Operating a patient medicines helpline: a survey study exploring current practice in England using the RE-AIM evaluation framework

Abstract

BackgroundPatient medicines helplines provide a means of accessing medicines-related support following hospital discharge. However, it is unknown how many National Health Service (NHS) Trusts currently provide a helpline, nor how they are operated. Using the RE-AIM evaluation framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance), we sought to obtain key data concerning the provision and use of patient medicines helplines in NHS Trusts in England. This included the extent to which the delivery of helplines meet with national standards that are endorsed by the Royal Pharmaceutical Society (standards pertaining to helpline access, availability, and promotion).MethodsAn online survey was sent to Medicines Information Pharmacists and Chief Pharmacists at all 226 acute, mental health, specialist, and community NHS Trusts in England in 2017.ResultsAdoption: Fifty-two percent of Trusts reported providing a patient medicines helpline (acute: 67%; specialist: 41%; mental health: 29%; community: 18%). Reach: Helplines were predominantly available for discharged inpatients, outpatients, and carers (98%, 95% and 93% of Trusts, respectively), and to a lesser extent, the local public (22% of Trusts). The median number of enquiries received per week was five. Implementation: For helpline access, 54% of Trusts reported complying with all ‘satisfactory’ standards, and 26% reported complying with all ‘commendable’ standards. For helpline availability, the percentages were 86% and 5%, respectively. For helpline promotion, these percentages were 3% and 40%. One Trust reported complying with all standards. Maintenance: The median number of years that helplines had been operating was six. Effectiveness: main perceived benefits included patients avoiding harm, and improving patients’ medication adherence.ConclusionsPatient medicines helplines are provided by just over half of NHS Trusts in England. However, the proportion of mental health and community Trusts that operate a helpline is less than half of that of the acute Trusts, and there are regional variations in helpline provision. Adherence to the national standards could generally be improved, although the lowest adherence was regarding helpline promotion. Recommendations to increase the use of helplines include increasing the number of promotional methods used, the number of ways to contact the service, and the number of hours that the service is available.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3690-9) contains supplementary material, which is available to authorized users.

A systematic review examining the effectiveness of medicines information services for patients and the general public

“…In the UK, patient medicines helpline services (PMHS) are available for patients who have received care within some secondary healthcare settings. [23] The primary function of a PMHS is to enable discharged patients to communicate with a pharmacy professional from the healthcare setting where they recently received care. PMHS are therefore means of providing medicines-related support following hospital discharge.…”

“…The first PMHS was established in the UK in 1992, [24] and a survey conducted in 2017 found that 52% of NHS Trusts 1 in England provide a PMHS. [23] Although PMHS were initially set up to improve patients' knowledge and use of their medicines, recent guidelines for their implementation have suggested other benefits, for both service users and healthcare organisations. [25] Additional benefits include reducing harm to patients, highlighting and correcting medicine-related errors, reducing unnecessary use of other healthcare services, and improving the patient experience of healthcare services.…”

“…Williams et al [23] surveyed pharmacy professionals (MI Pharmacists and Chief Pharmacists) in 2017 for their perceptions regarding the major benefits of their PMHS. The top 10 perceived benefits were as follows: avoiding harm to patients (88%; n = 137/156), improving patient medication adherence (85%; n = 133/156), providing assurance to patients that they can access professional help from home (83%; n = 129/156), improving the patient [67,73] 36-65% (51%; 41%) 14-68 (82) 4 [55,76,77,81] 15-58% (40%; 38%)…”

Pharmacy professionals’ experiences and perceptions of providing NHS patient medicines helpline services: a qualitative study

“…Patient medicines helpline services (PMHS) have been set up by some National Health Service (NHS) Trusts 1 in England, with the aim of providing support to recently discharged patients regarding changes to their medicines regimen as a result of their hospital care. The first PMHS was set up in 1992, and a survey study conducted in 2017 reported that 52% of NHS Trusts in England provided a PMHS [12]. A recent systematic review examined the evidence regarding the effectiveness of PMHS, concluding that PMHS are typically valued by service users (e.g., satisfaction ratings are excellent) and that the advice provided to service users is usually followed.…”

What do patients ask when using a medicines helpline service?

“…Medicines helplines have the potential to improve healthcare through several mechanisms, including: improving medicines adherence, which may lead to reductions in re‐admission rates; reducing patient harm; reducing pressure on clinical staff time in primary and secondary care; improving information sharing; and enhancing patient experience 2 . Following a recent UK survey to evaluate how widely available medicines helplines are, it was found that 67% of acute trusts and 18% of community trusts provide a service 3 …”