title: Supporting underserved patients with their medicines: a study protocol for a patient/professional coproduced education intervention for community pharmacy staff to improve the provision and delivery of Medicine Use Reviews (MURs).
abstract: Community pharmacy increasingly features in global strategies to modernise the delivery of primary healthcare. Medicine Use Reviews (MURs) form part of the English Government's medicines management strategy to improve adherence and reduce medicine waste. MURs provide space for patient-pharmacist dialogue to discuss the well-known problems patients experience with medicine taking. However, 'underserved' communities (eg, black and minority ethnic communities, people with mental illness), who may benefit the most, may not receive this support. This study aims to develop, implement and evaluate an e-learning education intervention which is coproduced between patients from underserved communities and pharmacy teams to improve MUR provision.
  
  
  
  This mixed-methods evaluative study will involve a 2-stage design. Stage 1 involves coproduction of an e-learning resource through mixed patient-professional development (n=2) and review (n=2) workshops, alongside informative semistructured interviews with patients (n=10) and pharmacy staff (n=10). Stage 2 involves the implementation and evaluation of the intervention with community pharmacy staff within all community pharmacies within the Nottinghamshire geographical area (n=237). Online questionnaires will be completed at baseline and postintervention (3 months) to assess changes in engagement with underserved communities and changes in self-reported attitudes and behaviour. To triangulate findings, 10 pharmacies will record at baseline and postintervention, details of actual numbers of MURs performed and the proportion that are from underserved communities. Descriptive and inferential statistics will be used to analyse the data. The evaluation will also include a thematic analysis of one-to-one interviews with pharmacy teams to explore the impact on clinical practice (n=20). Interviews with patients belonging to underserved communities, and who received an MUR, will also be conducted (n=20).
  
  
  
  The study has received ethical approval from the NHS Research Ethics Committee (East Midlands-Derby) and governance clearance through the NHS Health Research Authority. Following the evaluation, the educational intervention will be freely accessible online.
authors.affiliation: Faculty of Medicine and Health Sciences, School of Health Sciences, University of Nottingham, Nottingham, UK.
authors.forename: Asam
authors.initials: A
authors.lastname: Latif
authors.affiliation: Faculty of Medicine and Health Sciences, School of Health Sciences, University of Nottingham, Nottingham, UK.
authors.forename: Kristian
authors.initials: K
authors.lastname: Pollock
authors.affiliation: Division of Social Research in Medicines and Health, School of Pharmacy, University of Nottingham, Nottingham, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Anderson
authors.affiliation: Centre for Health Innovation, Leadership and Learning, University of Nottingham, Nottingham, UK.
authors.forename: Justin
authors.initials: J
authors.lastname: Waring
authors.affiliation: School of Health and Life Sciences, Leicester School of Pharmacy, De Montfort University, Leicester, UK.
authors.forename: Josie
authors.initials: J
authors.lastname: Solomon
authors.affiliation: Division of Social Research in Medicines and Health, School of Pharmacy, University of Nottingham, Nottingham, UK.
authors.forename: Li-Chia
authors.initials: LC
authors.lastname: Chen
authors.affiliation: Centre for Pharmacy Postgraduate Education (CPPE), University of Manchester, Manchester, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Anderson
authors.affiliation: NHS South East Staffordshire and Seisdon Peninsular CCG, Burton on Trent, Staffordshire Nottingham, Staffordshire, UK.
authors.forename: Sulma
authors.initials: S
authors.lastname: Gulzar
authors.affiliation: The Queen's Pharmacy Centre, Nottingham, UK.
authors.forename: Nasa
authors.initials: N
authors.lastname: Abbasi
authors.affiliation: Faculty of Medicine and Health Sciences, School of Health Sciences, University of Nottingham, Nottingham, UK.
authors.forename: Heather
authors.initials: H
authors.lastname: Wharrad
mesh_terms: D000328:Adult; D003157:Community Pharmacy Services / Q000458:organization & administration* / Q000592:standards; D017723:Drug Utilization Review / Q000458:organization & administration / Q000592:standards; D004517:Education, Professional / Q000458:organization & administration*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008297:Male; D008507:Medically Underserved Area; D055118:Medication Adherence; D008875:Middle Aged; D010353:Patient Education as Topic / Q000458:organization & administration*; D024382:Professional Role
keywords: EDUCATION & TRAINING (see Medical Education & Training); PRIMARY CARE