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How prepared are pharmacists to support atrial fibrillation patients in adhering to newly prescribed oral anticoagulants?

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Abstract

Background The New Medicines Service (NMS) was implemented in the United Kingdom in 2011 and first evaluated in 2014, showing 10% increase on adherence. Objective To assess community pharmacists’ current practice, knowledge and confidence in supporting patients’ adherence as part of the NMS for patients on Oral Anti-Coagulants (OACs) for stroke prevention in Atrial Fibrillation. Setting Community pharmacists in London. Method An online cross-sectional survey was sent to pharmacists from their Local Pharmaceutical Committees and advertised by the Royal Pharmaceutical Society. Analysis was undertaken in SPSs v23 considering a confidence level of 95%. Main outcome measures pharmacists reported confidence of providing the NMS on OACs; training needs and skills for supporting adherence. Results A total of 257 valid responses were analysed (6.8% response rate; {Cronbach’s α = 0.676–0.892}). Data indicates that over a 2-month period, 25% of pharmacists had completed ≥6 NMS consultations for all OACs, of which 11% for new oral anticoagulants (NOACs). The key priorities in counselling items during the NMS consultation were to discuss actions to take when bleeding occurs, followed by supporting adherence. Pharmacists were more confident in their knowledge, skills and access to resources for Vitamin-K Antagonists (VKAs) than for NOACs (p < 0.005). Results also highlight pharmacists’ unfamiliarity with alert cards, lower for NOACs than VKAs (p < 0.001), albeit perceived as critically important. Half the sample mentioned to use the British National Formulary as information resource. Conclusion Results suggest the provision of NMS for NOACs is low. Supporting pharmacists with tailored education and adherence support might foster dissemination.

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Acknowledgements

The authors wish to acknowledge all the pharmacists who tool their time to answer the survey.

Funding

This study did not receive any funding. All costs were supported by the researchers and the organisations involved.

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Authors and Affiliations

  1. St Bartholomew’s Hospital, Barts Health NHS Trust, London, UK

    Nadya Hamedi & Sotiris Antoniou

  2. UCL Partners, 3rd Floor, 170 Tottenham Court Road, London, W1T 7HA, UK

    Nadya Hamedi, Amanda Begley & Sotiris Antoniou

  3. Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Campus Universitário, Quinta da Granja, Monte da Caparica, 2829-551, Caparica, Portugal

    Filipa Alves da Costa

  4. Portuguese Pharmaceutical Society (PPS), Rua da Sociedade Farmacêutica, 18, 1169-075, Lisbon, Portugal

    Filipa Alves da Costa

  5. UCL School of Pharmacy, London, UK

    Robert Horne & Sotiris Antoniou

  6. CLAHRC North Thames, London, UK

    Robert Horne

  7. BMA House, Tavistock Square, London, WC1H 9JP, UK

    Robert Horne

  8. Chair of Middlesex Group of Local Pharmaceutical Committees, 2nd Floor Offices, 1278 High Road, Whetstone, London, N20 9HH, UK

    Michael Levitan

Authors
  1. Nadya Hamedi
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  2. Filipa Alves da Costa
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Correspondence to Sotiris Antoniou.

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Conflicts of interest

Both Mr. Antoniou and Dr. Costa have received travel grants/honoraria from Bayer to present at conferences during the current year. Mr. Antoniou has also received honararia from Daiichi-Sankyo, Boehringer, Pfizer/BMS. None of these, however, directly relate to the work being presented here. The remaining authors declare that they have no financial relationships that might lead to a conflict of interest.

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Hamedi, N., da Costa, F.A., Horne, R. et al. How prepared are pharmacists to support atrial fibrillation patients in adhering to newly prescribed oral anticoagulants?. Int J Clin Pharm 39, 1273–1281 (2017). https://doi.org/10.1007/s11096-017-0529-0

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  • DOI: https://doi.org/10.1007/s11096-017-0529-0

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