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Download the program summary.

Visit the HomeMeds website.

Developed by: Partners in Care Foundation
Program Administrator: June Simmons
Year Program First Implemented: 1997


The HomeMeds (also known as the Medication Management Improvement System) addresses medication problems among frail older adults using criteria developed by an expert panel to address four problem types.

These problem types are:

  1. Unnecessary therapeutic duplication (e.g. generic and brand name of same drug);
  2. Falls, dizziness, or confusion possibly caused by inappropriate psychotropic drugs (e.g. tranquilizers, antidepressants, sleep aids);
  3. Cardiovascular medication problems related to continued high blood pressure, dizziness, low blood pressure, or low pulse;
  4. Inappropriate use of non-steroidal anti-inflammatory drug (NSAIDs) in those with risk factors for peptic ulcer or gastrointestinal bleeding.

Agency staff members work with a consulting pharmacist to verify the accuracy and appropriateness of the client’s current medication list, identify problems that warrant re-evaluation by the physician, and follow through with the client and physician to resolve identified problems. In response to increasing nursing shortages, the intervention has been streamlined to enable non-nurse care managers to implement the system. Now a computerized risk assessment screening and alert process has been developed, using the medication list and clinical indicators (vital signs, falls, dizziness and confusion) to identify potential medication problems.

Supporting Evidence:

Between 1993 and 2003, the Medication Improvement Program was developed for elders receiving licensed home health care and proven effective in a randomized, controlled trial. Between 2003 and 2007, Partners in Care Foundation adapted HomeMeds for care management and computerized the screening. In 2004-2006, 615 clients were screened at three California Medicaid waiver sites. 49% of clients (N=299) had at least one potential medication problem.

Record review and consultation with the client led the pharmacist to recommend either:

  • Continuing the medications;
  • Revising the medication list;
  • Collecting additional information; or
  • Changing medications.

29% of clients had a medication problem serious enough for the pharmacist to recommend a change in medications, including re-evaluation by the physician. For the intervention group (N=99) 61% of recommended changes were implemented.

Positive client outcomes have included discontinuation of potentially harmful medicines, decreased confusion and dizziness, better pain control, decreased risk of falls, and improved blood pressure control.


Meredith S, Feldman P, Frey D, Giammarco L, Hall K, Arnold K, Brown NJ, Ray WA. Improving medication use in newly admitted home healthcare patients: a randomized controlled trial. J Am Geriatr Soc. (Sept 2002) 50 (9): 1484-91.[Online]: http://www.ncbi.nlm.nih.gov/pubmed/12383144.

Alkema GE, Frey D. Implications of Translating Research into Practice: A Medication Management Intervention. Home Health Care Services Quarterly. (2006) 25 (1-2):33-54. [Online]: http://www.informaworld.com/smpp/content~db=all~content=a904345997.




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