The overall aim of the MUR service is to improve patients' knowledge of their medication via concordant consultations that result in more effective use of medicines. In the context of discharge MURs, the aims of the MUR service may be outlined as follows:

• Establishing patients' actual use of medicines, including their understanding and experience of the medicine
• Identifying, discussing in a concordant manner and working towards medicines solutions in situations where there is deemed to be poor or ineffective use of medicines
• Identifying medication sideeffects and potential interactions
• Improving the cost-effective use of medicines with a view to reducing waste.

The MUR is not a clinical medication review. Community pharmacists do not have access to medical notes, they have limited information on diagnosis and condition management (including rationale for choice of medicines and any tests done and their results), and may have difficulty influencing, instigating and following up changes in medication. These are issues that would be covered in a clinical medication review rather than an MUR.