The Pharmaceutical Journal
Vol 276 No 7384 p61
21 January 2006

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Funding of community pharmacist MURs not justified

Available evidence does not support the Government’s funding of medicines use reviews in community pharmacies, an editorial in this month’s Journal of Epidemiology and Community Health argues (2006;60:92).

Richard Holland, Richard Smith and Ian Harvey, of the University of East Anglia’s school of medicine, say that no study has found a positive effect of medicines use reviews on mortality or a clear improvement in quality of life in older populations. “The most successful interventions have been delivered by small numbers of pharmacists working in close liaison with primary care physicians,” they say. They add that services set up at a distance from physicians have either failed to deliver clear positive outcomes, or have potentially worsened health outcomes. “No high-quality health economic analysis has been published, making it impossible to assess if this is an effective use of scarce health resources even when optimally delivered.”

“Despite this, the UK government has decided to invest £40 million [through the new community pharmacy contract] in providing pharmacist-led services delivered within community pharmacy where pharmacists are at a distance from the physicians they hope to influence, and are unlikely to have ready access to patient records,” they say. MURs should, they argue, be expected to demonstrate not just effectiveness but also cost-effectiveness before being introduced more widely.

Richard Holland and Ian Harvey were among the researchers who conducted the HOMER study, which suggested pharmacists medication reviews increase emergency hospital admissions (PJ, 22 January 2005, p71).