The importance of NHS-industry partnership for medicines optimisation has been underlined by experts on pharmacy management.

Speakers at the Pharmacy Management National Seminar on 17 April argued that the growing prevalence of long-term conditions (LTC) made it vital for pharma and the NHS to work together in improving sub-optimal medication regimes.

The growing role of community pharmacists in guiding patient decisions on medication was also discussed at an event that brought together pharmacists and the pharma industry.

Keynote speaker Dr Charles Alessi (pictured), Chairman of the National Association of Primary Care, said that GPs were not meeting the clinically and economically vital challenge of medicines optimisation.

“We are in an age of personalisation, of trying to understand value and of dealing with mixtures of clinical conditions,” he said.

But poor follow-up of patient outcomes was resulting in 50% of people with LTC ceasing to take any medication within a year, while “we glibly go on thinking that’s all right”.

Joint working was an important way forward, he argued, with pharma companies helping doctors to address issues such as medicines interaction and compliance.

Dr Alessi also noted that community pharmacists were emerging as the “best placed” healthcare professionals to help people with LTC manage their medication.

Peter Rowe, former national QIPP lead for medicines use and procurement, warned that continuing austerity would mean no additional funding to deal with the “demographic time bomb” of the ageing population.

Medicines optimisation was essential, he said – and the changes had to be fundamental, not incremental. That meant “the NHS must work with pharma to better monitor patient outcomes”.

Other speakers discussed the common interest of industry and the NHS in patient compliance with treatment; and conversely, the need for doctors to help patients move on from unsuccessful treatments.

Pharmaceutical and medical device companies making combination products need to pay more attention to patient experience, according to a new study by technology design and development firm Cambridge Consultants.

A survey of healthcare providers and over 240 insulin-injecting diabetes patients showed that by paying better attention to device usability, companies could improve patient compliance and health outcomes.

The patients surveyed used combination products such as injection pens and insulin pumps daily. The study showed that:

• 75% of patients had been given a choice of drug delivery device. Of these, 21% did their own research before choosing a device.

• Among patients who had changed their devices, ‘lifestyle’ factors such as discretion (28%) and portability (21%) were the biggest influences.

• All the healthcare providers surveyed believed that better device usability leads to better drug compliance.

“The findings challenge traditional medical device industry conceptions about compliance and the patient experience,” said Melanie Turieo, Human Factors Team Leader at Cambridge Consultants. “The industry has been good at maximising drug efficacy but patient experience factors have not really been a primary focus. Only now are we seeing the patient experience take centre stage.

“Drug makers need to realise that if you consider the patient’s broader needs throughout the development process – from conception to design, development and commercialisation – you are likely to have a more successful and effective product, resulting in improved compliance and therefore improved patient outcomes.”

Based in Cambridge (UK) and Boston (USA), Cambridge Consultants is a leading technology design and development company. Its successes include the Vena platform for medical device interoperability.

The MHRA has called on the pharma industry and regulators to tackle over-prescribing and patient non-compliance.

The head of the regulatory group has warned that GPs are prescribing too many drugs to elderly patients, with a negative effect on both patients’ health and NHS budgets.

A review of doctor training in pharmacology is to be conducted, following a study which found that patients over 80 are receiving an average of eight different medicines, many of which are unnecessary.

Between 1999 and 2009, the number of prescribed by GPs in England has increased by 67%.

Professor Sir Alasdair Beckenridge said: “Some drugs are continued for long periods beyond the point when they are needed. They were justified in the short term but not in the long term. Pharmacists should be able to question prescriptions that doctors write and ask ‘Is this really necessary?’”

He added: “Training in pharmacology for doctors has been squeezed. We have set up a working party to look at it. We are very concerned about this.”

Professor Beckenridge has also raised the issue of patient compliance, stating that it should be the responsibility of regulators, the industry, doctors and pharmacists to ensure prescriptions are taken correctly.

The Department of Health has said that it plans to review use of drugs as a key part of its Quality, Innovation, Prevention and Productivity (QIPP) programme.

The appearance of medication can have an effect on patient compliance, recent research has indicated.

Researchers at the University of Bombay found that the colour, shape, taste and even name of a tablet or pill can impact on the outcomes and possibly even side effects.

The research could be important for patient compliance, which may be improved by making medications more appealing to patients.

Patients’ choice of OTC tablets is strongly influenced by colour, writes R.K. Srivastava and colleagues in the International Journal of Biotechnology, with red and pink tablets preferred over other colors.

“Patients undergo a sensory experience every time they self-administer a drug, whether it's swallowing a tablet or capsule, chewing a tablet, swallowing a liquid, or applying a cream or ointment,” the team said.

“The ritual involving perceptions can powerfully affect a patient's view of treatment effectiveness.”