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  • Couple of silly questions

    Hello everyone. Thanks in advance for any help. Have a number of questions I can't seem to find answers to. Hope you can help.

    Can a prescription intervention (type MUR) be performed for a patient on a single medicine (as opposed to multiple medications for an MUR)?

    Just wanted to confirm...is the following statement true: We don't require GP permission / consent to perform any form of MUR activity for any given patient (I'm quite sure it is).

    With regard to third parties sitting in on an MUR, I understand that patient consent must be obtained for this. However no information is given on the qualifications of the third party. Can a counter assistant be given just as much opportunity to 'sit in' as a pre-reg?

    Thanks again

  • #2
    Re: Couple of silly questions

    Hi,
    I'm a GP and have never been asked to give consent for MURs. I receive plenty so would assume you are correct.
    ChopperT

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    • #3
      Re: Couple of silly questions

      Originally posted by ChopperT View Post
      Hi,
      I'm a GP and have never been asked to give consent for MURs. I receive plenty so would assume you are correct.
      ChopperT
      Welcome GP
      as a GP, what do you think about MURs? are they useful for improving patient's health? do you feel a lot are being done just to meet targets(i.e MURs for dispensers...etc).

      would be interesting to see listen to GPs point of veiw about the whole MUR thingy
      Regards
      [COLOR=Olive]xxxx They tried to break my back, but i survived. whatever doesn't kill you, will only makes you stronger xxxx
      [/COLOR]

      Comment


      • #4
        Re: Couple of silly questions

        Originally posted by DumbandNumb View Post
        With regard to third parties sitting in on an MUR, I understand that patient consent must be obtained for this. However no information is given on the qualifications of the third party. Can a counter assistant be given just as much opportunity to 'sit in' as a pre-reg?
        anyone: neighbours, interested bystanders, dogs, anyone who has the patient's permission. Even the GP
        ....just my opinion

        Comment


        • #5
          Re: Couple of silly questions

          I think that it would be perfectly acceptable for a pre-reg student to ask (or for their tutor to ask if it's OK) to sit. Not so sure about counter staff, unless they're there as chaperones.

          Comment


          • #6
            Re: Couple of silly questions

            Originally posted by Raoul View Post
            Welcome GP
            as a GP, what do you think about MURs? are they useful for improving patient's health? do you feel a lot are being done just to meet targets(i.e MURs for dispensers...etc).

            would be interesting to see listen to GPs point of veiw about the whole MUR thingy
            Regards
            I have yet to receive an MUR that has contained any information worthy of changing the patient's management. I do not think this is the fault of our local pharmacists, it is more that we basically do similar work to the MUR every six months when we do medication reviews. At that time if there is a significant problem we correct it and if it is something irrelevant we pretend we haven't heard it! On most of the occasions that the patient has been recommended to see a GP it is for something trivial that is not bothering the patient significantly or not worth changing the meds list for. Unfortunately the more that a patient is asked about symptoms/problems/possible side effects the more likely they are to report the trivial things that they wouldn't have mentioned otherwise.
            I don't mind receiving them as they don't take long to look at and one day may contain something important. I also appreciate that pharmacists, like GPs, are prepared to do fairly unfruitful work if there is extra funding for it.

            Comment


            • #7
              Re: Couple of silly questions

              Nice one Chops!

              I have not, and never will have, the slightest inclination to carry out anything even resembling an MUR. As you clearly state, the docs are already doing it for us...I wouldn't waste my time. You guys rock!

              By way of postscript, I did a repeat prescription for 21 items for one patient..also received a car-bootload of co-codamol soluble and seretide 500 discus inhalers dating back five years..all unused.
              Last edited by Fleegle; 11, November 2008, 09:57 PM.
              Don't Stop Believing

              http://youtube.com/watch?v=rnT7nYbCSvM

              Comment


              • #8
                Re: Couple of silly questions

                Originally posted by ChopperT View Post
                I have yet to receive an MUR that has contained any information worthy of changing the patient's management.
                Can be a useful learning exercise for pharmacists - patients keep coming up with diseases I know little about.
                Part of the problem is that MURs are targets rather than targeted.
                If you want some extra work - do a search of patients with Adcal D3 on repeat - who aren't requesting it. Perhaps a different flavour or brand would aid compliance?
                We used to sort this out by talking to patients - but at least as part of a targeted MUR there is a payment for it.

                Jeff

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                • #9
                  Re: Couple of silly questions

                  Originally posted by ChopperT View Post
                  I don't mind receiving them as they don't take long to look at and one day may contain something important.
                  Any more brown noses out there?
                  Don't Stop Believing

                  http://youtube.com/watch?v=rnT7nYbCSvM

                  Comment


                  • #10
                    Re: Couple of silly questions

                    Originally posted by ChopperT View Post
                    I I do not think this is the fault of our local pharmacists, it is more that we basically do similar work to the MUR every six months when we do medication reviews. At that time if there is a significant problem we correct it and if it is something irrelevant we pretend we haven't heard it! Unfortunately the more that a patient is asked about symptoms/problems/possible side effects the more likely they are to report the trivial things that they wouldn't have mentioned otherwise.
                    Some years ago I was part of a team which was asked to go into a surgery which had, for reasons which I won't go into, been run by a series of locum GP's. We were asked to do a paper review at first and follow that up with face to face discussions where we thought it necessary (e.g. where it appeared that side effects were being treated, where there were complex regimens etc.
                    What we found was that virtually all the patients who should have had regular blood tests had not had them. The exception of course was Warfarin, since that was managed elsewhere. We did do some MUR's type interviews but didn't find many significant problems. We did find some issues (like lack of call back from hospital when there should have been)
                    Later I did some for a surgery where the GP's were very conscientious about reviews and there were very few instances where I found something missed. Other pharmacists I have known in these circumstances have taken over reviewing the MUR's and filtering out the useful ones.
                    What we did find was more info on OTC medication.
                    Dr C's practice is opening a pharmacy; I would suggest that they pass all the outside MUR's over to the pharmacist and ask him/her to filter them. If it's a 100 hour job, then I'm sure there'll be some quiet time which could usefully be occupied reading through such reviews.

                    Comment


                    • #11
                      Re: Couple of silly questions

                      I thought that GPs were not allowed to open a pharmacy. Presume that now anyone can. Certainly in one town Dispensing Drs have applied to open 100 hour pharmacy. However, they are down a side street and little footfall.

                      Cannot see how they could justify this just as a means of retaining dispensing in town.

                      Application in name of well known pharmacist who champions dispensing Dr applications.
                      johnep

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                      • #12
                        Re: Couple of silly questions

                        maybe because of pressures the quality of the MUR's you get from the local pharmacists leave something to be desired.
                        i personally did two last week that i considered relevent. the first was a patient who because he was feacally incontenent and had a female GP would not share this with her. the second a patient that kept having ideas of self harm because of her quality of life. both not strictly related to their medications but requiring i thought urgent referral. which i did. i hope and am sure the doctors involved actioned my MUR's and did not just file them away. so some MUR's are of value. the week before i did an MUR on a diabetic who had never had his disease explained to him. he was still taking sugar in drinks, eating sweets etc. no one had told him otherwise. i suggested a diet from his GP and or a referral to a dietician. bet his HbAlc would be interesting but according to him his Gp did not do any bloods so we may never know.

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