Implementation of medication use review in community pharmacies in Latvia

The problem of polypharmacy increases globally and also in Latvia - the number of patients simultaneously using five and more medications grows, contributing to increasing number of problems regarding use of medicines. Medication use review (MUR) is a service offered by pharmacies in a number of different countries. This service involves a pharmacist-patient consultation to improve patients’ knowledge and promote rational use of medicines. A pilot study (2019-2020) in five pharmacies was organized in Latvia – pharmacists underwent a training programme based on methodology by University of Tartu; patients with polypharmacotherapy (five and more medicines) were recruited by General practitioners (GPs) and pharmacists to three subsequent consultations.  Aim of the study was to identify necessity, reAdīness and obstacles of MUR implementation in Latvia. The focus group was organized (December 2020) to explore opinions of the pharmacists participating in the pilot study regarding implementation of the study and its results, as well as views regarding introduction of MUR in Latvia – potential gains, obstacles and preconditions. The semi-structured interview was recorded, subsequently transcribed verbatim and answers were coded according to the guidelines of qualitative data processing methodology. The pilot study results were evaluated positively by pharmacists – knowledge of patients and medication adherence improved; communication skills, knowledge and confidence of the pharmacists increased after the pilot study. The main obstacles were lack of time and space for consultations, lack of interest of the GPs, patients’ lack of information about the project, insufficient number of appropriately trained pharmacists. Successful implementation of MUR in Latvia has a potential to contribute to enhanced role and prestige of a pharmacist in health care, time savings of physicians, as well as to better outcomes in patients’ health, as the result of more rational use of medicines.