Understanding the patient perspective of the English community pharmacy Medicines Use Review (MUR)

Abstract

Health policy-makers and pharmacy's representative bodies seek to better utilize the skill of community pharmacists so as to support patients' use of medicines and associated health care outcomes. The English Medicines Use Review (MUR) is an NHS-funded community pharmacy service that aims to improve patients' knowledge of medicines and their use. MURs represent an opportunity for patients to gain additional help with their medicines as well as fostering inter-professional collaboration between pharmacists and general practitioners (GPs). To describe patients' perspective of the MUR service and their understanding of the value that they derive from it. This study employed a qualitative approach involving 10 weeks of ethnographic observation in two English community pharmacies. It employed observations of 54 patient-pharmacist MURs consultations and subsequent interviews with 34 patients. A thematic approach was used to analyze the data. All patients reported feeling comfortable speaking with the pharmacist, who they saw as a knowledgeable expert on medicines. They appreciated the time spent with them in a private consultation. The MUR provided patients with reassurance about their medicines, that they were "doing the right thing." Despite these positive views, when asked to describe the purpose of their MUR, patients provided ambivalent accounts and reported that the consultation did little to improve their knowledge of medicines or affect how they used them. Patients' accounts of MURs suggested they held broadly positive views about the service. However, evidence that MURs were fulfilling their formal policy aims and intentions was limited. Policy-makers and those seeking to promote community pharmacy's professional agenda should note the patients' perspective, assessment and perceived value of MURs in order to develop services, which are better tailored to patient need.