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Community pharmacy Medicines Use Review: current challenges

机译:社区药房药品使用审查:当前的挑战

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With a growing aging population, the appropriate, effective, and safe use of medicines is a global health policy priority. One concern is patients’ non-adherence to medicines, which is estimated to be up to 50%. Policymakers seek to reconfigure medicine management services and consider community pharmacy as especially well-placed to improve medicine use. In England and Wales, a commissioned medication review service called “Medicines Use Reviews (MURs)” was made available in through the National Health Service (NHS) in 2005. This involves a patient–pharmacist consultation to improve patients’ knowledge and the use of medicines and to help reduce avoidable waste. However, over a decade since their introduction, questions remain over the extent to which the MUR policy has successfully been embedded in practice and translated into more effective use of medicines. The MUR intervention continues to hold many challenges ranging from poor public awareness and acceptance of MURs, organizational constraints, and issues over interprofessional collaboration. Many of these challenges are not exclusive to the MUR service, or even to the community pharmacy setting. Nevertheless, by identifying and exposing such challenges, an opportunity exists for policymakers and commissioners to seek to improve this service to patients. This narrative review explores the current challenges that face MURs. Damschroder et al’s consolidated framework for implementation research is employed to help organize these challenges from patient and professional perspectives across multiple contexts. Over the past decade, MUR policy and practice has continued to evolve, being shaped by research, organizational and professional influences, and policy. Reforms to the service suggest that the MURs are becoming more responsive to patients’ need and preferences. It is intended that this review will create impetus and scope for further debate, service reconfiguration, and ultimately service improvement.
机译:随着人口老龄化的增加,适当,有效和安全地使用药物是全球卫生政策的重点。一个问题是患者对药物的不依从性,据估计高达50%。决策者寻求重新配置药物管理服务,并认为社区药房在改善药物使用方面处于有利地位。在英格兰和威尔士,2005年通过国家卫生局(NHS)提供了一个委托的药物审查服务,称为“药物使用审查(MURs)”。这涉及患者-药剂师的咨询,以提高患者的知识和对药物的使用。药物并帮助减少可避免的浪费。然而,自从实施MUR政策以来的十多年中,仍然存在许多问题,MUR政策已成功地纳入实践并转化为更有效的药物使用。 MUR干预继续面临许多挑战,包括公众意识不强和对MUR的接受程度,组织限制以及专业间协作问题。这些挑战中的许多挑战不仅是MUR服务甚至社区药房所独有的。然而,通过识别和暴露这些挑战,政策制定者和专员有机会寻求改善为患者提供的服务。这篇叙述性评论探讨了MUR面临的当前挑战。 Damschroder等人的实施研究综合框架用于帮助在多种情况下从患者和专业角度组织这些挑战。在过去的十年中,MUR的政策和实践不断发展,受到研究,组织和专业影响以及政策的影响。服务的改革表明,MUR对患者的需求和偏好越来越敏感。本次审查旨在为进一步的辩论,服务重新配置以及最终改善服务创造动力和范围。

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