Evidence map›Paper›PMID 35760564›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2022

Early implementation of the structured medication review in England: a qualitative study.

Mary Madden, Thomas Mills, Karl Atkin, Duncan Stewart, Jim McCambridge

Abstract read
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In one paragraph

Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Patients' experiences of a patient-centred polypharmacy medication review intervention: a mixed-methods study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
    Trial
  5. Trial
  6. Structured medication reviews: prescribing change is not the same as medicines optimisation.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
    Article
  7. Impact of structured medication reviews on prescribing in English primary care: a retrospective observational cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
    Observational
  8. Exploring the implementation and integration of structured medication reviews in primary care: a qualitative evaluation using normalisation process theory.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
    Article
  9. Article
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  11. Review
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  16. Structured medication reviews: progress since 2020 and opportunities for improvement.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Mary MaddenDepartment of Health Sciences, University of York, York.
Thomas MillsPHIRST London, London South Bank University, London.
Karl AtkinDepartment of Sociology, University of York, York.
Duncan StewartCentre for Primary Health and Social Care, School of Social Professions, London Metropolitan University, London.
Jim McCambridgeDepartment of Health Sciences, University of York, York.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNHS England has introduced a new structured medication review (SMR) service within primary care networks (PCNs) forming during the COVID-19 pandemic. Policy drivers are addressing problematic polypharmacy, reducing avoidable hospitalisations, and delivering better value from medicines spending. This study explores early implementation of the SMR from the perspective of the primary care clinical pharmacist workforce.

aimTo identify factors affecting the early implementation of the SMR service. DESIGN AND

settingQualitative interview study in general practice between September 2020 and June 2021.

methodTwo semi-structured interviews were carried out with each of 10 newly appointed pharmacists (20 in total) in 10 PCNs in Northern England; and one interview was carried out with 10 pharmacists already established in GP practices in 10 other PCNs across England. Audiorecordings were transcribed verbatim and a modified framework method supported a constructionist thematic analysis.

resultsSMRs were not yet a PCN priority and SMR implementation was largely delegated to individual pharmacists; those already in general practice appearing to be more ready for implementation. New pharmacists were on the primary care education pathway and drew on pre-existing practice frames, habits, and heuristics. Those lacking patient-facing expertise sought template-driven, institution-centred practice. Consequently, SMR practices reverted to prior medication review practices, compromising the distinct purposes of the new service.

conclusionEarly SMR implementation did not match the vision for patients presented in policy of an invited, holistic, shared decision-making opportunity offered by well-trained pharmacists. There is an important opportunity cost of SMR implementation without prior adequate skills development, testing, and refining.

Indexed as

consultation standardsCOVID-19implementationmedication reviewpolypharmacyprimary health care

Identifiers

PMID35760564
PMCPMC9242674

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.