QOF 'should incentivise referrals for pharmacy drug reviews'

GPs should be handed QOF targets to refer more patients for medicines use reviews (MURs) at pharmacies to tackle non-adherence to treatments, researchers say.

Researchers: lack of collaboration of MURs is a 'missed opportunity'
Researchers: lack of collaboration of MURs is a 'missed opportunity'

Non-adherence to primary care prescriptions costs the NHS in England £300m a year. But GPs and pharmacists rarely collaborate over MURs despite the potential to reduce this waste, according to University of Nottingham researchers.

Their study found patients using pharmacy MUR services found them valuable, but none had been referred by their GP.

The lack of referrals to the service is a 'missed opportunity' to improve treatment adherence and spot medication problems, the researchers said.

They argued that QOF targets for referral to MURs would complement existing GP medication checks and help to improve the effective use of medicines.

Over two million MURs took place in English pharmacies in 2011/12 at a cost of £68m.

Surveys show many GPs question the value of the reviews, complaining of duplicated work, overcomplicated paperwork and limited effectiveness in improving patient compliance with treatment.

To investigate the potential of the service, the research team interviewed 34 patients who underwent an MUR and 17 pharmacy staff across two community pharmacies.

They found that patients and pharmacists broadly welcomed the reviews, although some patients feared they were 'going behind their GP's back' by attending.

Researchers found the checks picked up prescribing issues that previously had gone unnoticed, including non-adherence and the need for changes to prescriptions.

The study authors concluded: 'The MUR service has failed to capitalise on a potential opportunity to foster interprofessional collaboration to support patients to take medicines appropriately.'

Policy-makers 'should consider integrating pharmacy medicines management services such as the MUR and the recently introduced New Medicines Service into QOF measures to incentivise GP engagement and position MURs so they complement existing GP medication reviews', they said.

The authors added: 'Our findings suggest that there is scope for developing a much more effective and joined-up service that transcends traditional boundaries between GPs and pharmacists, reduces the occurrence of medicine related problems presented to GPs and supports patients to obtain greater benefit from their treatments.'

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