Community pharmacist perceptions of delivering post-hospital discharge Medicines Use Reviews for elderly patients

Abstract

Background
The UK’s Department of Health has recommended that formal communication channels between hospital and community pharmacy should be established so that post discharge Medicines Use Reviews (dMUR) become an integral part of the medicines pathway.

Objective
To investigate the perspective of community pharmacists on the usefulness of dMUR referrals from hospital, the suitability of patients referred and overall views on the service.

Method
Self-completed survey distributed to 21 community pharmacists who had received referrals from the hospital during a 9-month randomized controlled feasibility study.

Results
Nineteen pharmacists (90.4%) returned the survey. Seven (36.8%) felt that it was hard to engage patients with dMURs. Failure or inability of patients to attend the pharmacy were the most common barriers.

Reasons for medication changes (n=5) and indications for new medicines (n=4) were the most common examples of extra information that would be useful on referral.

Community pharmacists held positive opinions on the dMUR service and could see the benefit to patients. Pharmacists wanted more referrals but reported performing few dMURs outside this study.

Conclusion
This study highlights the need to improve communication between hospital and community pharmacies and to overcome barriers to performing dMURs outside the pharmacy premises in this patient group.

Impact of Findings on Practice
• Referral of elderly patients from hospital to community pharmacy for a Medicines Use Review is well received by community pharmacists and is feasible
• Reasons for medication changes and indications for new medicines started in hospital would be welcomed with the referral
• Difficulty in patients leaving home to attend the pharmacy was the most common barrier to completion of the reviews
• Contractual restrictions placed on UK community pharmacists limit their ability to provide the service to housebound patients