Developing Structured Medication Reviews
This is aimed at GP pharmacists (and their GP peers / mentors) who are:
Conducting structured medication reviews (SMRs)
Needing to expand their skills and knowledge to provide further patient care and increase contributions to the GP team
How do I identify what areas to develop?
What are you seeing a lot of in your SMRs? Such a high dose PPIs or Hba1cs > 63.
Which conditions are prevalent in your patient population? Such as, asthma, depression.
Are there any skill / knowledge gaps within the GP team?
What areas are ‘time-efficient’? Such as statin for primary prevention.
A suggested list of areas for development is available here.
→ Have a discussion with your GP mentor about what areas to prioritise.
I have completed my SMART objectives.
What do I do next?
→ Reflect on your levels of competency with your GP support / pharmacist mentor
Do you need any further support / training?
Look to putting in mechanisms to reflect and continually update competence using potentially:
Planned / unplanned reflective case discussions
GP / patient feedback
Plan - what do I do next?
→ With support from your GP / pharmacist mentors develop relevant SMART objectives
This may include:
Relevant reading - for example, of guidelines
Writing a clinical management plan (CMP)
Attending training / workshops
Reflecting and discussing relevant cases
Completing a training log
Action agreed SMART objectives
Example in practice
SP is new to general practice from hospital.
She has started completing SMRs but does not feel confident in using her IP qualification to make changes.
Due to COVID there are a lot of patients on antidepressants; SP and her GP prioritise their optimisation.
With support, SP completes and reflects on the following:
Reading NICE and local guidance, completing CPPE online training and shadowing mental health nurse
Completing a log of 10 patients where SP reviews and then it is discussed with GP
Develops a CMP for use in practice
SP now feels a lot more confident reviewing anti-depressants, and has successfully tapered, stopped and increased current medication.
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