Pharmacists’ and patients’ views and feedback on Italian Medicines Use Review (I-MUR)

Rationale, aims and objectives: Although medicine review services are offered by community pharmacists in many countries, they are non-existent in Italy. A novel intervention I-MUR, was developed for patients with asthma aiming to improve medicines use. The aim of this study was to obtain pharmacists’ and patients’ views on the acceptability of the I-MUR service provided by community pharmacists to asthma patients in four regions of Italy. Methods: Pharmacists’ expectations, experiences and attitudes to delivering the I-MUR were obtained through questionnaires distributed before and after delivering the I-MUR, plus focus groups. Patients’ views were obtained via questionnaires, distributed by the pharmacists and returned anonymously. Results: Seventy-four pharmacists provided the I-MUR service to 895 asthma patients; 49 pharmacists completed both questionnaires, 53 participated in focus groups and 246 patients returned questionnaires. Barriers anticipated most frequently by pharmacists before the I-MUR were lack of time (53%) and lack of co-ordination with other health professionals (61%), while lack of financial compensation was identified by 37%. Lack of co-ordination proved the most common actual barrier (88%), with lack of financial compensation being cited less frequently after providing the intervention (8%). Ninety-six percent of pharmacists anticipated providing both education on inhaler technique and medication counselling, but in practice slightly fewer had provided these (90% and 86% respectively). Focus groups highlighted a lack of relevant undergraduate education to support medication review and structural barriers within some pharmacies, but described positive patient feedback and desire to extend the I-MUR. Patients’ respondents were positive; 62% indicated the reason for having an I-MUR as making sure that they were using medication correctly, 75% considered they benefited from it and 86% would recommend it to others. Conclusions: The I-MUR service was perceived positively by both pharmacists and patients, supporting the extension of medicine review services to community pharmacists in Italy.