Investigation of the extent to which community pharmacists in two clinical commissioning groups feel able to support a hospital-initiated medication support referral service for older people

Abstract

Focal points

What is the level of engagement by community pharmacists with a hospital referral scheme for post discharge medicines use reviews (MURs) for older people?
An almost universal willingness by community pharmacists to be involved in the project was demonstrated.
Only around half would offer telephone MURs and less than one in five were able to offer domiciliary MURs.
Engagement was high but the mechanisms to offer MURs were primarily limited to MURs at the pharmacy. This raises concerns over the practicalities of providing a post‐discharge MUR referral service to this patient group.

Introduction

The Department of Health recommends that patients recently discharged from hospitals are routinely referred to community pharmacies to get the support they need to take their medicines effectively and that post discharge MURs should become an integral part of the medicine pathway.1

However, community pharmacists are rarely informed when one of their regular patients has been in hospital and pilot studies have shown that less than 3% of patients signposted to the service receive a post discharge MUR.2

Aim

To assess the willingness and ability of community pharmacists to meet the needs of recently discharged older people with regards to the provision of MURs.

Methods

All community pharmacies (n = 77) in the area surrounding a district general hospital were sent information on the study along with a sign‐up form. The form requested that the community pharmacist confirm their consent to partake in the post discharge MUR referral scheme being set up by the hospital, and provide their contact details, including a safe‐haven fax number through which to receive referrals. They also had to complete a short tick box questionnaire to indicate whether they could provide domiciliary or telephone MURs. Forms were emailed to pharmacies via the Local Pharmaceutical Committee. These were circulated twice, after which pharmacies who had not returned sign‐up forms were contacted by telephone to check they had received them and to answer any questions. Those who requested it were sent the details of the study again. Up to two further telephone reminders were made, to maximise recruitment. Ethics approval was gained from the local NHS Research Ethics Committee.

Results

Sign‐up forms were received from 73 out of the 77 pharmacies in the hospital's catchment area. Responses were totalled and the number of pharmacies able to offer domiciliary and telephone MURs is displayed in Table 1.