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Letters to the Editor
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Medicines use reviews
Need to reconsider “10-minute” campaign
From Dr F. R. Goldstein, MRPharmS, and others
As a primary care trust, we are committed to supporting our pharmacists
with their undertaking of medicines use reviews (MURs). We have a system
set up whereby we receive feedback on MURs and we have been impressed
by the quality and outcomes. It is therefore of great concern to us that
Lloydspharmacy is advocating, via its advertising campaign, that an MUR
can be conducted in 10 minutes.
Although we acknowledge the need to recruit patients and to manage an
MUR service as part of the routine work of a pharmacy, we are concerned
that the “10- minute” message undervalues the usefulness
of a MUR, misguides patients with regard to the time an MUR will take
and finally places extreme pressure on pharmacists to complete the review.
Our evidence suggests that on average, an MUR will require a minimum
of 20 minutes’ patient contact. Within this time frame, the pharmacist
is able to provide valuable information and advice to a patient regarding
his or her medicines. If pharmacists are pressured to conduct their reviews
in less time, the quality of the reviews will inevitably suffer.
We would encourage Lloydspharmacy to reconsider its advertising campaign
on MURs and offer a more professional and suitable timescale.
Ruth Goldstein
Community Pharmacist Facilitator
Genine Riley
Head of Medicines Management
Richard Jenkins
Clinical Governance and Prescribing Lead
Burntwood Lichfield and Tamworth Primary Care Trust
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ANDY MURDOCK, pharmacy director at Lloydspharmacy replies:
It is
pleasing to note that the primary care trust’s view of the service
is consistent with our own and that it is committed to supporting the
profession to
deliver what, we would all agree, is a valuable patient service.
Our campaign is based on a general professional view. The Pharmaceutical
Services Negotiating Committee guidance titled “10 steps to success with medicines
use reviews” uses the 10-minute message at several points to encourage
conversation and engagement between the pharmacist and patient.
Our “10-minute” message, based on the advice above, is a constructive
approach, using marketing techniques and concepts to ensure that we obtain patient
engagement — which is crucial.
We have been quite clear in our extensive training, in our advertising, both
window poster and explanatory leaflet, that everyone has different needs,
so that the review may be of variable time and, indeed, we state “we do not
mind if it takes longer”.
Within the contract, funding for the service was based on a 30-minute timing,
which also included preparation and “wash up” time. If the PCT
believes that the essential patient contact time is averaging out at around
20 minutes
then I would suggest that the current MUR fee is inadequate. On that basis
would the PCT assist the PSNC in recommending an elevated fee?
Lloydspharmacy has placed tremendous effort in ensuring that all our pharmacies
and pharmacists have been extensively trained and are engaging in this service.
To date, we have carried out in excess of 50,000 MURs — more than any other
provider. We are extremely proud of what we are doing and are committed to delivering
this contract as I hope our actions are demonstrating. It is on that basis that
I cannot accept Dr Goldstein’s arguments and hope that she and her colleagues
will ultimately be persuaded by our results as we continue our efforts in this
area. |
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The
Pharmaceutical Journal