National Trends and Policy Impacts on Provision of Home Medicines Reviews and Residential Medication Management Reviews in Older Australians, 2009–2019

Comprehensive medicines reviews such as Home Medicines Review (HMR) and Residential Medication Management Review (RMMR) can resolve medicines-related problems. Changes to Australia’s longstanding HMR and RMMR programs were implemented between 2011 and 2014. This study examined trends in HMR and RMMR provision among older Australians during 2009–2019 and determined the impact of program changes on service provision. Monthly rates of general medical practitioner (GP) HMR claims per 1000 people aged ≥65 years and RMMR claims per 1000 older residents of aged care facilities were determined using publicly available data. Interrupted time series analysis was conducted to examine changes coinciding with dates of program changes. In January 2009, monthly HMR and RMMR rates were 0.80/1000 older people and 20.17/1000 older residents, respectively. Small monthly increases occurred thereafter, with 1.89 HMRs/1000 and 34.73 RMMRs/1000 provided in February 2014. In March 2014, immediate decreases of –0.32 (95%CI –0.52 to –0.11) HMRs/1000 and –12.80 (95%CI –15.22 to –10.37) RMMRs/1000 were observed. There were 1.07 HMRs/1000 and 35.36 RMMRs/1000 provided in December 2019. In conclusion, HMR and RMMR program changes in March 2014 restricted access to subsidized medicines reviews and were associated with marked decreases in service provision. The low levels of HMR and RMMR provision observed do not represent a proactive approach to medicines safety and effectiveness among older Australians

Evaluating the psychometric properties of the PERMA profiler

This paper reports on an investigation of the psychometric properties of the PERMA Profiler—a popular measure of well-being—with a large sample of Australian adults (n = 1942). We assessed the factor structure, scale reliability, and convergent and discriminant validity of the Profiler. Theory and evidence point to a second-order factor structure whereby the five PERMA elements constitute first-order factors that in turn load on a single general well-being factor. The Profiler displayed acceptable reliability for all subscales except Engagement and demonstrated the expected convergent relationships with measures of Flourishing, Optimism, Depression, and Psychological Distress. Further, the expected discriminate relationships were observed with measures of Anxiety and Stress. An important contribution of this research is to suggest that the elements of the Profiler all reflect, to an extent, a single general well-being factor. At a practical level, we provide information on the strengths and limitations of the Profiler in order to aid researchers and practitioners in their work