I did an interesting MUR the other day on a gentleman who takes blood pressure tablets and uses inhalers for asthma.
 
During the MUR it became apparent to me that he was in denial regarding his medication and really wished to be free of all of it. He had started jogging to improve his health and lose weight - which is admirable and I applauded this; but as he was now feeling fitter, he decided that he would stop his steroid inhaler and only use his blue inhaler when necessary. As he told me this I could hear his chest wheezing...
 
I explained the importance of regular steroid inhaler use to alleviate, and treat, his condition - and we discussed the idea of stepping down (and up) as conditions change; but in a sensible way - preferably with GP approval. He told me that the GP had previously given him similar advice - which he had ignored; but agreed to use the inhaler as prescribed in future after our discussions. 
 
It's easy to be in denial; and in most cases probably occurs because people are ignorant of the consequences of benefit versus risk - good communication is so important.
 
Once a patient understands about the medication, patients are so much more compliant - and MURs are a great tool to get this information across and reinforce good messages!

I did a really interesting MUR on a patient the other day - it was an intervention MUR.
 
A lady called into the pharmacy stating that she had virtually no diazepam left - our computer records showed that she should have some and this triggered the MUR!
 
During the consultation, I was alerted to a huge problem - that she had stopped all her blood pressure medication (lisinopril & amlodipine) and her other heart medicine three weeks ago...
 
Why...?
 
Well, because she had been to the surgery; and the GP had told her that her bloods were a bit low...and he would have to give her a course of injections to bring it up again. Later on, she reflected on what the doctor had said and being confused, assumed her blood pressure was dangerously low and stopped her tablets - whereas the GP was talking about B12 injections for anaemia!
 
I urgently spoke to the surgery, and she has started her tablets again and will be seen soon by the doctor...
 
It just goes to show the importance of good communication during consultations...