International Journal of Clinical Pharmacy

, Volume 39, Issue 6, pp 1273–1281 | Cite as

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

  • Nadya Hamedi
  • Filipa Alves da Costa
  • Robert Horne
  • Michael Levitan
  • Amanda Begley
  • Sotiris AntoniouEmail author
Research Article


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.


Anticoagulants Community Pharmacy Services Medication adherence New Medicine Service Pharmaceutical care United Kingdom 



The authors wish to acknowledge all the pharmacists who tool their time to answer the survey.


This study did not receive any funding. All costs were supported by the researchers and the organisations involved.

Conflicts of interest

Both Mr. Antoniou and Dr. Costa have received travel grants/honoraria from Bayer to present at conferences during the current year. Mr. Antoniou has also received honararia from Daiichi-Sankyo, Boehringer, Pfizer/BMS. None of these, however, directly relate to the work being presented here. The remaining authors declare that they have no financial relationships that might lead to a conflict of interest.

Supplementary material

11096_2017_529_MOESM1_ESM.pdf (196 kb)
Supplementary material 1 (PDF 195 kb)


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Nadya Hamedi
    • 1
    • 2
  • Filipa Alves da Costa
    • 3
    • 4
  • Robert Horne
    • 5
    • 6
    • 7
  • Michael Levitan
    • 8
  • Amanda Begley
    • 2
  • Sotiris Antoniou
    • 1
    • 2
    • 5
    Email author
  1. 1.St Bartholomew’s HospitalBarts Health NHS TrustLondonUK
  2. 2.UCL PartnersLondonUK
  3. 3.Centro de Investigação Interdisciplinar Egas Moniz (CiiEM)CaparicaPortugal
  4. 4.Portuguese Pharmaceutical Society (PPS)LisbonPortugal
  5. 5.UCL School of PharmacyLondonUK
  6. 6.CLAHRC North ThamesLondonUK
  7. 7.BMA HouseLondonUK
  8. 8.Chair of Middlesex Group of Local Pharmaceutical CommitteesLondonUK

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