Pharmacists have given a mixed response to news that the service has been found to significantly increase patients’ adherence to new medicines and that it will save the NHS approximately a net amount of £20 per patient in terms of patient outcomes.
Practical considerations for community pharmacies such as workload and working environment have been recognised by the evaluation, which finds that local staffing and resource issues impact on the provision of New Medicine Service (NMS); pharmacies with higher numbers of staff are better able to manage and deliver the NMS service without placing excessive burden on staff.
Problems with supply of drugs is also mentioned in the report, leading pharmacists to question whether resolving these, rather than funding the NMS, would be a better use of NHS funds.
The research also finds that the likelihood of medicine adherence following an NMS may be almost double if the service is conducted by a small multiple compared with an independent pharmacy. “Staffing, work planning, the use of technology and scheduling affect pharmacies’ ability to deliver NMS,” conclude the researchers from Nottingham University, which was commissioned by the Department of Health to conduct the evaluation. They continued: “Small independents were most likely to report struggling with this.”
Patients were also found to be more likely to be adherent if the intervention is conducted by a pharmacy that is co-located with a general practitioner. “Co-location enabled closer working between pharmacists and GP to confirm and refer patients, possibly leading to a triangular relationship between patient, pharmacist and GP, rather than two separate bi-lateral relationships.”
Supermarket pharmacies had the lowest effectiveness, which is said to be due to “the less developed relationships with patients and a different business prioritisation”, according to researchers.
“Patients have a lot to gain from the NMS — as this study shows — and it is excellent news that 90% of pharmacies in England are now offering this service,” said Dr Maureen Baker, Chair of the Royal College of General Practice.
In total, around 25% of medicines prescribed for long-term conditions are not taken as directed, and 15% of people receiving new medicines take few, if any, doses. Harm caused by non-adherence includes poor health-related quality of life, increased hospitalisations and premature mortality. Evidence shows that problems with newly prescribed medicines appeared rapidly, and are widespread.
Responding to the researchers, who concluded that the service should be commissioned in the future, PSNC chief executive Sue Sharpe said: “We will be using the outcomes to inform our ongoing negotiations.”
More information from The New Medicine Service Evaluation: www.nottingham.ac.uk/~pazmjb/nms/