More than a fifth of housebound patients referred to GP following domiciliary MURs

Data taken from domiciliary medicines use reviews in 91 pharmacies across Nottinghamshire and Derbyshire show that 30.3% of patients experienced problems or concerns with their medicines.

Pharmacist vising patient at home

Around a fifth (21.6%) of housebound patients were referred to their GP after pharmacists carried out domiciliary medicines use reviews (MURs), a study has found.

Research looking at domiciliary MURs outcomes across Nottinghamshire and Derbyshire from April 2016 to March 2017 showed that 16.8% of housebound patients reported side effects from their medication, while 16.7% of patients reported missed doses and 30.3% experienced “other problems or concerns”.

The results, published in Integrated Pharmacy Research and Practice (4 May 2018)[1]
, also showed that more than a quarter (27.8%) of patients had stockpiles of unused medicines, some of which were expired.

Domiciliary MURs are carried out in the patient’s own home and are intended to provide the standard MUR to those who are unable to attend a pharmacy. This evaluation of the service, in which 91 pharmacies took part, included data from 1,092 domiciliary MURs for housebound patients taking six or more medicines.

Following the reviews, 55% of patients received advice about their medicines, whilst 44.3% received a medicines cabinet check. Almost a quarter (23.4%) of patients received a review of, or introduction to, compliance aids. 

Domiciliary MURs can be provided as an advanced service as part of the community pharmacy contract. However, study author Asam Latif, clinical academic lecturer at the University of Nottingham’s Faculty of Medicine and Health Sciences, said that “the logistics mean few are carried out in practice” and additional funding makes them a more feasible option for community pharmacists to undertake.

Latif views the domiciliary MUR service as part of a broader approach to support medically under-served patients who he identifies as including housebound patients, people with disabilities and those from black and minority ethic communities. Latif has co-developed an e-learning programme for pharmacy staff, which he hopes will raise awareness of the needs of these patient groups.

“We have found that people from these communities typically have the worst health outcomes but struggle with support from health professionals,” he said.

“I would like to see more work into people from under-served communities.”

References

[1] Latif A, Mandane B, Anderson E et al. Optimizing medicine use for people who are homebound: an evaluation of a pilot domiciliary Medicine Use Review (dMUR) service in England. Integr Pharm Res Pract 2018;7:33–40. doi: 10.2147/IPRP.S160149

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Citation
The Pharmaceutical Journal, PJ, May 2018, Vol 300, No 7913;300(7913):DOI:10.1211/PJ.2018.20204834