Pharmacist-led New Medicines Service for cardiovascular patients transitioning to primary care: A real-world study on drug-related problems, satisfaction, and self-efficacy

Background Patients transitioning from hospital to home while starting long-term cardiovascular medicines are likely to experience drug-related problems. The New Medicine Service may support their readmission to primary care. Aim To evaluate the implementation of the NMS on drug-related problems, satisfaction with information and self-efficacy in patients who start with cardiovascular medicines. Secondary objectives included identifying risk factors for DRPs and first-fill discontinuation. Methods A living-lab study in an outpatient pharmacy and 14 community pharmacies in Almere, the Netherlands, involved patients ≥18 years receiving new cardiovascular prescriptions. Two weeks after dispensing, a telephone counseling session aimed to identify and resolve 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 the 1647 eligible patients, 743 received the NMS. Pharmacist unavailability (33.3%, n=548) led to substantial drop-out. Of all patients, 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 in use (adj. OR 0.65), and use of chronic medicines (adj. OR 1.71) influenced DRPs. First-fill discontinuation was the same post-NMS, but patients who experienced a DRP discontinued more often (14.8% vs. 8.6%, p=0.030). Conclusions Implementing the NMS in a real-world transitional care setting allowed pharmacists to identify DRPs and provide counseling 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.