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Ashford Clinical Commissioning Group Joint Working Case Study

Improving asthma outcomes in Ashford Clinical Commissioning Group via a Medicines Use Review

A Joint Working Case Study between Ashford CCG and Teva UK Limited

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This is an example of how Ashford Clinical Commissioning Group (CCG) worked on a local joint working project with Teva UK Limited to deliver an MUR support programme, which included inhaler technique training, Medicine Use Review (MUR) training and other support services.

Project Rationale

Long-term conditions, including respiratory illness and asthma, featured in Ashford CCG’s 2013-14 plans and priorities.

Medicines Use Reviews (MURs) provide pharmacists with the opportunity to influence patients’ knowledge and adherence to treatment.

The joint working project was envisaged to help support and train surgery healthcare professionals (HCPs) and community pharmacists on inhaler technique to a consistently high standard.

Desired Outcomes

The objectives of this joint working project were:

  1. Improve the education and experience of asthma patients as measured by a patient questionnaire
  2. Train surgery HCPs and community pharmacists on inhaler technique to a consistently high standard as measured by them completing accredited training
  3. Improve the volume, quality and delivery of asthma MURs as measured by pharmacy and patient questionnaires
  4. Improve liaison between practices and pharmacy as measured by collective stakeholder feedback

Joint Working Project with Teva UK Limited

In order to achieve these outcomes, Ashford CCG worked in collaboration with Teva UK Limited as they provided:

  • Project management and support of communication between pharmacy and practices
  • Experience of delivering medicine use reviews through sponsoring the provision of National Service for Health Improvement (NSHI) to deliver an MUR support programme
  • Teva UK Limited co-ordinated the project and provided a source of contact for all stakeholders involved
  • Both Ashford CCG and Teva UK Limited abided by the relevant regulatory bodies and guidance, including the ABPI Code of Practice.

Methodology and approach agreed


Outcomes achieved

Following the initial mailing to patients, the response to the MUR invitation was an attendance rate of 5% (24 patients).

With agreement from the practice and pharmacies taking part in the project it was agreed that an additional mailing would take place with the objective of increasing attendance. The final attendance was 6% (33 patients).


At the time of MUR, the pharmacist identified the following:

  • 21/33 (64%) patients had issues highlighted that required attention
    • 15/21 (71%) had poor asthma control
    • 10/21 (48%) were not using their medication as prescribed
    • 5/21 (24%) were overusing their B2 agonist
    • 16/21 (76%) had poor inhaler technique
    • 9/21 (43%) had asthma that effected their daily living


  • 18 (54%) patients seen by the pharmacist were advised to book an appointment with their Practice Nurse for a further review, as a result of issues associated with poor asthma control identified at the time of their MUR (of these, 10 patients attended a further review).


MUR Patient feedback

  • All 33 Patients (100%) completed a questionnaire, evaluating the MUR experience immediately after their review.
  • Results were very encouraging and showed that:
    • 67% of patients felt that they knew more about their asthma and their medicines
    • 79% of patients felt that as a result of attending the MUR they had a better understanding of how to use their medicines
    • 76% felt more confident in using their inhalers correctly
  • 21 patients (64%) noted that they would do something differently as a result of their MUR. Changing how they would use their inhalers was a frequent response.

Benefits of Joint Working with Teva UK Limited

This project demonstrated a successful collaborative approach to address a significant issue facing the local health economy. A consideration for future projects will be to ensure greater engagement with pharmacists to improve both patient recruitment and project outcomes.

Joint working between Teva UK Limited and the NHS must be for the benefit of patients or the NHS and preserve patient care1


1. Department of Health. Best practice guidance for joint working between the NHS and the pharmaceutical industry, 1 February 2008