Aim To examine medicine management in older people from non‐English speaking backgrounds (NESB) after discharge from hospital. Method A literature review, followed by focus group discussions with hospital clinicians. Patients 70 years and over from Greek, Chinese, Russian and English speaking backgrounds were interviewed. Case histories were developed based on the interviews and a review of the patients' medical records. Data were clustered and themes extracted. Educational resources were produced for clinicians comprising an action guide and a composite audiovisual case study. These resources were used in further focus group discussions with hospital clinicians to determine current practice for identifying and managing medication management risks for patients from NESB. Results Major themes identified included: patients' lack of knowledge about medications and medication changes; interpreter services not used routinely; and inadequate communication between health professionals. There was little evidence of systematic, standardised processes for identifying people at risk of medicine mismanagement or for the implementation of actions to minimise risks. Conclusion There is a need for effective communication about medications, particularly when patients are transferred from hospital to the community. For people from NESB, this also includes the use of interpreters and translated educational material. A patient journey map and medicine management action guide provides a framework for clinicians to optimise safe medicine management and continuity of care.

Background: A novel medicines management pathway for patients with chronic heart failure was developed and commenced at the Prince of Wales Hospital in 2002. Aim: To evaluate whether the novel medicines management pathway facilitated by the community liaison pharmacist and medication management review facilitator helped implementation of home medicines reviews and improved medication management. Method: A survey of general practitioners, community pharmacists, accredited pharmacists and patients was conducted. Results: General practitioners, community pharmacists and accredited pharmacists reported that the collaboration between the community liaison pharmacist and the medication management review facilitator improved the hospital and community link, and home medicines review implementation. Most patients noted they learnt something new about their medicines and that they could ask more questions of their general practitioner and pharmacist. Conclusion: This model improved communication between hospital and community and implementation of home medicines reviews in heart failure patients. J Pharm Pract Res 2006; 36: 175-9.

LETTERS TO THE EDITOR Medication safety and patient participation: pharmacist, emergency department and beyondTo the Editor, We would like to inform your readers about a resource available to all on the New South Wales government web site (listed below) and to briefly describe the processes involved in its development, using a health promotion and 'systems' approach. The resource, 'What to do with your tablets and medicines when coming into hospital', was developed with input from emergency and pharmacy department staff, community health services, multicultural health unit and consumers.The emergency department is at the interface between the community and hospital. To ensure safe use of medicines, clear communication about medication issues between patients, carers, doctors, nurses and pharmacists is of utmost importance. Given the time constraints in a busy emergency department and the lack of accurate information at presentation, it is not surprising that identifying and hence preventing medication-related admissions is inconsistently done. Around 2 to 3% of all hospital admissions in Australia are medication-related as are 6 to 7% of all hospital emergency admissions. 1,2 The National Medicines Policy framework advocates a partnership approach with patients to enhance the quality use of medicines. 3 As patients seen in the emergency department are often unaware of the names of their medications, their dosages or how to take them, the emergency department and community liaison pharmacists at the Prince of Wales Hospital saw the need to involve patients at the beginning of their admission, by educating them about their role in knowing about their medications. 4 Because many hospitals do not have a comprehensive emergency department pharmacy service, pharmacists are not always available in the emergency department to sort through medication issues on admission. 5 Patients themselves could bridge this gap by carrying a current medication list and bringing in all their medications from home, thus helping health professionals to compile an accurate medication history on admission.A poster and pamphlet were developed, encouraging patients to bring all medicines into hospital and to all doctors' appointments, to know what medications they are taking and to keep an up-to-date medication list and show it to relevant health professionals. 6 The English version was translated into the six most common languages of patients presenting to the hospital (Arabic, Cantonese, Greek, Italian, Spanish, Russian). The posters were displayed throughout the hospital and the pamphlets were distributed to all outpatient areas in the hospital. Thai and Vietnamese translations were added on request by our Respiratory Clinic. The pamphlet message has now gone beyond our emergency department and our hospital and is available in English and the six foreign languages at .