MURs on Children?

[andrew paxton]

Can we do MURs on children? Most places I work (I'm a locum) say you can't, but with no real reason given. If MURs are for the benefit of the patient, which is the reason I do them, rather than the benefit to the bottom line, then surely a child shouldn't be excluded from the benefits that are available. There are obviously two strands to that, though: the child that can give consent, and the child that is too young or too ill to do so. I cannot see that the first shouldn't have one. The second is more difficult, but they are the particular children that are likely to have medicines use issues, and I think that some sort of special MUR should be invented for their parents or guardians on their behalf.
Any opinions please?

[Pharmanaut]

Can we do MURs on children? Most places I work (I'm a locum) say you can't, but with no real reason given. If MURs are for the benefit of the patient, which is the reason I do them, rather than the benefit to the bottom line, then surely a child shouldn't be excluded from the benefits that are available. There are obviously two strands to that, though: the child that can give consent, and the child that is too young or too ill to do so. I cannot see that the first shouldn't have one. The second is more difficult, but they are the particular children that are likely to have medicines use issues, and I think that some sort of special MUR should be invented for their parents or guardians on their behalf.
Any opinions please?

There could be scope for inhaler technique and other basics.
However, its a minefield I would prefer to keep out of. There would be stumbling blocks, such as child protection issues, CRB checks and always having a chaperone available for you in addition to the presence of a parent/guardian. One vexatious accusation could see you suspended with your reputation and life in shreds.

Probably best left to the medics and their staff.

[andrew paxton]

Yes, I see your point, but I still think that there is a need for such a service. The list of Enhanced Services includes a similar type of service designed for, I suppose, Vulnerable Adults, and if such a service were commissioned locally, I think it could be extended to children. It appears not to exclude talking to parents or carers, as the MUR does. See http://www.psnc.org.uk/data/files/Ph...e_spec/en6.pdf

[Raju]

I phoned the PSNC with this once - they said yes you can do it provided you judge that the child is competent enough to benefit from the MUR.

[mrmeds]

I phoned the PSNC with this once - they said yes you can do it provided you judge that the child is competent enough to benefit from the MUR.

and competent to give consent

[johnep]

Is this Gillick competence as for under age EHC?
johnep

[andrew paxton]

Or Fraser Competence

[DavidS]

I phoned the PSNC with this once - they said yes you can do it provided you judge that the child is competent enough to benefit from the MUR.

I think things have moved on with the introduction of the NMS and formalised written consent. Up til Sept 29th the PSNC had not considered children in the NMS delivery, and I would want to see something written by the PSNC before phoning a child at home to discuss their medication. As far as MURs go post Oct 1st 2011, If they turn up with their parents, who sign the consent form, that will be fine - or with a pre-signed consent form. I don't think there is any reason why parents should not have signed such a form.

[johnep]

At one time Lloyds compass system was showing qvar as cfc free steroid. Routinely given to underage children. I queried and found pt had been on for months.
Left note for regular pharmacist. (I was working a Saturday). An MUR or NMS would have highlighted this.
johnep