So what is a SMR?

10 October 2023

You may have heard the term bandied around, but never understood what it meant.  Here we can answer some of the most common questions regarding SMRs.


What does SMR actually stand for?

SMR is an acronym standing for Structured Medication Review.


So what is a Structured Medication Review?

As the name suggests it is where a clinician spends time investigating and reconciling all medications that prescribed to a patient.  This allows them to ensure that there medicines remain safe, medically effective, and cost effective.


Who carries out SMRs?

Both the PCN Clinical Pharmacists and PCN Pharmacy Technicians are able to carry out SMRs depending on their complexity.  All of our staff are either on, or have completed the CPPE Training Pathway, and are therefore able to carry these out depending on their level of experience.


How do we decide which patients should be prioritised for an SMR?

Part of the funding for a PCN comes via the Investment and Impact Fund.  Within this clinically approved targets are set to encourage areas that should be focussed on.  The focus may then shift slightly year on year as we are guided towards specific cohorts, but examples are:

-  Patients at risk of harm due to medication errors/high risk medications

-  Patients living with severe frailty 

-  Patients using potentially addictive medicines

-  Permanent care home residents aged 18 years and above


How long does a SMR take?

Each case is different depending on the complexity and capacity of the patient, as well as the number of medications and co-morbidities, not to mention the experience level of the pharmacist.  Shorter and simpler SMRs can take around 30 minutes, while more complex ones may take up to an hour.  This includes preparation time, talking to the patient, making any necessary amendments, and a follow up if required.


Where are SMRs conducted?

They can be carried out face to face, over the phone, or by video call.  It is up to the pharmacist and patient to decide what suits them best.  


Can I request an SMR?

If you fall into one of the targeted cohorts, you will be contacted automatically in due course.  However, if you are on multiple medications and feel like you may benefit from a review, you can contact your surgery and request one.

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