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NMS should be permanent, evaluation recommends

A long- awaited study by the University of Nottingham has found the new medicine service "significantly" improves patient adherence to their medicines and saves the NHS money

The new medicine service (NMS) should be commissioned permanently because it "significantly" improves adherence and saves NHS money, researchers have said.  

A long-running independent evaluation of the service by the University of Nottingham, published today (August 14), found that patients were overall 10 per cent more likely to continue taking their medicine if they received NMS consultations. However, it found significant variation in this effectiveness between types of pharmacies.  

The study, which gathered data from 504 patients who received the service across 46 pharmacies, found that 70 per cent of patients who used the NMS had adhered to their medicines 10 weeks after they were prescribed, compared with 60 per cent of those who received standard NHS care.


By measuring the amount of contact patients had with any part of the NHS, the researchers concluded that the reduced contact NMS patients required with GPs and hospitals resulted in savings of £21 per person, even after factoring in the cost of delivering the NMS consultations.


As part of the evaluation, which took place across the East Midlands, South Yorkshire and London between January 2012 and February 2014, the researchers found patients were "positive and supportive" of the service. NMS was seen as a way for patients to enhance their relationship with a community pharmacist and explore other health issues, the researchers said. 


Pharmacists were also generally supportive and saw the service as an opportunity to educate patients and identify potential health risks associated with their medicines, the researchers said.


The researchers found that the setting of the service could influence its effectiveness, with patients who received the NMS in a small multiple almost twice as likely to be adherent as those in an independent. However, the data for larger multiples and supermarkets was "inconclusive", they said.


Patients were also more likely to be adherent if their NMS intervention was conducted in a pharmacy co-located with a GP, the researchers said.




Watch: Annabelle Collins and Sam Horti discuss the findings of the University of Nottingham's NMS survey


Recommendations

The evaluation's authors concluded that the service needed to be integrated into local primary care systems for it to develop further. This would involve creating a "triangular relationship" between patients, GPs and pharmacists that focused on optimising patients' medicines use, they said.


Granting pharmacists access to patient records would also help them to identify patients who would benefit from the service, the authors said. 


The researchers recommended expanding the service – which is currently only available to patients with asthma, COPD, type 2 diabetes, hypertension or on anticoagulants - to include other medicines, such as those prescribed to mental health patients. Further work was also needed to establish whether the NMS was effective for specific patient groups, such as the home-bound, non-native English speakers and those in remote areas, they added.


The service has already been extended temporarily four times due to delays in the evaluation, which was originally due to be published last summer. PSNC has said that the long-term future of the service will be announced when the delayed funding settlement for 2012-13 and beyond has been agreed.


PSNC chief executive Sue Sharpe said the evaluation was an "excellent result" that would inform these ongoing funding negotiations with the NHS. "Given the results, we are of course optimistic about the future development of the service," Ms Sharpe said.


Last week, C+D revealed readers were divided about the value of the service.


Click here to read the report in full.



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