title: Post discharge medicines use review service for older patients: recruitment issues in a feasibility study.
abstract: BACKGROUND
  The community pharmacy medicines use review (MUR) service in England has been identified as a way of providing support with medication to recently discharged patients; however initial uptake of post-discharge MUR has been low.
  
  
  OBJECTIVE
  To identify barriers to recruitment into a randomised controlled feasibility study of a hospital referral system to older patients' regular community pharmacists.
  
  
  METHODS
  Ward pharmacists at Southport District General Hospital identified patients aged over 65 to be approached by a researcher to assess eligibility and discuss involvement in the trial. Participants were randomised to referral for a post discharge MUR with their regular community pharmacist, or to standard discharge care. Reasons for patients not participating were collected.
  
  
  RESULTS
  Over a 9-month period 337 potential participants were identified by ward pharmacists. Of these, 132 were eligible and 60 were recruited. Barriers to recruitment included competing priorities among ward pharmacists, and national restrictions placed on MURs e.g. housebound patients and those requiring carer support with medication. Lack of expected benefit resulted in a high proportion of patient refusals.
  
  
  CONCLUSIONS
  The current provisions for post discharge MURs exclude many older people from participation, including those possibly in greatest need. Unfamiliarity with the role of the pharmacist in transitional care may have affected patients' perceived 'cost-benefit' of taking part in this study.
authors.affiliation: Southport and Ormskirk Hospitals NHS Trust, Southport, UK. helen.ramsbottom@nhs.net.|University of Wolverhampton, Wolverhampton, UK. helen.ramsbottom@nhs.net.
authors.forename: Helen Frances
authors.initials: HF
authors.lastname: Ramsbottom
authors.affiliation: Keele University, Keele, UK.
authors.forename: Ray
authors.initials: R
authors.lastname: Fitzpatrick
authors.affiliation: University of Central Lancashire, Preston, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Rutter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003157:Community Pharmacy Services; D004739:England / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D059065:Medication Reconciliation / Q000379:methods*; D010351:Patient Discharge; D018579:Patient Selection; D010595:Pharmacists; D024382:Professional Role; D012017:Referral and Consultation
keywords: Hospital discharge; Medication review; Older people; Pharmacist; Recruitment; Study challenges