Work

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

Year: 2024

Type: article

Abstract: 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.

Source: International Journal of Clinical Pharmacy

DOI: 10.1007/s11096-024-01829-4

Authors: Hendrik T. Ensing, Nelly Kurt, Ruby A. Janssen, Ellen S. Koster, Eibert R. Heerdink

Institutions: Utrecht University, University of Applied Sciences Utrecht, University Medical Center Utrecht

Language: English

Topic: Pharmaceutical Practices and Patient Outcomes

Subfield: Geriatrics and Gerontology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,890