The Pharmaceutical Journal
Vol 278 No 7450 p523-524
5 May 2007

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• White Paper (4)
• MURs (2)
• Dispensing errors
• Chemotherapy
• Medication review
• Pfizer
• Locum pharmacy

Letters to the Editor

Medicines use reviews (MURs)

It does not take a £25 MUR to identify problem

From Dr J. A. Harding, MRPharmS

I read the letter from David Jenkins (PJ, 28 April, p486) with interest. I suggest to Dr Jenkins that it does not need a medicines use review costing £25 to identify that Patient B, who had been taking clopidogrel and aspirin for three years, may be at serious risk of a gastric bleed. Responsibility for prescribing rests with the prescriber, but I believe that a pharmacist who dispenses such a combination without consideration of the appropriateness of the drugs is not acting in the patient’s best interest and may indeed be contributing to a potential patient safety incident.

Essential service 1 is designed to improve quality of the dispensing service and reduce risks to patients. Let this be used to best advantage and all will benefit.

Jenifer Harding
Assistant Director Medicines Management
Sandwell Primary Care Trust

We probably all do MURs to a level we are comfortable with

From Mr P. Melnick, MRPharmS

I read David Jenkins’s letter (PJ, 28 April, p486) with particular interest because I have been in similar situations.

At first sight, I would support his view that in the strictest sense one could not comment about Patient B who had been taking clopidogrel and aspirin for three years because it would be beyond the scope of a medicines use review. But what if the patient subsequently had a haemorrhage? Could we be sued for failing to flag up a potential problem? Are there not parallels here with the Migril case? And what if we had raised the issue with the prescriber previously but that fact had not been recorded either at the surgery of the pharmacy?

I suspect that we probably all do MURs to a level we are comfortable with and I have previously approached this problem more obliquely by noting on the MUR form that I had counselled the patient to report any unexplained bruising, stomach pain or black stools promptly.

Perry Melnick
Ilford, Essex

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