Adherence

This page contains information for pharmacists about successfully doing medicine use reviews for children and young people.


Medicines use reviews (MUR)

Patients with respiratory disease have been identified nationally for targeting through MURs.

An MUR is designed to support a more in depth medication review. It involves an accredited community pharmacist undertaking structured adherence-centred reviews with a patient receiving prescribed medicines, particularly those receiving medicines for long term conditions like asthma.

It should take 10-15 minutes to complete (normally face to face). During an MUR the patient can discuss any issues or concerns they may have with taking their medicines. It is the perfect opportunity to assess inhaler technique, collect an asthma control test score, or discuss any side effects or concerns patients may have with their medicines. You could also reinforce key messages relating to asthma management.

MUR can be used to establish:

  • Correct or reinforce good inhaler technique.
  • If there a personalised asthma action plan? Is it up to date?
  • Is the child on the correct management step? Remembering to step up during exacerbations and step down following improvement.
  • Does the child have a spacer? Is it compatible with the metered dose inhaler (MDI)? Is it due for replacement?
  • Over use of relievers or under use of preventers/inhaled corticosteroid (ICS) in the last 12 months.
  • Address any issues or concerns the child or parent may have e.g. long term use of ICS.
  • Promote important public health messages- recognition of trigger factors, reinforce the importance of flu vaccination and participation in an active lifestyle.

Follow advice from Pharmaceutical Services Negotiating Committee about medicine use reviews

Can children have an MUR?

Anyone who has the capacity to give informed consent and engage in discussion with a pharmacist can have an MUR. Under the current regulatory framework it is not appropriate to conduct an MUR with the parent, carer or guardian of a person who is not competent.

Where an MUR is to be conducted with a competent child, the pharmacist should be aware of the local safeguarding (child protection) policy and guidelines and should know where to refer any young person who they are concerned about. Visit your local CCG’s website for more details about safeguarding.

New medicine service (NMS)

This service provides support for people with long-term conditions newly prescribed a medicine to help improve medicines adherence; it is initially focused on particular patient groups and conditions.

Starting a new medicine or a change in prescribed regime can lead to confusion and uncertainty in patients which can lead to non-adherence issues. For example, when patients step up in asthma management, this can be a particularly anxious time for the parents of children with asthma.

NMS is equally applicable to children and young people as it is to adults. It can be a valuable tool in identifying issues with non-adherence at an early stage in treatment.

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