A community pharmacy asthma MUR project in Hampshire and the Isle of Wight

live with asthma. An average community pharmacy provides a service for more than 450 asthma sufferers. Research indicates that a large proportion of these patients are inadequately controlled. The Asthma Insights and Reality in Europe (AIRE) study showed that only 5.3 per cent of the population surveyed met all the goals of the Global Initiative for Asthma (GINA) asthma management guidelines. Adherence is the extent to which patients take as intended the medicines which are prescribed for them. It is recognised that a significant contributory factor to unsatisfactory asthma control is poor adherence to prescribed medication: up to 70 per cent of patients with asthma do not adhere to some aspect of their recommended treatment. Non-adherence can be categorised into two main types: primary and secondary. Primary non-adherence is when patients do not have their prescriptions dispensed. Secondary non-adherence is when patients do not take their medicines the way in which they are prescribed. In asthma, this typically involves the under-use of inhaled steroid treatments or inappropriate inhaler technique by patients. The consequences of each of these can be increased use of “reliever” inhalers leading to deterioration in the patient’s asthma, necessitating intervention by the GP or emergency hospital admission because of an acute exacerbation. Medicines use review (MUR) is an advanced service in the community pharmacy contractual framework.The aim of the MUR is to achieve a concordant consultation about medicine-taking by establishing the patient’s actual use, understanding and experience of taking their medicines.The ultimate aim is to improve the clinical and cost effectiveness of prescribed medicines thereby reducing medicines wastage and improving patient outcomes through improved adherence. MURs are often a stand-alone service and not integrated into the overall patient care pathway. However, community pharmacists have identified asthma as one of the areas in which they would like to offer a more clinical service. By targeting patients with asthma for an MUR, community pharmacists may be able to improve medicines management leading to improved inhaler technique, increased adherence with appropriate treatment and improved outcomes. This project evaluated the MUR interventions made by community pharmacists in the Hampshire and Isle of Wight area and the service through feedback from patients, community pharmacists, GPs and other healthcare professionals involved in the care of the patient.