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module menu icon What is the community pharmacy experience of the DMS?

What is the community pharmacy experience of the DMS?

Pharmacists providing the DMS have already identified benefits of the service for patients in relation to safety, efficacy and building relationships. It is reported that:

  • Patients are appreciative of being contacted soon after they return home from hospital, finding the calls supportive, informative and caring
  • DMS is very effective in identifying medicines that have been stopped in hospital but which are still present (for example) in multi-compartment compliance aids, which the pharmacist can rectify
  • Conversations with patients also revealed suboptimal adherence, previously undisclosed, which the pharmacist can address and encourage the patient to revisit with their GP
  • As with other consultations, the DMS becomes easier to conduct and manage with experience.

While the DMS has the potential to improve the safe and effective use of medicines at the transfer of care between hospital and community, there are also challenges (and solutions) that community pharmacists have identified (see piv).

Tips for effective, efficient remote consultations

When focusing on the DMS consultation with the patient (stage 3), it is important to recognise that when people are admitted to hospital, medicines are often not at the forefront of their minds – and when being discharged, they may be preoccupied with wanting to go home and the challenges they will face when they get there. A phone call following a DMS referral, soon after they arrive home, is very supportive – and patients really seem to appreciate this.

The CONSULT model has some helpful tips when it comes to managing remote consultations in a pharmacy context. Community pharmacists are already very experienced regarding remote consultations, of which phone calls are the most common. Most pharmacies do not yet have easy access to NHS approved video consultation systems but may use a video calling method (e.g. WhatsApp or FaceTime) if the patient chooses this. Although it can be more difficult to gauge a person’s emotional state on a phone call compared to face-to-face, some people actually feel more comfortable communicating in this way. It is important not to assume that a phone call is less useful than face-to-face contact. 

NHSE has issued some guidance about remote consultations and the PSNC website has more information.

Table 1: CONSULT model for remote pharmacy consultations
C Consider remote consultation or not What's needed? Information (email/text) via phone, video or face-to-face?
O Organise and test technology

Is software and hardware working?

Can I use them confidently? 

N Necessary requirements to hand Clinical records, environment (quiet, lighting, camera), equipment available, recording method?
S Start the consultation purposefully

Can you hear and see each other? 

Others present (carers, interruptions)? 

Explain oddities, taking notes

Agree agenda (both)

Outline structure, manage expectations (time)

U Undertake the review

Use your standard process, e.g. '7 Steps' medication review (NHS Scotland)

Remember to keep person-centered

Triage and arrange face-to-face if needed

L Listen and agree next steps

Use shared decision-making (benefit/risk, alternative, no action)

Check in and summarise often 

Offer information and organise new appointment if needed

T Terminate appropriately

Both you and patient summarise actions

Remember safety netting

Be the last person to leave the call