Discharge Medicines Review

Comprehensive suite of resources available to help pharmacy teams in Wales implement and deliver the DMR service

The discharge medicines review (DMR) service builds on the existing Medicine Review Service in Wales, providing support to patients recently discharged between care settings, ensuring that changes to medicines are followed up in community.

It is hoped that the service will:

  • lead to a reduction in risk of medication errors and adverse drug events
  • improve communications between healthcare professionals
  • increase patient involvement in thier own care
  • reduce medicines wastage
  • contribute to avoiding medicines-related admissions to hospitals or care homes
  • better use the skills of pharmacists in optimising medicines use.

There are two parts to the service:

1. Patient identification and medicines reconciliation. This involves checking to ensure that medicines prescribed in one care setting, e.g. hospital, match medicines prescribed by the GP when the patient returns home.Any discrepancies found should be highlighted to the GP.

2. Support for adhering to medication. This is a discussion with the patient to establish how they use their medicines. This also ensures that any discrepancies identified in the first stage of the service have been actioned and rectified.