|
• White Paper (3)
• MURs
• The profession
• The Society (2)
• MDS (2)
• Onlooker
Letters to the Editor
|
Medicines use reviews (MURs)
£
25 MUR fee is money well spent
From Dr D. J. Jenkins, MRPharmS
I fear that Jenifer
Harding (PJ, 5 May, p523) may have missed the point
of my previous letter (PJ, 28 April, p486), which was merely to suggest
that the same intervention may be regarded as a usage or clinical issue,
depending on context, and that pharmacists should regard the distinction
as artificial. However, Dr Harding does raise some interesting points about
due diligence and the medicines use review service’s value for money,
about which I would like to respond.
For the record, in the case described in my previous letter, I was working
as a locum and the patient was housebound. She had hypertension, angina,
type 2 diabetes (insulin-treated) and rheumatoid arthritis, and was prescribed
12 items (methotrexate, folic acid, aspirin and clopidogrel [both prescribed
by the GP for three years], atenolol, lisinopril, simvastatin, omeprazole,
insulin, needles, test strips, lancets). She was offered an MUR, which
was conducted at her home, because she never saw a pharmacist face-to-face.
Her drug regimen was potentially complex and I wanted to be sure that her
physical difficulties did not compromise her diabetes management.
We would all like to work in a system in which all prescribing is evidence-based
and all patients are reviewed regularly and thoroughly by GPs who always
respond to pharmacists’ concerns. The reality is rather different,
however, and the MUR provides an excellent complementary mechanism for
pharmacists to try to avert patient safety incidents and help improve patient
care.
I agree that, in this case, the GP should have stopped the clopidogrel
after 12 months and that a pharmacist presented with a prescription for
it after this time should have contacted the prescriber (he or she may
well have done so every month for all that I, or Dr Harding, know) but
the fact is that the MUR did get the clopidogrel stopped. Since this will
result in savings to the local drug budget of over £400 per year,
I consider that the £25 MUR fee was money well spent.
David J. Jenkins
St Ives, Cornwall |
The
Pharmaceutical Journal