The benefits of Medication Regimen Review (MRR) in institutional settings have been demonstrated in a number of studies, however, there is no published Australian data on the cost benefits of conducting medication review in the community setting. This project aimed to evaluate the cost and clinical benefits of the provision of MRR involving an innovative model of collaboration between community pharmacists and general practitioners (GPs) in a local Division of General Practice in Sydney, Australia. GPs' and pharmacists' satisfaction with the MRR process was also assessed at the of the project. There were two cohorts of patients; 105 in Stage 1 and 175 in Stage 2, hence a total of 275 patients, representing the patients of 35 GPs. The reviews were performed by 45 community pharmacists who had completed a training programme in MRR. The protocol was as follows:

1. A pro-forma MRR request form was completed by the GP including relevant clinical information and the patients current regimen
2. The review was conducted by the pharmacist and documented in a pro-forma report
3. Pharmacists and GPs met face to face to discuss the review findings and recommendations for each patient
4. Three months later GPs were surveyed to verify any accepted recommendations and changes to regimen

A clinical panel estimated the clinical significance of the changes to regimen for a subset of 141 cases. The patients had an average of five diagnoses with cardiovascular disease (34%) and musculo-skeletal (15%) representing the most common conditions. A total of 2220 medications were prescribed, representing a mean of 8 per patient. In all, 869 changes to therapy were observed at the 3 month follow up: 47% drug ceased; 17% dose reduced; 11% dose increased; 15% drug changed. Examining the impact of MRR on the mean number of medications per patient, the null hypothesis of no difference pre and post MMR was rejected. There was a mean reduction in one medication per patient (p<0.001). Considering health outcomes, overall reviewers rated at least 40% of the MRR recommendations leading to a positive effect on the patient's health. For the 141 patients, the average annual cost saving associated with conducting an MRR was $222.43. This was driven by the changes which actually took place, and reflected savings in both medication costs and the use of health care resources. Overall, there was a high level of satisfaction reported by a majority of participants. This study provides a good indication that MRR through GP pharmacist collaboration in the community can lead to positive clinical benefits and reduction in health care costs.