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Letters to the Editor
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Medicines use reviews
We should not berate ourselves
From Dr D. Petty, MRPharmS
I do not think that we should be berating ourselves for not
doing six-monthly medicines use reviews on people aged 75 years and over, who are taking
four or more medicines (PJ, 1 April, p373).
GPs, with the help of practice pharmacists, have made great strides in
improving the number and quality of MURs. The Medicines Management Collaborative
and organisations like the Medicines Partnership have moved MURs into
the consciousness of most GPs and most patients now get an annual review — a
great improvement on only a few years ago.
The national service framework’s target of carrying out six-monthly
reviews with people prescribed four or more medicines has never been
evidence-based and represents a huge workload for primary care professionals.
GPs, practice pharmacists and community pharmacists (doing MURs) would
make better use of their time in concentrating on those patients who
need more frequent reviews. These include, for example, vulnerable older
people (eg, living on their own), “frequent flyers” (those
who have unplanned acute hospital admissions) and those experiencing
problems with their medicines, eg, non-adherence and adverse effects.
Carrying out an MUR with “Mrs Smith” who is prescribed paracetamol,
aqueous cream, multivitamins and senna may score points with the Department
of Health but it is “Mr Jones”, who has just had a myocardial
infarction and has only been prescribed a glyceryl trinitrate spray and
aspirin, who would benefit most from a clinical MUR.
Duncan Petty
Practice Pharmacist, Bradford, and
Lecturer School of Healthcare, University of Leeds
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The
Pharmaceutical Journal