Pragmatic Evaluation of Effectiveness and Acceptability of the Bristol Medication Review Toolkit (BRISMED)

Funding:

This project is funded by the NIHR Health and Social Care Delivery Research (HSDR) Programme, NIHR154205.

What is the problem?

At a medication review a patient meets a GP or pharmacist to discuss the medicines they are using. Medication reviews are important to check that the medicines a patient is taking are the right ones for their conditions. Reviews also check that medicines are being used in a safe and effective way. Medication reviews are part of normal health care for people taking medicines long-term. But research shows that medication reviews do not always improve care. Also, patients are not always included in decisions about their medicines. The National Institute for Health and Care Excellence (NICE) gives advice and guidance to the NHS. NICE has said better medication reviews are needed and many doctors and pharmacists agree.

What is the aim of the research?

To improve medication reviews, researchers at the University of Bristol have developed the “Bristol Medication Review toolkit”. Doctors, pharmacists, patients and researchers worked together to develop the toolkit. The toolkit gives doctors and pharmacists advice about how to do a medication review. It also gives patients advice about how to get the most from a review.

We now want to find out if giving GP practices the Bristol Medication Review toolkit improves medication reviews. We also want to find out if patients, doctors and pharmacists find the toolkit easy to use.

How will this be achieved?

The project has three parts:

1. We will give the Bristol Medication Review toolkit to around 500 GP practices across the UK, and give advice on how to use it. We will speak to patients, GPs and pharmacists to make sure the toolkit is as useful as possible, and that practices know how to use it properly.

2. For a year, we will compare medication use in the 500 GP practices that are using the Bristol toolkit with 500 GP practices that are not using it. We will collect information recorded by doctors and pharmacists in GP practice computer systems. We want to find out if medicines are being used safely, and other things like the number of medicines being given to patients. We will also look for any other changes in the use of health services (for example, hospital admissions).

3. We will interview patients, doctors and pharmacists about their views and experiences of medication reviews. We will ask some doctors and pharmacists about their experience of using the Bristol toolkit. A survey will be sent to some patients to find out about their experiences of their medication review. We will also audio-record some medication reviews, survey GP practices, and collect information from their computer systems, to find out how practices do medicine reviews, with and without the toolkit.

The results will help us find the best way to carry out medication reviews in the future. This will help ensure medicines are used in a safe and effective way. It will also make sure patients are fully involved in discussions about their medicines. If the toolkit is found to be helpful and easy to use, it will be simple to make it available to all GP practices. We will share our findings with doctors, pharmacists, NHS managers and policymakers (who decide what health services are provided), and with other researchers. Patients and members of the public have helped with the design of the research and with the toolkit we are testing. They will also help carry out the research and share our findings in ways that everyone can understand.

Who is leading the research?

Dr Deborah McCahon, Research Fellow, University of Bristol and Professor Rupert Payne, Professor of Primary Care and Clinical Pharmacology, University of Exeter.

Further information:

For more information or to get involved with this project, please contact bnssg.research@nhs.net