Abstract
Objective of the study Medicines use review and prescription intervention (‘MUR services’) is the first advanced service within the NHS community pharmacy contract and is a structured review that is undertaken by a pharmacists with patients on multiple medicines. The objective of this study was to investigate factors that influence the number of Medicines use reviews (MURs) performed by community pharmacists and to explore community pharmacists’ attitudes towards the service. Setting This study was conducted with pharmacists who were employed by one UK community pharmacy chain. Method A questionnaire was developed to investigate factors that influence the number of MURs performed and pharmacists’ attitudes towards MURs. It consisted of a series of attitudinal statements together with brief demographic data. Questionnaires were distributed to a sample of 280 pharmacists accredited to provide the service during April and May 2006. Main outcome measure Factors affecting the number of MURs performed and community pharmacists’ attitudes towards MURs. Results Sixty per cent (167/280) of pharmacists returned a completed questionnaire. Twenty-seven per cent of respondents had not performed any MURs, 43% had conducted one to 14 reviews and 31% had conducted 15 or more. Job title affected the number of reviews performed; respondents categorised as ‘Store based’ pharmacists performed significantly more MURs than those working as ‘Locums’ but not significantly more than ‘Managing’ pharmacists. Pharmacists reporting access to an accredited consultation area performed significantly more MURs than those who did not. Those working more than 20 h per week performed significantly more MURs than those working less. Gender, time since qualification, the pharmacy size and those having or currently undertaking a clinical diploma were not found to be associated with the number of MURs performed. Most respondents reported that MURs were an opportunity for pharmacist to use their professional skills in an extended role and patients would benefit from the service. However they reported concerns about GPs opinion of the service, lack of time and support staff to conduct MURs and were unhappy about consultation areas. Conclusion This study demonstrates that pharmacists perceive MURs to be an opportunity for an extended role and of value to patients. However, this study has identified perceived barriers, including the availability of a consultation area suitable for performing MURs, time to perform MURs and support staff. The number of MURs performed by pharmacists appears to be affected by the pharmacists’ job title, their working hours and the presence of a consultation area. Additional support for ‘locum’ pharmacists was also highlighted and may be needed.
Similar content being viewed by others
References
Implementing the new community pharmacy contractual framework. Information for primary care trusts. London: Department of Health; 2005. www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4109256 (accessed 01/11/2007).
From compliance to concordance: achieving shared goals in medicine taking. Royal Pharmaceutical Society of Great Britain and Merck Sharpe & Dohme. London: Royal Pharmaceutical Society of Great Britain; 1997.
Donovan JL, Blake DR. Patient non-compliance: deviance or reasoned decision-making? Soc Sci Med 1992;34:507–13.
Task force on medicines partnership and the national collaborative medicines management services programme. Room for review: a guide to medication review: the agenda for patients, practitioners and managers. London: Medicines Partnership; 2002. http://www.npc.co.uk/med_partnership/assets/room_for_review.pdf (accessed 24/01/2008).
Webstar Health. Evaluation of room for review—a guide to medication review. Part 1—the PCT and professional view. London: Task Force on Medicines Partnership; 2005. http://www.npc.co.uk/med_partnership/assets/rfr_eval1.pdf (accessed 24/01/2008).
National Service Framework for older people. London: Department of Health 2001. www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4003066 (accessed 01/11/2007).
Medicines and older people: implementing medicines-related aspects of the NSF for older people. London: Department of Health; 2001. http://site320.theclubuk.com/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4008020 (accessed 01/11/2007).
General pharmaceutical services in England and Wales 1996–97 to 2005–06. London: Department of Health; 2006.
Gush A. Is funding for advanced services being misdirected? Pharm J 2006;276:320.
Ewen D, Ingram MJ, MacAdam A. The uptake and perceptions of the medicines use review service by community pharmacists in England and Wales. Int J Pharm Pract 2006;14(Suppl 2):B61–2.
Hall J, Smith I. Barriers to medicines use reviews: comparing the views of pharmacists and PCTs. Int J Pharm Prac 2006;14(Suppl 2):B51–2.
Blenkinsopp A, Celino G, Bond C, Inch J. Medicines use reviews: the first year of a new community pharmacy service. Pharm J 2007;278:218–23.
Domiciliary Medication Management—Home Medicines Review. Helping your patients manage their medicines at home. Commonwealth of Australia: Commonwealth Department of Health and Aged Care; 2001.
Rigby D. Medication management reviews gathering momentum. Aust Pharm 2003;22(4):282–8.
Hudson K, Frayne N. HMR challenges in a small, rural division of general practice. Aust J Pharm 2003;84:270–3.
Bajramovic J, Emmerton L, Tett E. Perceptions around concordance—focus groups and semi-structured interviews conducted with consumers, pharmacists and general practitioners. Health Expect 2004;7:221–34.
Kyle G, Nissen L. A community nurse referral system for HMRs—can it work? Aust Pharm 2006;25(4):326–31.
Emblen G, Miller E. Home medicines review the how and why for GPs. Aust Fam Physician 2004;33:49–51.
James DH, John DN, Thomas R, Roberts D. General Practitioners’ views about the medicines use review service. Int J Pharm Pract 2007;15(Suppl 2):B57–8.
Blenkinsopp A, Celino G, Bond CM, Inch J, Gray N. Community pharmacists’ experience of providing medicines use reviews: findings from the national evaluation of the community pharmacy contractual framework. Int J Pharm Pract 2007;15(Suppl 2):B45–6.
Connelly D. British pharmaceutical conference. Start enjoying the MUR rollercoaster. Pharm J 2006;277(Suppl):B35.
Chambers R, Wakley G, Blenkinsopp A. Supporting self care in primary care. Oxon: Radcliffe Publishing; 2006. p. 81–100, ISBN 18-461-9070-3.
Tann J, Blenkinsopp A. Innovation in community pharmacy: accelerating the speed of change. London: RPSGB 2004.
Rogers EM. Diffusion of innovatiosns. 4th ed. New York: The Free Press; 1995. ISBN 00–292–6671-8.
Acknowledgements
The authors would like to thank the study participants, the pharmacy chain where this study was conducted for allowing this study to take place and to Division of Social Research in Medicines and Health, School of Pharmacy, The University of Nottingham.
Financial support of the study
None
Conflict of interests
AL worked part-time for the community pharmacy chain where this study was conducted.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Latif, A., Boardman, H. Community pharmacists’ attitudes towards medicines use reviews and factors affecting the numbers performed. Pharm World Sci 30, 536–543 (2008). https://doi.org/10.1007/s11096-008-9203-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11096-008-9203-x