Pharmacist’ perception of structured medication review in UK primary care: A qualitative study.

Abstract

Objectives: The objective of this study was to to investigate pharmacists’ experience and perceptions of structured medication review services (SMR) within UK primary care and its effectiveness. Methods: A qualitative semi-structured interview design was employed. The study’s inclusion criteria were primary care network (PCN) pharmacists who are currently working in general practices within the West or East Berkshire region and are involved in the structured medication review service. The interview questions were modified based on the pilot interview feedback and through interviews to formulate the final 26 questions. Via the MS Teams programme, the interviews conducted relied on the prepared guide. The data were transcripted verbatim and thematically analysed using NVivo12 software. This research was approved by the University Research Ethics Committee. Key findings: Ten interviews were conducted. The interviews transcripts underwent the six prescribed Braun and Clarke phases of thematic analysis to generate 33 codes that were subsequently grouped into four themes, namely the SMR process; the pharmacist factors; the patient factors and barriers to SMRs. The service’ key elements were to comprehensively review the appropriateness and indications of the medications and to check patient preferences about their treatment plans and to apply the deprescribing process. The pharmacists indicated a several positive impacts of SMRs; having sufficient time for comprehensive review; an increased awareness about medication safety; updated therapeutic monitoring and improvement of patients’ quality of life (QoL). The the pharmacists’ workload were found to be affected by the SMRs which, in turn, can be overcome by an organised appointments schedule and a cooperative team. The pharmacists reported nine barriers, the most cited of which were remote SMR; issues relating to time limitations and a lack of support at the outset. Conclusions: There was a positive perspective about the SMR impact on patient treatment plan and their QoL. Also, this study signified the shared decision-making approach and the deprescribing process in the SMRs. However, few barriers were faced by PCN pharmacists like, time issues, need for support and face-to-face training.