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Technical Notes: The New Medication Service (NMS)

Source: The New Medication Service (NMS) - Andy the Pharmacist
Goal: Training guide for pharmacy staff to implement and manage the NMS effectively.


01: Introduction and Purpose [00:00:00]

The New Medicine Service (NMS) is a professional consultation service provided by pharmacies for patients starting a new medication for specific long-term conditions.

  • Primary Aim: To support patients in the initial weeks of treatment to ensure they take medication safely and effectively.
  • The "Why": * Patient Health: Improves quality of life and treatment outcomes.
    • NHS Efficiency: Reduces medicine wastage and prevents hospital admissions due to non-adherence.
    • Financial Impact: Creates measurable savings for the healthcare system.

02: The Three-Stage Workflow [00:00:36]

Stage 1: Engagement (Day 0)

  • Trigger: When a patient presents a prescription for a new eligible medication.
  • Process:
    • Identify eligibility based on condition.
    • Explain the service and benefits.
    • Consent: Obtain formal written consent.
    • Contact: Agree on a follow-up method (Telephone or In-Person).
  • Staff Role: This stage can be initiated by any member of the pharmacy team.

Stage 2: Intervention (Weeks 12)

  • Timeline: 7 to 14 days after the patient starts the medicine.
  • Process:
    • Pharmacist discusses how the patient is getting on.
    • Identify barriers (side effects, forgetfulness, or poor technique).
    • Pharmacist provides clinical advice or refers back to the GP if serious issues arise.

Stage 3: Follow-Up (Weeks 34)

  • Timeline: 2 to 3 weeks after the Intervention stage.
  • Process:
    • Review any prior issues identified in Stage 2.
    • Reinforce the long-term benefits of the medication.
    • Confirm the patient is now taking the medicine as prescribed.

03: Operational Implementation [00:01:41]

Identifying Candidates

  • The Golden Question: "Are any of these medications new for you?"
  • The Visual Cue: Draw a small star on the right-hand side of the drug name on the prescription. This alerts the pharmacist that an NMS opportunity exists.

Eligibility Criteria (Target Conditions) [00:02:01]

The service is limited to patients with:

  1. Asthma and COPD: Respiratory issues (e.g., new inhalers).
  2. Hypertension: High blood pressure.
  3. Antiplatelets/Anticoagulation: Blood thinning medications.
  4. Type 2 Diabetes: Blood sugar management.

The Paperwork [00:02:35]

  • Consent Form: Must be signed and dated by the patient.
  • Phone Number: Essential to capture an accurate number for the follow-up call.
  • Dispensary Workflow: If labeling a prescription for an absent patient, check records. If it looks like a new NMS drug, "star" the script and add a consent form to the basket for the pharmacist to handle during the handout.

04: Visual Reference Guide

Visual Element Description / Purpose
Progress Chart A linear timeline showing the 3 stages: Engagement \rightarrow Intervention \rightarrow Follow-up.
Condition Icons Visual symbols for Lungs (Asthma), Heart (Hypertension), Blood Drop (Anticoagulants), and Sugar (Diabetes).
The "Star" System A POV shot showing a staff member marking a script to signal the pharmacist.
Rob Case Study A real-world example of an asthma patient using an inhaler incorrectly, corrected by the NMS intervention.
Adherence Graph Shows non-adherence dropping from 1 in 5 (20%) to 1 in 10 (10%) via the NMS.

05: Summary and Key Takeaways

High-Level Summary

The NMS is a structured pharmacy intervention designed to catch medication errors and adherence issues early. By utilizing a three-step process—Engagement, Intervention, and Follow-up—pharmacies can halve the rate of patient non-adherence for critical conditions like diabetes and hypertension.

Key Insights

  • Team Effort: Identification isn't just for pharmacists; counter staff and dispensers are the "front line."
  • Early Intervention: Most problems occur in the first 2 weeks of treatment.
  • Clinical Safety: Provides a safety net to refer patients back to GPs before health deteriorates.
  • Statistics: NMS reduces non-adherence from 20% down to 10% by the final stage.
  • Patient Care: The service exists because "we care" about patient outcomes, not just dispensing boxes.

Glossary of Terms

  • Adherence: Taking medications exactly as prescribed (timing, dose, technique).
  • COPD: Chronic Obstructive Pulmonary Disease (lung condition).
  • GP: General Practitioner (Primary Care Doctor).
  • Hypertension: High Blood Pressure.
  • Intervention: A discussion to identify and solve a healthcare problem.