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NMS should include antidepressants, say Devon pharmacists after pilot success

Introducing antidepressants into the NMS could help address patient concerns, says Boots pharmacy manager Tom Kallis

Seven HLPs delivered ' fantastic' NMS-style service to patients recently diagnosed with depression and say national service expansion 'makes sense'


The new medicines service (NMS) should be expanded to include antidepressants, pharmacists have said following the success of a Plymouth mental health pilot.

The pilot, organised by Devon LPC, involved seven healthy living pharmacies (HLPs) delivering an "NMS-style" service to patients who had been recently diagnosed with depression. Patients were each offered two consultations each, at which pharmacists provided advice on minimising side effects and reassured them about how their medicine worked, the LPC said.

Tom Kallis, manager at a Boots pharmacy in Plymouth that delivered the pilot, said the information given by pharmacists was of "great benefit" to patients and introducing antidepressants into the NMS "make sense".

The "fantastic" service, which ran in May and June, had helped patients cope with the stigma associated with antidepressants, he told C+D.

Of the 30 patients who took part in the pilot a third initially experienced side effects from their medication. One in six were uncertain whether their medicine was working the pilot revealed. The service gave pharmacists an opportunity to address these concerns, said Mr Kallis. 

"It's [about] explaining how the medicines work, and saying [the effects are] completely normal. You may feel worse in the first week; you may feel that there's no effect, but it's really important to persevere and you will reap the benefits," he added.

Graham Parsons, Devon LPC's development pharmacist for HLPs in Plymouth and organiser of the pilot, said he hoped the scheme would show that delivering the NMS to patients diagnosed with depression was a "viable option".

"I don't think there's any reason why it can't be delivered. People can disengage [with their medication regime] at the start because of adverse affects and they need that extra support," he told C+D.

If pharmacists were to deliver the service nationally they would need extra training, Mr Parsons stressed, especially when talking to patients contemplating suicide.

To deliver the service, pharmacists were required to finish a one-hour training course on managing depression and attend a mental health training event in April. Of the 30 patients who took part in an initial conversation, 19 returned for a second consultation and Mr Parsons said he was pleased with the low dropout rate.

Mr Parsons plans to publish an evaluation of the pilot to determine whether there are any barriers to pharmacists delivering the service nationally.

Last month, an evaluation of the NMS recommended that the service be extended to cover more drugs, including mental health medication.

Do you think the NMS should be expanded to cover patients with depression? 

We want to hear your views, but please express them in the spirit of a constructive, professional debate. For more information about what this means, please click here to see our community principles and information

Andrew Low, Community pharmacist

It's a good idea if pharmacists had the time to counsel patients on antidepressants on their medication.
A few words could go a long way.
I was on sertraline recently and it made me feel very sleepy and disturbed my sleep.I had to go off on sick leave.
My GP told me about the side-effects and said that "sertraline was probably the least of these devils".From pharmacy training I did know about side-effects like drowsiness but the force of them took me by surprise.
One thing I do recommend is Sahaja Yoga,which is a form of meditation.It is free and you can go to local meetings and look it up on the Internet.

N O, Pharmaceutical Adviser

How about treating NMS on par with MUR structure? 50:50 targeted and non-targeted !! This way you don't impose any restrictions on the drugs to choose, which allows the pharmacist an ability to decide if a NMS is necessary or not.


Numerous time I have approached patients with regards to NMS and ben told that its being monitored by the GP.

I rather scrap the scheme and put the funding back into dispensing eg : weekly scripts for blister pack patients or other services like flu jabs.

Worringly surgeries are beginning to dispense script in 2 monthly cycles - recently locumed for a Pharmacy where scripts numbers down 25% due to this alone.......

Nick Hunter, Community pharmacist

Disagree with you, Mesut on scraping NMS and putting money back in to dispensing - this is a backward step for the profession. We must move to a fee structure that properly rewards holistically caring for patients.

If changes to period of treatment is impacting on number of items for a pharmacy contractor they need to make a claim under the Drug Tariff - see Part XIVC - Devolving the Global Sum - Temporary Safeguarding Payments (claim 2). It works - I have recommended to several of my contractors and they have benefited.


Silly Man.....over 90% of the income of pharmacy comes through dispensing.. You are shooting yourself in the foot by demeaning the dispensing process......

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