Objective: To understand the contribution of the Medicines Use Review consultation to counseling practice in community pharmacies.
Methods: Qualitative study involving ten weeks of observations in two community pharmacies and interviews with patients and pharmacy staff.
Results: 'Traditional' counseling on prescription medicines involved the unilateral transfer of information from pharmacist to patient. Over-the-counter discussions were initiated by patients and offered more scope for patient participation. The recently introduced MUR service offers new opportunities for pharmacists' role development in counseling patients about their medicines use. However, the study findings revealed that MUR consultations were brief encounters dominated by closed questions, enabling quick and easy completion of the MUR form. Interactions resembled counseling when handing out prescription medicines. Patients rarely asked questions and indeterminate issues were often circumvented by the pharmacist when they did. MURs did little to increase patients' knowledge and rarely affected medicine use, although some felt reassured about their medicines. Pragmatic constraints of workload and pharmacy organisation undermined pharmacists' capacity to implement the MUR service effectively.
Conclusion: Pharmacists failed to fully realise the opportunity offered by MURs being constrained by situational pressures.
Practice implications: Pharmacist consultation skills need to be reviewed if MURs are to realise their intended aims.
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