Pharmacists' medicines-use reviews 'bordering on fraud'
By Gareth Iacobucci
Medicines-use reviews (MURs) carried out by pharmacists have no real benefit for patient care and are often performed for little other reason than to make money, a major new analysis concludes.
The wide-ranging report, on the impact of incentives across primary care, found delivery of some MURs was ‘bordering on fraudulent', with pharmacists admitting to being paid for reviews of ‘limited value'.
The report for the National Institute for Health Research found GPs often ignored the findings of reviews, with even pharmacists acknowledging this was because of the widespread perception they were simply a ‘tick-box' exercise.
The quality of the service provided by pharmacists was ‘highly variable' and some pharmacies were choosing to conduct reviews that were ‘less resource intensive, of limited benefit and cursory in nature.' One pharmacist quoted in the report admitted: ‘I just pick the ones who are on the least amount of medication.'
The damning report, submitted to the Department of Health, will place pressure on ministers to consider scrapping MURs altogether.
Researchers said almost all participants in the study reported hearing ‘tales' about other pharmacies undertaking ‘perfunctory reviews, which were rushed and likely to have a detrimental effect on the public's perception of pharmacists'.
This was particularly said to be true of large multiple pharmacies, due to the pressure to hit target levels of MURs, with reviews often thought to be ‘pressuring patients'.
The report said some pharmacies were guilty of ‘wasting patients' time' with MURs, adding: ‘Most patients had little to say about their experiences in pharmacies and among the small number who had experienced MURs, opinions were mixed.'
Study leader Professor Ruth McDonald, professor of healthcare innovation at the University of Nottingham, concluded: ‘Our data raises concerns about the quality of MURs and the extent to which these represent value for money.'
‘Given the role envisaged for community pharmacy in policy documents generally, the growth in MUR volumes more specifically and proposals being developed on targeting MURs, further research in this area is urgently required.'
Dr Andrew Green, a GP in Hull and member of the GPC prescribing subcommittee, said MURs were often ‘very superficial' and were not cost effective.
He said: ‘The huge difficulty is pharmacists don't have access to the records. Particularly with things like chronic diseases, patients are asked to do reviews for things that they've already done, and it's an unnecessary duplication of work.'Even some pharmacists acknowledged MURs were just a tick-box exercise Even some pharmacists acknowledged MURs were just a tick-box exercise Full report