Evidence map›Paper›PMID 41927146›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2026

Exploring the implementation and integration of structured medication reviews in primary care: a qualitative evaluation using normalisation process theory.

Claire Reidy, Anna Seeley, Katherine Tucker, Adaku Agwunobi, Paul A Bateman, Christopher Elles Clark, Andrew Paul Clegg, Gary A Ford, Seema Gadhia, William Hinton and 16 more

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Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

26 authors.

Claire ReidyNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK claire.reidy@hants.gov.uk.ORCID 0000-0002-0013-6843
Anna SeeleyNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Katherine TuckerNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0001-6544-8066
Adaku AgwunobiSaïd Business School, University of Oxford, Oxford, UK.
Paul A BatemanNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0003-0626-7809
Christopher Elles ClarkExeter Collaboration for Academic Primary Care, University of Exeter, Exeter, UK.ORCID 0000-0002-7526-3038
Andrew Paul CleggAcademic Unit for Ageing and Stroke Research, University of Leeds, Leeds, UK.ORCID 0000-0001-5972-1097
Gary A FordRadcliffe Department of Medicine, University of Oxford, Oxford, UK.
Seema GadhiaHealth Innovation Oxford and Thames Valley, Oxford, UK.ORCID 0000-0003-1311-6718
William HintonNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Fd Richard HobbsNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0001-7976-7172
Sundus JawadNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0009-0008-3997-3025
Kamlesh KhuntiDiabetes Research Centre, University of Leicester, Leicester, UK.
Gregory Yh LipLiverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK.ORCID 0000-0002-7566-1626
Simon de LusignanNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0002-8553-2641
Jonathan MantPrimary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.ORCID 0000-0002-9531-0268
Deborah McCahonCentre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0003-2768-293X
Bernardo Meza-TorresNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Rupert A PayneExeter Collaboration for Academic Primary Care, University of Exeter, Exeter, UK.ORCID 0000-0002-5842-4645
Rafael Perera-SalazarNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Samuel SeiduDiabetes Research Centre, University of Leicester, Leicester, UK.
James SheppardNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 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.ORCID 0000-0003-3638-028X
Rebecca K BarnesNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStructured medication reviews (SMRs) were introduced into primary care in England in 2020 for patients living with multiple long-term conditions (MLTC), polypharmacy, increased frailty, in care homes, or at risk of medicines-related harm. SMRs aim to optimise the therapeutic potential of medication and reduce medicine-related harms through holistic reviews.

aimTo explore the day-to-day work being undertaken with, and by, clinical pharmacists to implement, embed, and integrate SMRs into practice, and consider how to optimise SMRs. DESIGN AND

settingQualitative one-to-one interviews with clinical pharmacists undertaking SMRs and SMR service leaders/managers (SMR leads) in England between February 2023 and November 2024.

methodParticipants were recruited as part of a wider evaluation of the roll-out of SMRs in England. Interview topic guides and qualitative data analysis were informed by normalisation process theory.

resultsEighteen clinical pharmacists and five SMR leads participated. Participants reported often having to explain the purpose of SMRs and clinical pharmacists' roles to patients, partly owing to patients not being informed about SMRs. Participants valued SMRs and expressed that trust-building and tailored consultations were important for optimising medications. Integration of SMRs into routine practice varied because of high workload, inconsistent leadership support, inadequate administrative/pharmacist technician resource, and lack of training. However, participants described SMRs as valuable for identifying and addressing unmet needs and supporting holistic, person-centred care across MLTC pathways.

conclusionThe findings demonstrate the need for improved information on SMRs for patients and primary care teams, adequate and appropriate resource allocation, and enhanced support for consultation skills training to optimise medicines use.

Indexed as

Drug Utilization ReviewMedication Therapy ManagementPharmacistsPrimary Health CareEnglandHumansPolypharmacyProfessional RoleQualitative Researchclinical pharmacistsgeneral practicemedicines optimisationnormalisation process theorypolypharmacystructured medication reviews

Identifiers

PMID41927146
PMCPMC13531564

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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.