title: Randomised evaluation of the Italian medicines use review provided by community pharmacists using asthma as a model (RE I-MUR).
abstract: BACKGROUND
  The Italian Ministry of Health decided to introduce community professional services in 2010. This trial provides an opportunity to evaluate the outcomes of a new professional pharmacy service: Italian Medicines Use Review (I-MUR) aimed at reducing the severity of asthma and its associated costs.
  
  
  METHODS
  This is a cluster randomised controlled trial of the I-MUR service. Data will be collected over time before, during and after pharmacists' intervention. Fifteen Italian regions will be involved and it is aimed to recruit 360 community pharmacists and 1800 patients. Each pharmacist will receive training in medicines use review, recruit five patients, administer the Asthma Control Test and provide the I-MUR service. Pharmacists will be allocated to different groups, one group will be trained in and provide the I-MUR service immediately after completion of the baseline ACT score, the other group will receive training in the I-MUR and provide this service three months later. Group allocation will be random, after stratification by region of Italy. The I-MUR service will involve gathering data following each patient consultation including demographic details, patients regular medications, including those used for asthma, their attitude towards their medications and self-reported adherence to treatments. In addition, pharmacists will identify and record pharmaceutical care issues and any advice given to patients during the I-MUR, or recommendations given to doctors. Pharmacists will upload trial data onto a web platform for analysis. The primary outcome measure is the severity of asthma before, during and after the I-MUR assessed using the Asthma Control Test score. Secondary measures: number of all active ingredients used by patients during and after the I-MUR, number of pharmaceutical care issues identified during the I-MUR, patients' self-reported adherence to asthma medication during and after the I-MUR, healthcare costs based on the severity of asthma, before, during and after the I-MUR service provision.
  
  
  CONCLUSIONS
  This study has been developed because of the need for a new way of working for pharmacists and pharmacies; it is the first trial of any community pharmacy-based pharmaceutical care intervention in Italy. The results will inform future policy and practice in Italian community pharmacy.
  
  
  BACKGROUND
  ISRCTN72438848 .
authors.affiliation: Medway School of Pharmacy, University of Kent and Greenwich, Central Avenue Chatham Maritime, Chatham, ME4 4TB, Kent, UK. a.manfrin@kent.ac.uk.
authors.forename: Andrea
authors.initials: A
authors.lastname: Manfrin
authors.affiliation: Medway School of Pharmacy, University of Kent and Greenwich, Central Avenue Chatham Maritime, Chatham, ME4 4TB, Kent, UK. t.thomas@kent.ac.uk.
authors.forename: Trudy
authors.initials: T
authors.lastname: Thomas
authors.affiliation: Medway School of Pharmacy, University of Kent and Greenwich, Central Avenue Chatham Maritime, Chatham, ME4 4TB, Kent, UK. J.Krska@kent.ac.uk.
authors.forename: Janet
authors.initials: J
authors.lastname: Krska
mesh_terms: D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D016000:Cluster Analysis; D003157:Community Pharmacy Services / Q000592:standards; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007558:Italy; D007802:Language; D008297:Male; D008875:Middle Aged; D010595:Pharmacists / Q000191:economics; D012017:Referral and Consultation / Q000191:economics
chemical_list: D018927:Anti-Asthmatic Agents