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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 dirc@dirc.ca
 Update as of May 8, 2007 : Recent changes have been made to the Personal Medication Review forms based on pharmacists feedback. Click HERE for a list of these changes.
To help you start delivering the MedsCheck program, DIRC pharmacist Nisha Kadikar walks through the process in a 20 minute video and slide presentation. Note: This presentation is designed for Internet Explorer and a high-speed Internet connection. The program may take up to a minute to load.
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 help@dirc.ca, or (800) 268-8058 or (416) 385-DIRC.
Identify Patients
Determination of eligibility:
Taking 3 or more chronic prescription medications
No Meds Check review in previous 365 days
Promotion of service by:
Dialogue with patients on availability of service
Notification through a prescription insert with dispensed medications
- [ pdf ]
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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.)
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Complete Documentation and Follow-Up
Address issues that were identified and document them in the Action Plan form (Form 3)
- [ pdf ]
Complete the Personal Medication Record (Form 4) for the patient.
- [ pdf ]
Ask the patient if they have any further questions or concerns.
Ask the patient to complete the Personal Medication Review Satisfaction Survey
- [ pdf ]
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 ]
Document the completion of the Medication Review in the Patient Profile in your computer system.
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Reimbursement
Submit claim electronically to ODB for reimbursement.
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Comments and feedback on these tools are welcomed at dirc@dirc.ca.
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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