In defence of quality MURs
Provide high quality MURs or don't bother, says pharmacist Claire Field
Given recent headlines concerning abuse of the medicines use review (MUR) service solely for remuneration it seems timely to re-state the importance of MURs for our patients and the positive impact they provide. As a profession we should be united in protecting their benefits – the MUR service provides community pharmacists with the perfect opportunity to demonstrate our unique role in the medicines optimisation pathway.
High quality, patient-centred MURs result in valuable interventions – pharmacists identify when medicines are not being used appropriately, flag-up side-effects and liaise with the prescriber to solve these issues. They make cost-efficiencies, suggest stopping unnecessary prescriptions and make countless healthy living recommendations.
Even when no intervention is necessary, an MUR is a relationship-building experience. Patients are far more likely to return for a consultation when they are experiencing difficulties again in the future, rather than going directly to the GP.
The first national audit of MURs published in 2010 found that 93% of people were likely to follow the advice they were given during an MUR and 84% found the review improved their knowledge of their medicines.
A recent pilot undertaken by Cornwall and Isles of Scilly LPC demonstrated that domiciliary MURs have the potential to reach out to the patients most at risk of hospital admissions and therefore most in need of our input. The pilot highlighted a reduction in unplanned hospital admissions of up to 88% and a reduction in A&E visits of 62.5%, demonstrating the huge value and benefit of MURs for the frail elderly population.
Effective MURs, undertaken by well-trained pharmacists, can improve patients’ health and save the NHS money. At a time when our payments are being cut and pharmacies are being put at risk of closure, we should be taking every opportunity to demonstrate our worth.
As for those who may look to abuse the system, the guidance clearly states that NHS England must terminate MUR arrangements if notice is given that a pharmacy is failing to comply with their obligations. The solution therefore is clear, the commissioner and regulator should act decisively if presented with evidence of poor compliance to send out a message that this type of practice is unacceptable.
Pharmacists must either provide high quality MURs to their patients or not bother at all.
Claire Field works as a community pharmacist in Cornwall