In October 2011, the Department selleck screening library of Health for England commissioned the New Medicine Service (NMS), a community pharmacy Advanced Service offering additional support to patients starting a new medicine for asthma/COPD, hypertension, type 2 diabetes or anticoagulant/antiplatelet treatments. It is known that not all patients take their medicines as prescribed and the rationale behind the NMS is to

improve patient adherence to medicines. The service is structured for the patient to have a consultation with the pharmacist seven to 14 days after their new medicine has been initiated with a follow-up consultation 14 to 21 days after that. This study was undertaken to evaluate both the effectiveness and the cost effectiveness of the NMS. The effectiveness data at week 10 is reported find more here. 504 patients eligible to receive the NMS were randomly assigned to receive either the New Medicine Service

or Current Practice stratified by disease and recruiting pharmacy. Adherence to the new medicine was assessed through telephone interviews and self-completed postal questionnaires at 6 weeks, 10 weeks and 26 weeks post recruitment. Telephone interviews captured patient adherence using the NMS questions ‘Since we last spoke have you missed any doses of your new medicine, or change when you take it (prompt: when did you last miss a dose)?’ Postal questionnaires deployed the Morisky Medication Adherence Scale1 (MMAS-8, with permission). Successful outcome used a composite adherence measure developed for the study and included patients adherent to the new medicine, or patients for which the new medicine was changed or stopped by the prescriber. Patient initiated changes or stoppages were classed as non-adherent. Intention to treat analysis, with outcome adjusted for pharmacy clustering, NMS disease category, age, sex and medication count, was employed. This study had ethical approval. At 10 weeks (26 week data not fully collected at time of submission), 60%

of questionnaires were returned (n = 284), 85% of patients were successfully contacted by telephone (n = 387), and 52 patients had withdrawn from the study. Adherence assessed using the NMS questions (n = 443), yielded an odds ratio Exoribonuclease (95% CI) of 1.68 (1.09, 2.58, p = 0.02), and adherence probabilities of 0.67 (0.60, 0.74) vs. 0.78 (0.72, 0.84) in favour of the NMS arm. Adherence assessed using the MMAS-8 tool (n = 321) yielded an odds ratio of 1.78 (1.06, 3.00, p = 0.03), with adherence probabilities of 0.69 (0.61, 0.77) vs. 0.80 (0.73, 0.87) in favour of the NMS arm. This suggests a significant effect of NMS on patient adherence; a patient is 11 pp more likely to be adherent to their medicine having received the New Medicine Service compared to current practice.