The NPA’s updated ‘New Medicine Service’ resource helps the whole pharmacy team to provide excellent pharmaceutical care

The NPA has updated resources to support pharmacy teams in England to deliver the New Medicine Service. The resources, which can be downloaded from npa.co.uk, includes information
on communicating with patients, record keeping, engaging with GPs and how to recruit and retain patients. The following is a case study extracted from the resource.

Miss F presents in the pharmacy with a prescription for metformin tablets 500mg. The dosage instructions are to take one daily at breakfast for one week, then one twice a day at breakfast and with the evening meal for one week, then one three times a day, with breakfast, lunch and dinner.

The dispensing technician notices from the PMR that the patient, who is a regular patient of the pharmacy, has not had this medicine before and flags the prescription as possibly suitable for an NMS.

The pharmacist determines that metformin falls into the type 2 diabetes category of the NMS and the patient is therefore eligible for the service, provided that this is the first time the patient has been prescribed metformin and it has been prescribed for type 2 diabetes. The technician marks the prescription with a note that the pharmacist needs to speak to the patient.

Patient engagement

Miss F collects her medicine and the pharmacist confirms with her that this is the first time she has been prescribed metformin. The pharmacist ascertains that Miss F has been diagnosed with type 2 diabetes; she has tried diet and lifestyle changes but her blood glucose levels are still too high so the doctor has prescribed metformin.

The pharmacist checks that the dosage instructions are appropriate for a person starting metformin, and then goes through them with the patient to make sure she understands how to take the medicine. The pharmacist then explains the NMS to Miss F, who decides that she would like to receive this service. Miss F completes a consent form and agrees that the pharmacist can telephone her in two weeks time.

Intervention

Two weeks later, the pharmacist telephones Miss F and determines that she still consents to the NMS taking place. The pharmacist discusses with Miss F how she has been getting on with her metformin. Miss F took it once a day for week, as directed, then took it twice a day for a week, and is about to start taking it three times a day.

She has had no problems with remembering to take the medicine as she takes it with meals. She has had some diarrhoea, but that seems to have cleared up now. The pharmacist advises Miss F that diarrhoea can be a side effect of metformin, and that it is not usually a long- term effect.

Miss F has seen a dietician and is trying to follow his advice on diet. However, she is concerned that, although she has lost some weight, she is still overweight. The pharmacist advises that weight loss can be very beneficial to patients with type 2 diabetes and that a combination of diet and exercise should help.

The pharmacist provides Miss F with advice on increasing her activity levels. Miss F and the pharmacist agree to speak again by telephone in two weeks time.

Follow up

Two weeks later, the pharmacist telephones Miss F to see how she has been getting on with her metformin. Her GP has issued a further prescription for metformin tablets 500mg, one to be taken three times a day.

She has not experienced a recurrence of the diarrhoea and has had no other side effects. She has started increasing her activity levels by going for a brisk walk most evenings and is thinking about joining a Zumba class that has started in her local village hall. The NMS is now complete, and the pharmacist completes the necessary records.

The full NMS pack can be downloaded via npa.co.uk.