Following the widespread coverage of allegations about unnecessary medicines use reviews (MURs), C+D asked readers to Tweet and email their stories of the best MURs they have delivered to patients. Here is one example that pharmacist Perry Melnick submitted:

The following example occurred when I locumed for a fairly large multiple. A prescription for a man in his late seventies – calling for timolol eye drops 0.25%, one drop in each eye daily – had been dispensed.

I mentioned aloud that I thought there was something wrong, as these eyedrops are usually applied twice daily. But the dispenser assured me that there was nothing wrong, because the patient had received the same prescription the previous month.

The patient medical record (PMR) quickly confirmed that this was the patient’s second visit for this item. On speaking to him, I established that these were indeed the drops that he had been using for the past three years, although none had ever been supplied at the hospital he had been attending.

However, on phoning his surgery I found out that the consultant's letter had requested that he be prescribed “long-acting timolol eye drops 0.25%, one drop in each eye daily”.

During my MUR with the patient, he mentioned that just a few days previously, his optician had expressed concern that his ocular pressure was high. However, it had returned to within normal range when he returned for a recheck the next morning. This could be easily explained, of course – the patient uses the drops every morning and their beneficial effect had worn off by the afternoon, when he had first been seen.

Neither the patient's GP, optician or the previous pharmacist had picked up on the fact that this man been taking the wrong formulation of eye drops for three years.

Yet it was not difficult to pick this up in an MUR. It simply required knowing: the usual dose for the prescribed eye drops; that prescribing for patients with either ocular hypertension or glaucoma is always initiated in hospital; and that such requests may be misinterpreted.

If the cost of this one intervention – which hopefully helped to preserve this man's eyesight – does not persuade the doubters of the value of MURs, then nothing will.

Perry Melnick is a locum pharmacist based in Essex

C+D will be publishing more examples of positive MURs over the coming week

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