Evidence map›Paper›PMID 41033757›Full record

ArticleBMJ open2025

Understanding structured medication reviews delivered by clinical pharmacists in primary care in England: a national cross-sectional survey.

Adaku J Agwunobi, Anna E Seeley, Katherine L Tucker, Paul A Bateman, Christopher Elles Clark, Andrew Clegg, Gary Ford, Seema Gadhia, F D Richard Hobbs, Kamlesh Khunti and 12 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Article
  2. 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
  3. 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
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

22 authors.

Adaku J AgwunobiNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Anna E SeeleyNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Katherine L TuckerNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0001-6544-8066
Paul A BatemanNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Christopher Elles ClarkExeter Collaboration for Academic Primary Care, University of Exeter Medical School, Exeter, UK.ORCID http://orcid.org/0000-0002-7526-3038
Andrew CleggUniversity of Leeds School of Medicine, Leeds, West Yorkshire, UK.ORCID http://orcid.org/0000-0001-5972-1097
Gary FordRadcliffe Department of Medicine, University of Oxford, Oxford, UK.
Seema GadhiaOxford and Thames Valley, Health Innovation Network, Oxford, London, UK.
F D Richard HobbsNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Kamlesh KhuntiUniversity of Leicester Diabetes Research Centre, Leicester, UK.
Gregory Y H LipLiverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK.
Simon de LusignanNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0001-5613-6810
Jonathan MantUniversity of Cambridge Primary Care Unit, Cambridge, UK.ORCID http://orcid.org/0000-0002-9531-0268
Deborah McCahonPopulation Health Sciences, Bristol Medical School, Bristol, UK.
Rupert A PayneExeter Collaboration for Academic Primary Care, University of Exeter Medical School, Exeter, UK.
Rafael PereraNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0003-2418-2091
Samuel SeiduUniversity of Leicester, Leicester, UK.
James P SheppardNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0002-4461-8756
Marney WilliamsNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Cynthia Wright-DrakesmithNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Richard J McManusNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Rebecca K BarnesNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK rebecca.barnes@phc.ox.ac.uk.ORCID http://orcid.org/0000-0001-8844-7496

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis study explored how Structured Medication Reviews (SMRs) are being undertaken and the challenges to their successful implementation and sustainability.

designA cross-sectional mixed methods online survey.

settingPrimary care in England.

participants120 clinical pharmacists with experience in conducting SMRs in primary care.

resultsSurvey responses were received from clinical pharmacists working in 15 different regions. The majority were independent prescribers (62%, n=74), and most were employed by Primary Care Networks (65%, n=78), delivering SMRs for one or more general practices. 61% (n=73) had completed, or were currently enrolled in, the approved training pathway. Patient selection was largely driven by the primary care contract specification: care home residents, patients with polypharmacy, patients on medicines commonly associated with medication errors, patients with severe frailty and/or patients using potentially addictive pain management medication. Only 26% (n=36) of respondents reported providing patients with information in advance. The majority of SMRs were undertaken remotely by telephone and were 21-30 min in length. Much variation was reported in approaches to conducting SMRs, with SMRs in care homes being deemed the most challenging due to additional complexities involved. Challenges included not having sufficient time to prepare adequately, address complex polypharmacy and complete follow-up work generated by SMRs, issues relating to organisational support, competing national priorities and lack of 'buy-in' from some patients and General Practitioners.

conclusionsThese results offer insights into the role being played by the clinical pharmacy workforce in a new country-wide initiative to improve the quality and safety of care for patients taking multiple medicines. Better patient preparation and trust, alongside continuing professional development, more support and oversight for clinical pharmacists conducting SMRs, could lead to more efficient medication reviews. However, a formal evaluation of the potential of SMRs to optimise safe medicines use for patients in England is now warranted.

Indexed as

Medication Therapy ManagementPharmacistsPrimary Health CareAdultCross-Sectional StudiesEnglandFemaleHumansMaleMiddle AgedPolypharmacySurveys and QuestionnairesMedication ReviewPharmacistsPolypharmacyPrimary Health CareSurveys and Questionnaires

Identifiers

PMID41033757
PMCPMC12496104

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.