scholarly journals Community pharmacy Medicines Use Review: current challenges

2018 ◽  
Vol Volume 7 ◽  
pp. 83-92 ◽  
Author(s):  
Asam Latif
2018 ◽  
Vol 103 (2) ◽  
pp. e2.49-e2
Author(s):  
Jeff Aston

AimTo identify the experiences of community pharmacists in caring for children/young people, or their parents/carers, taking long-term medicines.MethodA pre-piloted 13 point semi-structured survey, participant information leaflet, consent form and pre-paid return envelope were posted to all 354 community pharmacists who had dispensed a prescription from a single specialist paediatric hospital during November and December 2015. Community pharmacy addresses were obtained from the National Health Service Business Services Authority ePACT system. Telephone follow-up of non-responders and, if necessary, a repeat mailing was made from 3 weeks after the original return by date.Participants were asked about their experiences of undertaking a medication review with either children/young people or their parents/carers, medication-related problems presenting to them, adherence, information needs of patients/carers and what issues were reported to them from this group.The data were analysed using SPSS version 22 and NVivo version 10.ResultsA response rate of 76/354 (21.5%) was achieved. Eighteen (23.7%) respondents had undertaken a Medicines Use Review (MUR),122 (28.9%) a New Medicines Service (NMS)2 review and 16 (21.1%) had undertaken another type of medication review in a child/young person. Respondents reported that patients or their carers had presented to them with adherence issues including stopping the medicine (24, 31.6%) and changing the dose (28, 36.8%) without informing the prescriber. Patients or their carers had requested information from them about the indication (59, 77.6%), dose regime (63, 82.9%), administration (64, 84.2%) and adverse effects (58, 76.6%). Respondents also reported patients/carers experiencing difficulties obtaining further supplies of a medicine from their community pharmacy (47, 61.8%) and patients’ general practitioners declining to prescribe a medicine recommended by the patient’s hospital-based specialist (27, 35.5%).ConclusionThis study has demonstrated that children, and their carers, taking long-term medicines experience a range of issues that they present to community pharmacists. Many of these issues would fall within the purview of currently funded medication review services namely the NMS and MUR.1,2 However, the proportion of pharmacists in this study undertaking formal medication review with children or their parents/carers was low. Further work is required to demonstrate the outcomes that such a review could have in this cohort of patients.ReferencesPharmaceutical Services Negotiating Committee. MURs: The basics. What is the medicines use review and prescription intervention service? [Internet] 2016. Available from: MURs: The basics http://psnc.org.uk/services-commissioning/advanced-services/murs/murs-the-basics/ [Available: 19 May 2016].Pharmaceutical Services Negotiating Committee. New Medicines Service (NMS) [Internet] 2016. http://psnc.org.uk/services-commissioning/advanced-services/nms/ [Available: 19 May 2016].


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Urška Nabergoj Makovec ◽  
Igor Locatelli ◽  
Mitja Kos

Abstract Background Based on several existing patient-oriented activities, Medicines Use Review (MUR) service was standardized and officially adopted in Slovenia in 2015. Service aims to provide adherence support and ensure safe and effective medicines use. Therefore, the aim of the study was to evaluate the benefits of MUR in Slovenia, primarily the impact on medication adherence. Methods A randomised controlled trial was performed in community pharmacies to compare MUR with standard care. Patients were randomised into either the test (patients received MUR by a certified MUR provider at visit 1), or control group. The study primary outcome was self-reported adherence to multiple medications, assessed by electronic ©Morisky Widget MMAS-8 Software at the first visit (V1) and after 12 weeks (V2). A sub-analysis of intentional and unintentional non-adherence was performed. MUR impact was defined as the relative difference in ©MMAS-8 score after 12 weeks between the test and control group. A multiple linear regression model was used to predict MUR impact based on baseline adherence (low versus medium and high). Several secondary outcomes (e.g. evaluation of drug-related problems (DRPs)) were also assessed. Results Data from 153 (V1) and 140 (V2) patients were analysed. Baseline adherence was low, moderate and high in 17.6, 48.4 and 34.0% patients, respectively. In the low adherence subpopulation, test group patients showed a 1.20 point (95% CI = 0.16–2.25) increase in total ©MMAS-8 score (p = 0.025) compared to control group patients. A 0.84 point (95% CI = 0.05–1.63) increase was due to intentional non-adherence (p = 0.038), and a 0.36 point (95% CI = − 0.23-0.95) was due to unintentional non-adherence (p = 0.226). Additionally, statistically significant decrease in the proportion of patients with manifested DRPs (p < 0.001) and concerns regarding chronic medicines use (p = 0.029) were revealed. Conclusion MUR service in Slovenia improves low medication adherence and is effective in addressing DRPs and concerns regarding chronic medicines use. Trial registration ClinicalTrials.gov - NCT04417400; 4th June 2020; retrospectively registered.


Prescriber ◽  
2007 ◽  
Vol 18 (10) ◽  
pp. 8-8
Author(s):  
Alison Blenkinsopp

2019 ◽  
Author(s):  
Nuria García-Agua Soler ◽  
Eugenia Gómez-Bermúdez ◽  
Vicente J. Baixauli-Fernández ◽  
Sara Bellver-Beltrán ◽  
Javier Velasco-Martínez ◽  
...  

Abstract Background: Community pharmacy services play an important role in controlling some factors related to medicine use, and pharmaceutical services integrated with primary healthcare services are critical to achieve the desired outcomes and to significantly reduce harms that can otherwise arise from multiple medicine use, such as non-adherence or medicine-related problems. The aim of the REVISA project is to carry out a study on preliminary implementation of the medicines use review (MUR) service in Spanish pharmacies through pharmacist-led initiatives to obtain a better understanding of patients’ medication adherence and medicine-related problems, together with satisfaction and acceptability of the service and whether patients might be willing to pay for it in the future. Methods: A preliminary implementation, cross-sectional multicentre study was conducted using a convenience sample of voluntary community pharmacies from all regions of Spain. Descriptive and logistic regression analyses were undertaken. Results: Sixty-four community pharmacies participated and a total of 495 patients were enrolled. A slight predominance of women (56%) was noted, with a mean age of 66.09±14.71 years and a mean consumption of 5.68±2.97 medicines. As results of MUR, a total 550 referrals were made. Non-adherence with the medication (OR=1.74; 95% CI: 1.17 to 2.58), polypharmacy (OR=1.50; 95% CI: 1.02 to 2.20) and help with medication (OR=3.03; 95% CI: 1.45 to 6.34) were associated with referrals. Patients were adherent for 68.3% of their medicines. However, at the patient level, only 31.5% were adherent. Polypharmacy patients older than 65 years increased the risk of non-adherence (OR=1.56; 95% CI: 1.06 to 2.30).The mean time employed by the pharmacists in the MUR was 52.80±31.52 minutes (MUR-related cost of €17.27). Most patients expressed a high level of satisfaction with the MUR service (98.5%) and a willingness to pay for it (84%). Conclusions: The MUR service in community pharmacies in Spain can be delivered, that it appears to be acceptable to patients and that most patients said they would be willing to pay for it. Pharmacists self-reported the length of time taken to deliver a MUR although the feasibility of incorporating into everyday practice would need to be assessed.


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