a blood pressure monitor imageJuly 11 2018

New Medicines Service data indicates community pharmacists manage 19 out of 20 hypertensive patients without the need to refer a patient back to the GP.

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 two 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 researchers commented that pharmacists could manage patients’ negative feelings towards the new medication and uncertainty as to their efficacy. The concerns “could be managed via BP measurements, verbal advice, and reassurance, and do not require a pharmacist to have a prescribing qualification.” 

However, the significance of these negative feelings and uncertainties in the results “suggests that patients may not be accepting pharmacist advice and recommendations, or that pharmacists may not consistently offer this.”

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.