ID 32. A Snapshot of the Global Policies and Practices of Medicine Use Reviews by Community Pharmacist in the Management of Chronic Diseases: A Narrative Review.

Introduction: Significant differences exist in how community pharmacist (CP) is being utilized around the globe. Objectives: To explore various policies and practices of medicine use review (MUR) by CP in chronic diseases and, its impact and way forward for low- and middle- income countries (L&MIC). Materials and Methods: Narrative review, using key words, such as "medicine use review", medication therapy management? and "community pharmacy" in databases such as PubMed, and Scopus from 2004-2017 to include reviews, overviews, systematic reviews and meta-analyses on the policy, practice and impact of MUR. Studies on attitude or perception were excluded. Results: MUR opened an avenue of ongoing collaboration between CP and general practitioners. In terms of policies and practices, the situation in high-income countries was quite encouraging where on an average "type-II" medicine use review was widely in practice and has improved clinical, humanistic and economic outcomes in chronic disease patients. The high-income countries witnessed gradual yet cautious adoption of these services through effective policy shift. However, in L&MIC, a paucity of effective policies was noted. Nevertheless, an emergent recognition of the potential of CPs to contribute in healthcare delivery was evident. Conclusion: Promising impact of CPs involvement in the management of chronic diseases was evident in high income countries, however, the situation in L&MIC, which bear an overwhelming share of the global burden of chronic diseases, remains skimpy. Authors believe that way forward to a paradigm shift in any country must involve consensus building methods to bring relevant stakeholders on the same page. [ABSTRACT FROM AUTHOR]