Pharmacies can make a huge difference to patient outcomes by offering tailored support to manage their health and medicines, finds new research. Charlotte Rixon reports

Pharmacy support for older patients taking multiple medicines can lead to better medicines optimisation, fewer falls and improved quality of life, according to a study of an innovative scheme. Twenty-five community pharmacies in Wigan recruited 620 patients aged over 65 onto the Four or More Medicines (FOMM) Support Service, which was developed by the Community Pharmacy Future (CPF) project.

Participating patients had an average of three long-term conditions and were taking between five and nine medicines to manage them. The most common conditions were cardiovascular disease, chronic pain and musculoskeletal conditions.

Medication changes

An analysis of the service, published in the International Journal of Pharmacy Practice, revealed that pharmacists made 142 recommendations to prescribers regarding 110 patients, largely centred on the inappropriate prescribing of nonsteroidal anti-inflammatory drugs (NSAIDs) and proton pump inhibitors (PPIs). In 70 cases, pharmacists judged that the duration of treatment had gone on too long, while 33 patients were identified as being at risk of cautions or side effects from their medication.

Other reasons for reviewing a patient’s medication with their doctor included duplication of therapy or an inappropriately high dose, while pharmacists also suggested changes to patients’ medicines regimens to reduce their risk of falls. In just eight cases, the pharmacy teams identified a need for patients to start new medication.

Targeted support

The patients also received personalised advice on reducing their risk of falls and leading a healthier lifestyle, and were each given a booklet in which to record their progress. After six months of follow-up consultations, there was a significant reduction in the number of falls, while medicines adherence and quality of life also improved. “Our work has shown that delivering targeted and tailored support for patients when they visit a pharmacy brings real benefits,” said Clare Kerr, head of healthcare policy and strategy at Celesio UK, and a member of the CPF Management Committee.

“By reducing falls, pharmacists both saved the NHS money and improved patients’ confidence in what they were able to do.” She added that the scheme demonstrated that the service could be delivered by pharmacies “in a wide range of settings” and that the results added “robust evidence” for the benefits of commissioning services from community pharmacies.