Identifying criteria for assessing the quality of medicines use review referral documentation by community pharmacists

Aims and objectives The medicines use review (MUR) service was introduced in April 2005 for England and Wales as part of the new community pharmacy contractual framework. Following a MUR, community pharmacists are required to document their interventions and refer any unresolved issues to the patient’s general medical practitioner using a structured template. The patient also receives a copy of this form. Anecdotal feedback suggests that there is considerable variation in the quality of this documentation. The aim of this study was to develop explicit criteria against which the quality of MUR referral documentation can be assessed. Setting This study forms part of the Welsh School of Pharmacy’s ongoing monitoring and evaluation of its MUR accreditation assessment. Method A two-round electronic Delphi technique was used to develop a consensus of the key quality indicators to assess the quality of MUR referral documentation. Statements were generated following a systematic review of the literature plus interviews. Sixteen panellists who responded to an invitation to participate in the study were involved in the Delphi process (these were 10 out of 14 MUR accreditation tutors who were invited to take part and six pharmacy practitioners from a possible 22 primary care organisations in Wales) to rate the usefulness of these statements as a measure of pharmacists’ referral skills. Consensus was defined a priori as >70% of participants scoring the statement as 1–3 on an ordinal scale from 1–9 (where 1 is definitely and 9 is definitely not). Key findings The first round of the electronic Delphi survey comprised 30 statements of which consensus was gained for 19. Following the second round, consensus was achieved for 20 statements. Conclusion These criteria could be used to assess the quality of referral documentation following MUR and to provide feedback to pharmacists on their referral skills. However, further studies are needed to test the validity of the MUR quality indicators with community pharmacists and GPs and the feasibility of using this tool in practice