Pharmacist-led new medicine service: a real-world cohort study in the Netherlands on drug-related problems, satisfaction, and self-efficacy in cardiovascular patients transitioning to primary care
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Background
Patients transitioning from hospital to home while starting long-term cardiovascular medicines are likely to experience drug-related problems (DRPs). The New Medicine Service (NMS) may support readmission to primary care.
Aim
To evaluate NMS in a real world setting, for patients transitioning from hospital to primary care with newly prescribed cardiovascular medicines on identifying DRPs, patient satisfaction with medication information and patient self-efficacy. Secondary objectives were identifying risk factors for DRPs and assessing first-fill discontinuation.
Method
A cohort study in an outpatient pharmacy and 14 community pharmacies in Almere, the Netherlands, involved patients ≥ 18 years receiving new cardiovascular prescriptions. Usual pharmacy care was complemented with a telephone counselling two weeks post-dispensing to identify and address DRPs. Patient satisfaction and self-efficacy were assessed during a follow-up call. First-fill discontinuation was measured using dispensing data, and logistic regression identified risk factors for DRPs.
Results
Of 1647 eligible patients, 743 received NMS; 72.5% experienced ≥ 1 DRP. NMS improved patients’ satisfaction with information and self-efficacy ( p < 0.001). Outpatient visits (adj. OR 0.64), cardiovascular medicine use (adj. OR 0.65), and use of chronic medicines (adj. OR 1.71) influenced DRPs. First-fill discontinuation remained unchanged post-NMS, but patients with DRPs discontinued more often (14.8% vs. 8.6%, p = 0.030).
Conclusion
Implementing the NMS in a real-world transitional care setting allowed pharmacists to identify DRPs and provide counselling tailored to patient needs. Patients reported higher satisfaction with information and increased self-efficacy. Priority should be given to at-risk patients for DRPs, and deploy other pharmacy staff to perform the NMS.
