Optimizing medicine use for people who are homebound: an evaluation of a pilot domiciliary Medicine Use Review (dMUR) service in England
Received 18 December 2017
Accepted for publication 7 March 2018
Published 4 May 2018 Volume 2018:7 Pages 33—40
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Cristina Weinberg
Peer reviewer comments 2
Editor who approved publication: Professor Jonathan Ling
Asam Latif,1 Baguiasri Mandane,2 Emma Anderson,3 Caroline Barraclough,3 Samantha Travis4
1School of Health Sciences, University of Nottingham, Nottingham, UK; 2University Hospitals of Leicester NHS Trust, Leicester, UK; 3Centre for Pharmacy Postgraduate Education, The University of Manchester, Manchester, UK; 4NHS England, North Midlands, Mansfield, UK
Background: As global life expectancy increases, older people with chronic diseases are being required to manage multiple and complex medicine regimes. However, polypharmacy raises the risk of medicine-related problems and preventable hospital admissions. To improve medicine use, English community pharmacies are commissioned to deliver Medicines Use Reviews (MURs), which are typically delivered from the pharmacy. People who are homebound rarely receive the service. This paper describes the uptake and impact of a pilot project that seeks to provide domiciliary Medicines Use Reviews (dMURs).
Methods: Participating pharmacists collected data on their dMUR activity over a 12-month period. Outcome measures (eg, adherence, side-effects, pharmacist assessment of preventable hospital admissions) were recorded. Pharmacists were also invited to submit written testimonies of their experiences of undertaking dMURs.
Results: Out of 433 possible pharmacies eligible to take part in the pilot, 186 pharmacies expressed an interest, and 91 actively engaged in providing the dMUR service. The total number of dMURs performed were 1092 (mean number performed by each pharmacy was 12). Two thirds of patients reported problems and concerns about side-effects and missed doses regarding their medicines. Pharmacists’ assessment to prevent hospital admissions found that over one-third of the dMURs had contributed towards preventing either a possible or likely emergency hospital admission. Twelve pharmacists’ testimonies were submitted providing context of the problems patients faced with medicines.
Discussion: dMURs are feasible and improve patient medicines use. The results indicate that dMUR potentially prevents hospital admissions and readmissions. dMURs offer an opportunity to support the self-care agenda and ensure homebound patients can successfully manage their medicines.
Keywords: community pharmacy, domiciliary Medicines Use Reviews, dMURs, hospital admission, medicines management
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