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

Hamedi, N; da Costa, FA; Horne, R; Levitan, M; Begley, A; Antoniou, S; (2017) How prepared are pharmacists to support atrial fibrillation patients in adhering to newly prescribed oral anticoagulants? International Journal of Clinical Pharmacy , 39 (6) pp. 1273-1281. 10.1007/s11096-017-0529-0. Green open access

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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.

Type: Article
Title: How prepared are pharmacists to support atrial fibrillation patients in adhering to newly prescribed oral anticoagulants?
Location: Netherlands
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s11096-017-0529-0
Publisher version: http://doi.org/10.1007/s11096-017-0529-0
Language: English
Additional information: © Springer International Publishing AG 2017. This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Anticoagulants, Community Pharmacy Services, Medication adherence, New Medicine Service, Pharmaceutical care, United Kingdom
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy
URI: https://discovery.ucl.ac.uk/id/eprint/10024268
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