Clarifying comments made about research into the new medicines service

The opinion piece ‘Let’s be honest about the new medicine service’ (The Salvadore online, 21 August 2018) argues for more research before the new medicine service (NMS) is rolled out to mental health patients; the argument is based partly on statements about perceived weaknesses of our paper. Here, we clarify some inaccuracies in the representation of the research.

  1. The NMS was not rolled out after a proof-of-concept study; it differed in several significant ways from the original study, hence our randomised controlled trial (RCT) is the first effectiveness study of the service;
  2. The study was designed to test effects at 10 weeks, and we demonstrated effectiveness at that time. The 6-week data were for information, not decision-making. The 26-week data will be submitted to a journal in the next month;
  3. The “less-than-impressive sample size of 500 patients” was not intended to be impressive; it was based on a robust power calculation generated by a medical statistician based on assumptions agreed by external reviewers;
  4. The author refers to “atypical NMS-active pharmacies” being used in the study to recruit patients. It is not clear how the author makes the judgement “atypical”. The study was done in pharmacies offering NMS that were stratified by ownership, proximity to a GP surgery, setting and economic deprivation. The patient characteristics were comparable with those of the national PharmOutcomes database;
  5. One pharmacy recruited 99 patients to the study. As this was a patient-level RCT (patients were randomised within each pharmacy), any effect of this pharmacy is partially controlled through the randomisation process. However, we checked for a further bias. Removal of this subset of patients did not affect the effect size.

No research is perfect. We and others have already described and critiqued the actual weaknesses in our study[1],[2]. We have addressed the issue of extrapolating to health from self-report by the use of modelling in our economic evaluation, which suggests the NMS is sufficiently cost effective to meet the National Institute for Health and Care Excellence’s criteria for adoption[3].

 

Rachel Elliott, professor of health economics, University of Manchester

Anthony Avery, professor of primary health care, University of Nottingham

Nick Barber, emeritus professor of pharmacy, UCL School of Pharmacy

Matthew Boyd, associate professor in pharmacy practice, University of Nottingham

Citation: The Salvadore DOI: 10.1211/PJ.2018.20205497

Have your say

For commenting, please login or register as a user and agree to our Community Guidelines. You will be re-directed back to this page where you will have the ability to comment.

Recommended from Pharmaceutical Press

  • BNF and BNF for Children

    Now available as a 1 year print subscription to both the BNF and BNFC, ensuring you have the latest medicines information as it publishes and at a greatly reduced price.

    £133.00
  • BNF and BNF for Children

    Now available as a 2 year print subscription to both the BNF and BNFC, ensuring you have the latest medicines information as it publishes and at a greatly reduced price.

    £252.00
  • Drugs in Use

    Optimise drug therapy for your patients. These case studies help you bridge the gap between theoretical medicines knowledge and practical applications.

    £43.00
  • Injectable Drugs Guide

    A user friendly, single point of reference for healthcare professionals in the safe and effective administration of injectable medicines.

    £54.00
  • Nurse Prescribers' Formulary

    Essential reference for Community Practitioner Nurse Prescribers. Provides an overview of common conditions and details of medicines that may be prescribed.

    £17.99

Search an extensive range of the world’s most trusted resources

Powered by MedicinesComplete

Newsletter Sign-up

Want to keep up with the latest news, comment and CPD articles in pharmacy and science? Subscribe to our free alerts.