3. Medicines Related Consultation Framework (MRCF)

What is the purpose of the Medicines Related Consultation Framework (MRCF)?

• To effectively communicate with patients

• To demonstrate skills & behaviours of healthcare professionals

• To efficiently structure the conversation

• To discuss & make appropriate decisions with the patient

• All within a set time!

What is the Medicines Related Consultation Framework (MRCF)?

• Designed by professionals, experts, & academics

• Defined by the RPS as:

  • "A reflective tool to support the development of consultation skills for pharmacy practitioners"

What are the 5 sections of the Medicines Related Consultation Framework (MRCF)?

1. Introduction

2. Data collection & problem identification

3. Actions & solutions

4. Closing

5. Consultation behaviours

What does the intro consist of?

What does data collection & problem identification consist of in the MRCF?

• Full medication history & patient’s understanding of prescribed drugs

• Social history, including occupation & lifestyle factors

• Adherence check: missed doses & reasons for non-adherence

• Identifying & prioritising the patient’s pharmaceutical problems (e.g., side effects, interactions, effectiveness)

What does Section 3: Actions and Solutions involve in the MRCF?

• Considering the patient's beliefs about medication & how it affects treatment choice

• Involving the patient in the decision-making process

• Providing medication advice: why it’s important for adherence (e.g., timing, course length)

• Checking the patient’s ability to follow the plan & any potential issues (e.g., lifestyle conflicts)

• Ensuring patient understanding & satisfaction with the treatment plan

• Possible referrals if needed (e.g., to another healthcare professional)

What does Section 4: Closing involve in the MRCF?

• Safety netting: Ensure patient knows what to do if medication doesn’t work within the expected timeframe (e.g., follow-up appointment, GP consultation, A&E visit).

• Explain what to do if the patient faces difficulties and whom to contact.

• Provide a clear timeframe for follow-up.

• Offer an opportunity for the patient to ask further questions.

• Manage patient expectations about next steps and when to follow up.

What does Section 5: Consultation Behaviours involve in the MRCF?

• Skills needed: Active listening, using open/closed questions, empathy, and clear communication.

• Golden Minute: Give the patient a chance to express everything they need to say at the beginning.

• Empathy: Show support through tone, body language, and patient-friendly language.

• Respect: Avoid judgment or patronizing behaviour.

• Structured approach: Organise the consultation logically, summarise at appropriate points.

• Time management: Stick to the time limit (15-20 minutes), and keep the conversation on track.

• Documentation: Capture patient info accurately for effective follow-up.

How is the MRCF used in practice?

• Outpatient clinics: For consultations and treatment planning.

• New Medicines Service (NMS): Educating patients on new medications.

• Discharge Medication Review (DMR): Reviewing discharge meds and adherence.

• Emergency hormonal contraception: Assessing eligibility and safety.

• Specialist pharmacist-led clinics: For conditions like anticoagulation, asthma, diabetes.

• Independent prescribing: Guiding consultations and prescriptions.

How can we develop our consultation skills?