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Antifungal toenail 'paste' - and your other invaluable MURs

We asked you to submit your examples of #PositiveMURs – and you didn’t let us down

Medicines use reviews (MURs) have been the subject of much newspaper criticism in recent months, following allegations that managers at certain multiples routinely pressure pharmacists into conducting inappropriate MURs to boost profits.

The issue has divided opinion among readers, but most pharmacists agree that MURs are excellent when done properly. 

We asked you to send in examples of MURs you have done that have really made a difference to patients. You responded on Twitter, using the hashtag #PositiveMURs, and in emails and comments on our website. Here’s a selection – do keep sending them in.
@ChemistDruggist asked: What’s the best medicines use review you’ve done? 

Brendon Jiang 
I did a discharge MUR. A patient went from fit and healthy to a heart attack, hospital and six long-term medications. He was advised in hospital, but had an information overload so was really grateful for the MUR. 

I explained what each medicine was for, how and when to take them, the relative importance of each one, and what to expect. I gave lifestyle advice and extras – like what to do if a spray doesn’t work or doses are missed, or if an emergency supply is needed. Professionally satisfying.

Ben Merriman 
A patient had been lying down straight away after taking bisphosphonate, [causing] indigestion. I advised her to stay upright.

She was also taking a calcium supplement [along] with levothyroxine at breakfast, not two hours after. Now she’s taking calcium at lunch and tea.

Debbie Ferrigan 
One patient didn’t even put the asthma inhaler into her mouth. I discussed reducing the use of short-acting beta agonists and regular use of inhaled corticosteroids. 

Darshan Negandhi 
A patient asked me to show him how to use his salbutamol Easi-Breathe. I demonstrated by opening the top and pushing the canister. The importance of inhaler technique cannot be underestimated.

Hollie Jackson, via email
My best MUR was a few weeks ago when a lady admitted that she was not taking her terbinafine tablets by mouth.

Instead, she was crushing them, adding water and using it as a paste on her toenails. The same lady was using her sodium cromoglycate eye drops as a night-time eye lubricant.

I got [the prescription] changed to Loceryl nail lacquer and hypromellose eye drops.

A pharmacist posting online as M Marmite
Well-performed MURs are invaluable for many of our patients. My useful MUR was with Mrs A, who was about to deliver a baby any day.

She thought her inhaler was empty and was panicky. I found out it was full, checked her technique, calmed her down – and then talked about her delivery plans, pain medication and asthma control in labour.

Keep sending in your examples - tweet @ChemistDruggist using the hashtag #positiveMURs, or email [email protected] 

What is your best example of a positive MUR?

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