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WHY ARE PHARMACISTS NOT DOING MURs?
Hall J, Smith I, Adams A.
Background
The new contract for community pharmacy services seeks to draw on
the skills, expertise and experience of pharmacists and their staff to
improve the health of the population and in particular to help people
manage long term conditions (1). Medicines Use Reviews (MUR) are intended
to contribute to these aims by improving the patient's knowledge and use
of medicines. However, as this is a recently introduced initiative little
is known about whether pharmacists are willing and able to do MURs. This
paper aims to report the views of pharmacists not doing MURs.
Method
A pharmacist from each community pharmacy in two neighbouring PCTs
(n = 54) in the north west of England was invited to participate in this
study involving semi-structured telephone interviews. The researchers
completed the questionnaire and made notes during the interview. The interviews
took place in October 2005.
Findings
40 out of 54 (74%) pharmacists agreed to participate in the study.
Those pharmacists that expressed their views on MURs were very positive
towards this service (table 1).
| Table 1 - Pharmacist's views on MURs |
| Better use of pharmacists skills |
Makes job more interesting |
Improves relations with GPs |
Ten (18%) pharmacists were accredited to do MURs but only four (7%) had
carried out MURs. The reasons given by the pharmacists for not doing MURs
can be seen in table 2.
| Table 2 - Reasons given by pharmacists
for not doing MURs |
| Accredited to do MURs |
The PCT: |
- has not yet said if this pharmacy meets the requirements |
| - do not support pharmacists doing MURs |
| Patients: |
- are difficult to recruit for MUR |
| Not accredited to do MURs |
The proprietor: |
- does not want to provide this service |
| The premises: |
- are too small to include a consultation room |
| Lack of time: |
- to take the assessment
- to do MURs |
| Undecided: |
- as to which assessment to do |
Discussion
MURs are an advanced level service and therefore the decision to provide
the service has to be made by pharmacy contractors. However, if this initiative
is to make a positive contribution to patient care then more pharmacists
must become actively involved in providing MURs. Some barriers such as
size of the premises could be difficult to overcome without considerable
investment. A lack of PCT support has been claimed but this could be an
oversimplification as some of the pharmacies in the area had carried out
MURs. Pharmacists must be accredited prior to undertaking MURs and a number
of higher education institutions offer this but accreditation is not linked
to training. As some accredited pharmacists are not doing MURs and others
do not have the time to provide MURs, there could be a case for the provision
of MUR training that includes topics such as recruiting patients for MUR,
time management and delegation.
Conclusion
Many pharmacists see the benefit of MURs but if we wish
to see more pharmacists doing MURs, attention must be paid to the preparation
and support they need to initiate and operate the service.
References
1. Implementing the new community pharmacy contract. Department of Health,
London 2005
Presented at the HSRPP Conference 2006, Bath
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