Medicines use review

adoption and spread of a service innovation

Alison Blenkinsopp, Christine Margaret Bond, Gianpiero Celino, Jackie Inch, Nicola Gray

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background Research has shown that implementation of community pharmacy Medicines Use Review and Prescription Intervention (MUR) in the first year of the service in England and Wales was less extensive than anticipated. Several barriers to MUR becoming accepted and embedded in the National Health Service (NHS) were identified.
Objective To evaluate progress in the provision of the MUR service in England and Wales in its second year (April 1, 2006-March 31, 2007) compared with the first year; and to analyse trends from available national data from the third year of provision in 2007–2008.
Methods The analysis drew on the following data sources: routine data on provision of MURs for community pharmacies in a stratified random sample of 31 primary care organisations in England and Wales, and national datasets on MUR provision from the Pharmaceutical Services Negotiating Committee and NHS Information Centre.
Outcome measures The percentage of community pharmacies providing the MUR service, the numbers of MURs provided in 2006–2007 at pharmacy and primary care organisation level, and the extent of, and variation in, provision.

Key findings The percentage of community pharmacies providing the MUR service increased from 38 to 67.2%. Overall, 62 559 MURs were provided (a more than four-fold increase on the previous year), representing 13.8% of the possible maximum. The mean number of MURs provided (per provider) increased from 36 to 85. For existing providers the mean number increased from 36 to 111 (median 78, range 0–423). For new providers the mean number was 52 (median 17, range 1–401). More than half (52%) of the pharmacies in the sample claimed for fewer than 50 MURs. Overall, 82% of MURs were provided by multiples and this percentage was lower among new providers (62%) than existing providers (89%). Thirty-three (8.1%) existing MUR providers had no recorded MURs in the second year: almost two-thirds of these (64%) were independents. Eleven pharmacies (1.5%) provided the maximum number of 400 MURs per year: all but one were branches of multiples. Of the pharmacies not yet providing MURs, 78% were independent.

Conclusions Both numbers of MURs and numbers of providers of MUR services increased markedly during the service's second year. Those newly providing the service in the second year claimed for more than twice as many MURs as did those who had been ‘new providers' the previous year. Overall just over half of all providing pharmacies claimed for the equivalent of one MUR a week or fewer. Therefore the extent of ‘successful adoption’ of MURs is debatable. Differences in the level of provision continued between independent and multiple pharmacies in terms of both adoption of the service and the number of reviews conducted. As in the previous year, independent pharmacies were less likely to provide the MUR service and when they did the numbers conducted were lower than those provided by multiples.
Original languageEnglish
Pages (from-to)271-276
Number of pages6
JournalInternational Journal of Pharmacy Practice
Volume16
Issue number4
DOIs
Publication statusPublished - Aug 2008

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Pharmacies
Medicine
Innovation
Health
Information services
Wales
England
Pharmaceutical Preparations
National Health Programs
Primary Health Care
Organizations
Community Medicine
Information Centers
Pharmaceutical Services
Information Storage and Retrieval
Negotiating
Prescriptions
Outcome Assessment (Health Care)

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Medicines use review : adoption and spread of a service innovation. / Blenkinsopp, Alison; Bond, Christine Margaret; Celino, Gianpiero; Inch, Jackie; Gray, Nicola.

In: International Journal of Pharmacy Practice, Vol. 16, No. 4, 08.2008, p. 271-276.

Research output: Contribution to journalArticle

Blenkinsopp, Alison ; Bond, Christine Margaret ; Celino, Gianpiero ; Inch, Jackie ; Gray, Nicola. / Medicines use review : adoption and spread of a service innovation. In: International Journal of Pharmacy Practice. 2008 ; Vol. 16, No. 4. pp. 271-276.
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title = "Medicines use review: adoption and spread of a service innovation",
abstract = "Background Research has shown that implementation of community pharmacy Medicines Use Review and Prescription Intervention (MUR) in the first year of the service in England and Wales was less extensive than anticipated. Several barriers to MUR becoming accepted and embedded in the National Health Service (NHS) were identified. Objective To evaluate progress in the provision of the MUR service in England and Wales in its second year (April 1, 2006-March 31, 2007) compared with the first year; and to analyse trends from available national data from the third year of provision in 2007–2008. Methods The analysis drew on the following data sources: routine data on provision of MURs for community pharmacies in a stratified random sample of 31 primary care organisations in England and Wales, and national datasets on MUR provision from the Pharmaceutical Services Negotiating Committee and NHS Information Centre. Outcome measures The percentage of community pharmacies providing the MUR service, the numbers of MURs provided in 2006–2007 at pharmacy and primary care organisation level, and the extent of, and variation in, provision. Key findings The percentage of community pharmacies providing the MUR service increased from 38 to 67.2{\%}. Overall, 62 559 MURs were provided (a more than four-fold increase on the previous year), representing 13.8{\%} of the possible maximum. The mean number of MURs provided (per provider) increased from 36 to 85. For existing providers the mean number increased from 36 to 111 (median 78, range 0–423). For new providers the mean number was 52 (median 17, range 1–401). More than half (52{\%}) of the pharmacies in the sample claimed for fewer than 50 MURs. Overall, 82{\%} of MURs were provided by multiples and this percentage was lower among new providers (62{\%}) than existing providers (89{\%}). Thirty-three (8.1{\%}) existing MUR providers had no recorded MURs in the second year: almost two-thirds of these (64{\%}) were independents. Eleven pharmacies (1.5{\%}) provided the maximum number of 400 MURs per year: all but one were branches of multiples. Of the pharmacies not yet providing MURs, 78{\%} were independent. Conclusions Both numbers of MURs and numbers of providers of MUR services increased markedly during the service's second year. Those newly providing the service in the second year claimed for more than twice as many MURs as did those who had been ‘new providers' the previous year. Overall just over half of all providing pharmacies claimed for the equivalent of one MUR a week or fewer. Therefore the extent of ‘successful adoption’ of MURs is debatable. Differences in the level of provision continued between independent and multiple pharmacies in terms of both adoption of the service and the number of reviews conducted. As in the previous year, independent pharmacies were less likely to provide the MUR service and when they did the numbers conducted were lower than those provided by multiples.",
author = "Alison Blenkinsopp and Bond, {Christine Margaret} and Gianpiero Celino and Jackie Inch and Nicola Gray",
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T2 - adoption and spread of a service innovation

AU - Blenkinsopp, Alison

AU - Bond, Christine Margaret

AU - Celino, Gianpiero

AU - Inch, Jackie

AU - Gray, Nicola

PY - 2008/8

Y1 - 2008/8

N2 - Background Research has shown that implementation of community pharmacy Medicines Use Review and Prescription Intervention (MUR) in the first year of the service in England and Wales was less extensive than anticipated. Several barriers to MUR becoming accepted and embedded in the National Health Service (NHS) were identified. Objective To evaluate progress in the provision of the MUR service in England and Wales in its second year (April 1, 2006-March 31, 2007) compared with the first year; and to analyse trends from available national data from the third year of provision in 2007–2008. Methods The analysis drew on the following data sources: routine data on provision of MURs for community pharmacies in a stratified random sample of 31 primary care organisations in England and Wales, and national datasets on MUR provision from the Pharmaceutical Services Negotiating Committee and NHS Information Centre. Outcome measures The percentage of community pharmacies providing the MUR service, the numbers of MURs provided in 2006–2007 at pharmacy and primary care organisation level, and the extent of, and variation in, provision. Key findings The percentage of community pharmacies providing the MUR service increased from 38 to 67.2%. Overall, 62 559 MURs were provided (a more than four-fold increase on the previous year), representing 13.8% of the possible maximum. The mean number of MURs provided (per provider) increased from 36 to 85. For existing providers the mean number increased from 36 to 111 (median 78, range 0–423). For new providers the mean number was 52 (median 17, range 1–401). More than half (52%) of the pharmacies in the sample claimed for fewer than 50 MURs. Overall, 82% of MURs were provided by multiples and this percentage was lower among new providers (62%) than existing providers (89%). Thirty-three (8.1%) existing MUR providers had no recorded MURs in the second year: almost two-thirds of these (64%) were independents. Eleven pharmacies (1.5%) provided the maximum number of 400 MURs per year: all but one were branches of multiples. Of the pharmacies not yet providing MURs, 78% were independent. Conclusions Both numbers of MURs and numbers of providers of MUR services increased markedly during the service's second year. Those newly providing the service in the second year claimed for more than twice as many MURs as did those who had been ‘new providers' the previous year. Overall just over half of all providing pharmacies claimed for the equivalent of one MUR a week or fewer. Therefore the extent of ‘successful adoption’ of MURs is debatable. Differences in the level of provision continued between independent and multiple pharmacies in terms of both adoption of the service and the number of reviews conducted. As in the previous year, independent pharmacies were less likely to provide the MUR service and when they did the numbers conducted were lower than those provided by multiples.

AB - Background Research has shown that implementation of community pharmacy Medicines Use Review and Prescription Intervention (MUR) in the first year of the service in England and Wales was less extensive than anticipated. Several barriers to MUR becoming accepted and embedded in the National Health Service (NHS) were identified. Objective To evaluate progress in the provision of the MUR service in England and Wales in its second year (April 1, 2006-March 31, 2007) compared with the first year; and to analyse trends from available national data from the third year of provision in 2007–2008. Methods The analysis drew on the following data sources: routine data on provision of MURs for community pharmacies in a stratified random sample of 31 primary care organisations in England and Wales, and national datasets on MUR provision from the Pharmaceutical Services Negotiating Committee and NHS Information Centre. Outcome measures The percentage of community pharmacies providing the MUR service, the numbers of MURs provided in 2006–2007 at pharmacy and primary care organisation level, and the extent of, and variation in, provision. Key findings The percentage of community pharmacies providing the MUR service increased from 38 to 67.2%. Overall, 62 559 MURs were provided (a more than four-fold increase on the previous year), representing 13.8% of the possible maximum. The mean number of MURs provided (per provider) increased from 36 to 85. For existing providers the mean number increased from 36 to 111 (median 78, range 0–423). For new providers the mean number was 52 (median 17, range 1–401). More than half (52%) of the pharmacies in the sample claimed for fewer than 50 MURs. Overall, 82% of MURs were provided by multiples and this percentage was lower among new providers (62%) than existing providers (89%). Thirty-three (8.1%) existing MUR providers had no recorded MURs in the second year: almost two-thirds of these (64%) were independents. Eleven pharmacies (1.5%) provided the maximum number of 400 MURs per year: all but one were branches of multiples. Of the pharmacies not yet providing MURs, 78% were independent. Conclusions Both numbers of MURs and numbers of providers of MUR services increased markedly during the service's second year. Those newly providing the service in the second year claimed for more than twice as many MURs as did those who had been ‘new providers' the previous year. Overall just over half of all providing pharmacies claimed for the equivalent of one MUR a week or fewer. Therefore the extent of ‘successful adoption’ of MURs is debatable. Differences in the level of provision continued between independent and multiple pharmacies in terms of both adoption of the service and the number of reviews conducted. As in the previous year, independent pharmacies were less likely to provide the MUR service and when they did the numbers conducted were lower than those provided by multiples.

U2 - 10.1211/ijpp.16.4.0010

DO - 10.1211/ijpp.16.4.0010

M3 - Article

VL - 16

SP - 271

EP - 276

JO - International Journal of Pharmacy Practice

JF - International Journal of Pharmacy Practice

SN - 0961-7671

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ER -