within the health service to store and supply a patients own medications e.g. locked drawers by bedside
- Ensure medications are discarded with patient/carer's consent
- Ensure relevant medications are returned to patient/carer upon discharge
- Ensure appropriate and adequate counselling to patient and/or carer on the use of all medications provided on discharge.
Further information
Michael Furey
Manager Blood & Pharmaceutical Programs
Phone: 03 9096 2506
email: michael.furey@dhs.vic.gov.au
Lea Pope
Acting Director, Programs
Metropolitan Health & Aged Care Services
