Optimising StruCtured medicAtion Reviews (OSCAR): A mixed methods process evaluation with integrated real-time observational cohort study
OSCAR is a National Applied Research Collaboration (ARC) project funded by the National Institute for Health Research (NIHR), and sponsored by the University of Oxford.
Aims
The OSCAR study aims to understand how Structured Medication Reviews for patients with multiple long-term conditions are being conducted in England, what the challenges are, and how to best optimise them in the future.
What is a structured medication review?
A Structured Medication Review (SMR) is an appointment where a pharmacist (or other primary health care professional) goes through all of the medicines a patient is taking to ensure they are working safely and effectively for them. SMRs are primarily for people with several different medical conditions (multimorbidity); people taking many different medicines (polypharmacy); people living with frailty; and people in care homes. These reviews can either happen face-to-face or remotely.
Why is this study important?
SMRs aim to reduce medicines-related harm and while they seem sensible, little is known about how they are conducted and what they achieve.
Methods
We will gather information from surveys of pharmacists conducting SMRs across England, and observe what actually happens in a sample of these reviews with a diverse group of patients from different GP surgeries. We will invite some of the people whose reviews we have observed, as well as the pharmacists conducting them and relevant managers, to a research interview where we will ask them to tell us about their experiences.
In addition to this, de-identified routinely-collected data about past SMRs will be collected from a national primary care database called Oxford Royal College of GPs Clinical Informatics Digital Hub (ORCHID). This information will include the characteristics of patients who have had a structured medication review, and any adjustments made to their medicines as a result of that review (e.g. whether any medicines were stopped or changed).
How this could benefit patients
This research will generate new knowledge about how SMRs are conducted and experienced by pharmacists and patients, and what happens as a consequence of these reviews. We will feedback our findings to primary care networks to help improve equity, quality and effectiveness.
Help us with our research
Observations and interviews
We are currently recruiting:
- Pharmacists conducting SMRs to take part in observations and/or research interviews;
- Patients aged 65 or over, living with two or more different medical conditions and taking one or more medicine, who have been invited to a SMR, to take part in observations and/or research interviews;
- Medicines Optimisation leads to take part in research interviews.
See our information leaflets below to find out more, and if you are interested in taking part or have further questions, please get in touch with our study team: oscarstudy@phc.ox.ac.uk
If you are a pharmacist please click here
If you are a patient please click here
If you are a leader/manager please click here
This study has been reviewed and given a favourable opinion by South Central - Hampshire A Research Ethics Committee (22/SC/0373).