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a blood pressure monitor imageJuly 11 2018

Community pharmacy referrals for hypertensive patients under the New Medicines Service has not increased GP workload appreciably.


Analysis of 131,419 patient records in England has found that 4.5% of patients were referred by a pharmacist to a GP within the first 2 weeks of starting a new antihypertensive medication. The patients most commonly referred to the GP were those experiencing side effects, but other significant influences on referral were medication-related concerns and the drug class.

In terms of drug class, the introduction of an alpha blocker into the patient’s therapy was most likely to result in a referral, while patients prescribed angiotensin-II receptor blockers were least likely to be referred. 

The findings have been published in the British Journal of General Practice, with the researchers looking at data relating to the introduction of the New Medicines Service in 2011-12. It found that the mean age of patients assessed under the NMS was 65 years.

“These data are reassuring, in that additional pharmacist involvement does not increase medical workload appreciably, and support further development of pharmacist-led hypertension interventions,” said the researchers from the Nuffield Department of Primary Care Health Sciences, University of Oxford.

“The impact on clinical workload of additional pharmacy services is worthy of consideration. With the incidence of new hypertension cases at eight people per 1,000, a 4% referral rate would mean that of the 52 new hypertension cases per practice per year only two would need to be seen again by their GP within two weeks of medication initiation. 

“Without knowing the rate of patient re-presentation to GPs outside of the NMS, it is difficult to determine whether a 4% referral rate would indeed represent an improvement or worsening of the current situation; however, these numbers appear low.”

Link:
A Albrasi et al. ‘Hypertension referrals from community pharmacy to general practice: multivariate logistic regression analysis of 131 419 patients’. Br J Gen Pract 5 July 2018; bjgp18X697925.        

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