Abstract
Objective: This study assessed the impact of the new medicine service (NMS) on medication use in patients starting a new medication for a long-term medical condition in the United Kingdom (UK). Methods: A cross-sectional study was conducted in community pharmacies in the West Midlands area for three months from July to September 2012. The drug therapies/agents included in the study were antihypertensive, antidiabetics, anti-asthmatics and antiplatelet/anticoagulants.Results: 20 community pharmacists completed questionnaires related to 285 patients (160 female and 125 male). On the first NMS assessment, 82 patients reported drug-related problems including adverse effects and incorrect use of medications. Of these 82 patients, 58 received pharmacists' advice and 24 did not receive any advice. At the NMS follow up 39 (67%) of the 58 patients who received pharmacists' advice reported resolution of their drug-related problems while only four (17%) of the 24 patients who did not receive pharmacists' advice reported resolution of their problems (odds ratio 10.2, 95% CI 3.0-34.2 p<0.0001). The improvement in the correct use of medications by patients reported in this study for example by improving the inhaler technique of asthmatic patients is expected to have important implications for improving the healthcare outcome of patients with long-term conditions.Conclusion: This study provides support for the NMS as an opportunity to improve detection of adverse effects and improve the incorrect use of medicines by patients. Further research is needed to address the policy implications of the NMS, including analyses of the clinical and cost-effectiveness of this service, and the sustainability of this form of pharmacist intervention in the long-term in clinical practice.
Highlights
Research suggests that approximately 50% of patients with longterm medical conditions do not take their medications as prescribed [1]
Section A of the questionnaire required the pharmacists to provide details of their first consultation with the patients including patient’s age and gender, name and dosage of the medicine used by patient, any medication-related problems reported by the patient including adverse effects and incorrect use of medicine and any subsequent action taken or advice provided by pharmacists
Examples of possible actions taken by pharmacists included referral of the patient to the doctor and submission of a yellow card to Medicines and Healthcare products Regulatory Agency (MHRA) in the case of an adverse effect reported by the patient
Summary
Research suggests that approximately 50% of patients with longterm medical conditions do not take their medications as prescribed [1]. Poor adherence to medication by patients is associated with increased morbidity and death but is associated with a significant financial impact on the health services through medicines waste [3]. In the UK, community pharmacists are encouraged to play an active role in clinical services aimed at improving patient adherence with their medications. The NMS is based on actions and advice arising from the subjective assessment of patients who have been newly prescribed a medication for a long-term condition, combined with follow-up to address any concerns or issues patients may have once they have started using the new medicine. Issues identified within the NMS may include the ineffective use of medications and detection of adverse drug reactions (ADRs) that may affect compliance to medications
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