Investing for the future
Correspondents to The Journal towards the end of last year — and another last week (PJ, 7 January, p13) — raised a number of concerns about conducting medicines use reviews. The main anxiety was the time required to undertake them properly — 20 to 30 minutes per review seems not to be unusual.
This should not come as any surprise since undertaking any new activity
takes longer in the first few months than it does, say, one year later.
An article in this issue by Angela Alexander, of the School of Pharmacy,
University of Reading (p44 PDF (90K)),
emphasises this point in a different way that goes some way to explaining
why some pharmacists may be finding
the whole process a bit of an uphill struggle.
Other than dispensing, she points out, medicines use review is the first
service to be commissioned nationally from pharmacists, the first service
to require accreditation of both pharmacists and pharmacy premises and
the first service to demand a specified set of competencies. Nearly everything
about MUR is new. (Her article is primarily directed at community pharmacists
in England and Wales, although the situation is not dissimilar in Scotland.)
Dr Alexander also argues that the commissioning of future enhanced services
could depend on the demonstrated success of providing an MUR service.
Dr Alexander also produces a SWOT (strengths, weaknesses, opportunities
and threats) analysis of MURs drawn from the experiences of five groups
of pharmacists who attended training sessions at the University of Reading
(p45 PDF (90K)). There is a thread running through all four SWOT categories: communication.
Communication underpins the success of this service and will underpin
the successful development of all other services in the future.
Many people will have experienced the frustrations of waiting to see
GP registrars (ie, ones in training) and discovering that their clinics
over-run because they spend much longer with patients than do older hands.
The registrars have not yet seen the patterns in the health carpet, to
be able to anticipate lines of questioning and to reach diagnoses quickly
and confidently. This process is not unlike the one pharmacists learning
to conduct MURs successfully are experiencing.
Once pharmacists are more familiar with conducting MURs they will be
able to complete them more quickly. Time spent learning skills now will
be an investment for the future.
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