Community pharmacists’ perspectives on implementation of Medicines Use Review in Slovenia

Abstract

Background In December 2014 Slovene Chamber of Pharmacies defined procedures for Medicines Use Review (MUR) in Slovenia, together with an educational program and certification to ensure pharmacists' competency to perform MUR. The first 15 pharmacists were certified in June 2015 and implemented the service in their practices. Objective This study aimed to understand the implementation of MUR from the perspectives of the first community pharmacists providing the service in practice. Methods A focus group with first MUR providers took place in February 2016, 6 months after the first pharmacists were certified to provide MUR service. Based on regional and institutional criteria ten pharmacists from the first certified group were chosen and invited to participate in guided discussion, where the development and assurance of competencies, the provision of the service in practice and the future of the service were addressed. The discussion was voice recorded with written consent obtained from all participants. Analysis was performed in NVivo 11 software with the use of inductive qualitative content analysis approach. Main outcome measure Views, challenges and opportunities for the Medicines Use Review service in Slovenia. Results Seven pharmacists attended the focus group, 5 from public pharmaceutical institution and 2 from concessionary pharmacies. Three main thematical categories were identified: quality assurance of MUR, different stakeholders' perceptions of MUR and MURs' management. Pharmacists' broad knowledge in pharmacotherapy was emphasized as the basis of quality provision and main advantage in performing MUR in comparison with other healthcare professions. Recognisability of MUR among different stakeholders should be improved with comprehensive approach in marketing of the service. Positive patient feedback was reported, however persuading them to attend MUR presented a challenge. Better management of the service, especially in terms of work organization, would facilitate MUR provision. Conclusion Overall, positive experiences with implementation and provision were reported. To ensure MUR sustainability, the service needs to become more widely known and opportunities must be provided for continuing professional development of providing pharmacists.

Improved adherence with Medicines Use Review service in Slovenia: a randomized controlled trial

“…After the MUR interview, patients are provided with a personal medicines card that contains all the information that is needed to support effective and safe medicines use (dosing regimen, taking with/without food, special warnings, recommendations, etc.) [19,20]. Pharmacists, who intend to provide MUR, must first complete a specific educational program to ensure their competency for service provision.…”

“…According to the PRACTISE study [1,2], medicines use review services are offered in 14 European countries, among them in Slovenia. Almost 300 Slovenian community pharmacists throughout the country (data from 2020) are certified to provide a standardized Medicines Use Review (MUR) service; however, provision rates vary and service is not remunerated [19,20]. Implementation of MUR service within Slovenian pharmacy practice has been evaluated in several studies [19,21], among which a randomized controlled trial (RCT) was designed with the aim to evaluate the benefits of MUR service in Slovenia, with a specific focus on evaluating the impact of MUR on patient adherence to medicines.…”

Regulatory and clinical perspective on patient access to antidiabetic medicines in Slovenia

“…The research team consisted of four researchers working in an academic environment: two researchers and faculty professors, a researcher with a PhD in pharmacoeconomics and a second-year doctoral student. The researchers are familiar with qualitative study designs and have conducted several focus panels and other types of qualitative studies [3,4,5].…”

Factors Facilitating and Hindering Development of a Medication Use Review Service in Eastern Europe and Iran-Cross-Sectional Exploratory Study

“…One of the first Eastern-European countries to provide a nationally approved and funded MR service in community pharmacies was Slovenia in 2015 [ 13 , 16 ]. In relation to this service barriers to its provision were identified as lack of time in the pharmacy setting and recognition of the service by patients, physicians and health care payers.…”

“…In relation to this service barriers to its provision were identified as lack of time in the pharmacy setting and recognition of the service by patients, physicians and health care payers. Positive patient feedback and extension of professional role were recognized as MR facilitators [ 16 ]. The main barriers to implementing MR identified in other studies have mostly been connected to pharmacy workflow, staffing issues, lack of access to patient’s clinical information and cooperation with other healthcare specialists [ 9 , 17 , 18 ].…”