Background The community pharmacy medicines use review (MUR) service in England has been identified as a way of providing support with medication to recently discharged patients; however initial uptake of post-discharge MUR has been low. Objective To identify barriers to recruitment into a randomised controlled feasibility study of a hospital referral system to older patients’ regular community pharmacists. Method Ward pharmacists at Southport District General Hospital identified patients aged over 65 to be approached by a researcher to assess eligibility and discuss involvement in the trial. Participants were randomised to referral for a post discharge MUR with their regular community pharmacist, or to standard discharge care. Reasons for patients not participating were collected. Results Over a 9-month period 337 potential participants were identified by ward pharmacists. Of these, 132 were eligible and 60 were recruited. Barriers to recruitment included competing priorities among ward pharmacists, and national restrictions placed on MURs e.g. housebound patients and those requiring carer support with medication. Lack of expected benefit resulted in a high proportion of patient refusals. Conclusion The current provisions for post discharge MURs exclude many older people from participation, including those possibly in greatest need. Unfamiliarity with the role of the pharmacist in transitional care may have affected patients’ perceived ‘cost-benefit’ of taking part in this study.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
Mansur N, Weiss A, Beloosesky Y. Relationship of in-hospital medication modifications of elderly patients to postdischarge medications, adherence, and mortality. Ann Pharmacother. 2008;42(6):783–9.
Steering Group on Improving the Use of Medicines (for better outcomes and reduced waste). Improving the use of medicines for better outcomes and reduced waste: An action plan. Department of Health. 2012. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212837/Improving-the-use-of-medicines-for-better-outcomes-and-reduced-waste-An-action-plan.pdf. Accessed 14 Dec 2015.
Royal Pharmaceutical Society. Keeping patients safe when they transfer between care providers—getting the medicines right. Final Report. RPS. 2012. http://www.rpharms.com/current-campaigns-pdfs/rps-transfer-of-care-final-report.pdf. Accessed 14 Dec 2015.
Pharmaceutical Services Negotiating Committee/NHS Employers. Medicines use review and prescription intervention service specification. PSNC and NHS Employers. 2013. http://psnc.org.uk/wp-content/uploads/2013/06/MUR-service-spec-Aug-2013-changes_FINAL.pdf. Accessed 14 Dec 2015.
Royal Pharmaceutical Society. Keeping patients safe when they transfer between care providers—getting the medicines right. Individual reports from the Early Adopter Sites. RPS. 2012. http://www.rpharms.com/current-campaigns-pdfs/eas-finalreports.pdf. Accessed 14 Dec 2015.
Bhatti N, Blenkinsopp A, Devlin L, Farooq H, Kazi I, Mulla I, et al. Community pharmacists’ experiences of managing patients’ medicines after discharge from hospital: a preliminary study of discharge medicines use reviews. Int J Pharm Pract. 2013;21(Supp2):86–7.
McMurdo MET, Roberts H, Parker S, Wyatt N, May H, Goodman C, et al. Improving recruitment of older people to research through good practice. Age Ageing. 2011;40(6):659–65.
Fialová D, Topinková E, Gambassi G, Finne-Soveri H, Jonsson PV, Carpenter I, et al. Potentially inappropriate medication use among elderly home care patients in Europe. JAMA. 2005;293(11):1348–58.
Baqir W, Desai N, Harker N, Vyas A, Copeland R, Burdon M, et al. Can targeted medicines use reviews support safe transfer of care from hospital to community? Int J Pharm Pract. 2012;20(Supp2):82–3.
Petty DR, Zermansky AG, Raynor DK, Vail A, Lowe CJ, Freemantle N, et al. “No thank you”: why elderly patients declined to participate in a research study. Pharm World Sci. 2001;23:22–7.
Conflicts of interest
About this article
Cite this article
Ramsbottom, H.F., Fitzpatrick, R. & Rutter, P. Post discharge medicines use review service for older patients: recruitment issues in a feasibility study. Int J Clin Pharm 38, 208–212 (2016). https://doi.org/10.1007/s11096-015-0243-8