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Medical Consultation


The vision of the ASPIRE team is to generate high level evidence for an integrated patient-centred, and cost-effective model of community-based medication review.


Medication safety and the quality use of medicines became a national health priority area in 2019. This reflects, in part, rising rates of polypharmacy and growing awareness of avoidable medication-related harm in Australia and globally.


A patient-centred model for medication reviews was first conceptualised by Prof Timothy Chen in the late 1990s. With support from leading healthcare and professional organisations, Prof Chen won a government tender to establish a sustainable, cost-effective way of conducting medication reviews in primary care. The research of Prof Chen, Dr Sasha Bennett and Carlene Smith AM in Divisions of General Practice was integral to the introduction of the Australian Government’s Home Medicines Review (HMR) program in 2001 and helped strengthen the Residential Medication Management Program (RMMR) for residents in aged care facilities.


Research from various groups have found HMRs to be effective in detecting medication-related problems, reducing the number of medicines prescribed, improving the appropriateness of prescribing, improving a person’s understanding and adherence to medicines and their confidence in managing their medicines. HMRs have also been shown to delay and reduce hospital admissions.


While medication reviews have been an important tool to improve medication safety over the past 20 years, it was clear to Prof Chen and colleagues that the effectiveness of HMR and RMMR could be improved through better implementation.


The current HMR program is not well integrated with other health services and lacks a formal mechanism for targeting at-risk people at a time when they could benefit the most from an HMR. There is also a lack of formal communication channels between GPs and pharmacists to help foster collaborative, integrated care – a design element that was included in the original research but not adopted in the HMR program.


Realising the potential of Primary Health Networks as centres for medication safety activities and communications, Prof Chen, A/Prof Carl Schneider and A/Prof Dani Gnjidic jointly designed a PHN-based implementation model to target and coordinate medication reviews for at-risk patients after a hospital stay. From this work, the ASPIRE Chief Investigators team was formed, and the team developed a trial that was successful in winning a 2020 Medical Research Future Fund Grant opportunity: Quality, Safety and Effectiveness of Medicine Use and Medicine Intervention by

Pharmacists:  MRFQI000043.   


The ASPIRE team brings together researchers from a range of disciplines and includes experts in medication management, medication safety, polypharmacy, medicines use in older people, rural health, biostatics, health economics, implementation science and realist evaluation – with the shared vision of improving medication safety in the community.  


The organisational and governance structure for the ASPIRE trial is shown in the figure below.


  • The Chief Investigator Group is responsible for the design, oversight, analysis, and evaluation of the trial.

  • The Associate Investigators provide further expertise and advice.

  • The Trial Management Group is responsible for the day-to-day conduct of the trial.

  • The Trial Advisory Group is an independent group responsible for monitoring the safety and conduct of the trial.

  • The Trial Operations Committee is responsible for managing technical day-to-day issues.

ASPIRE Governance Structure.png
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