Making the most of your pharmacist

Pharmacists play a key role in helping to manage healthcare for people in the community. They are qualified to help you to use medicines safely, to help your medicines work as effectively as possible for you and to provide other services to help you stay well. Research shows that most people can get to their local pharmacy within 20 minutes, even if they live in rural areas. Each pharmacy will have at least one community pharmacist.

What can my community pharmacist do for me?

Along with dispensing medication, your community pharmacist can help you understand what the medicine does and how to take it to get the best result. Most pharmacies offer additional services. These might include some of the following. In most cases these services are free, but some pharmacies may charge for a particular service.

• Dispensing repeat prescriptions (so that you can collect your regularly prescribed medication directly from your pharmacy without having to go to your GP first).
• Safely disposing of unused or out of date medication.
• Advising on interactions between different prescribed or over-the-counter medicines.
• Delivering prescription medication to your home.
• Giving information on how to keep healthy, such as stopping smoking, eating a healthy diet and getting enough exercise.
• Performing health checks (for blood pressure, cholesterol or blood glucose).
• Giving information on how to treat minor health conditions such as coughs and colds, stomach upsets and headaches.
• Giving advice about medication aids, such as drug wallets or blister packs. 
• Carrying out 'New Medicine' appointments.
• Taking referrals from the local hospital when patients needing particular medicines are discharged.
• Referring you to other services or sources of support to help you to manage your condition.

New Medicine Service (NMS)

Some pharmacists offer a free NHS New Medicine Service for those who start a medicine for certain long term health conditions. This now includes epilepsy.

Having a NMS has been shown to help people in the first few weeks after they have been prescribed a new medicine. This is when people are most at risk of either not starting it, not taking it correctly, or stopping it because they are worried it isn't working, or it is causing side effects. Talking to the pharmacist in these early weeks can reassure people about any concerns.

How do I sign up for the NMS?

The pharmacist may ask you if you would like to sign up for the service, or a specialist or GP can refer you. You can also ask your community pharmacist for it for yourself, or on behalf of someone you care for.

What happens in the NMS?

The NMS consists of three phases and can take place in person, over the phone, or online. You can ask a friend or partner to be with you.

The pharmacist will talk to you about the new medicine, to check you know how best to take it, and to answer any questions, including how the new medicine might work alongside other medicines that you take.

After the first meeting the pharmacist will arrange a time to speak to you again in 7-14 days. At this second meeting you will be asked how you are getting on and if you have had any side effects. They may be able to suggest ways to help you to remember to take the medicine if this is an issue for you. Finally the pharmacist will arrange a follow-up 14-21 days after the second appointment. If there are any concerns at this appointment the pharmacist may advise you to get back in touch with your specialist. At all stages of the NMS the pharmacist can give information on your medicines and offer possible healthy living suggestions.

Pharmacists in GP Practices

Each GP practice now has a pharmacist to support GPs and patients with medication. Many have been trained so they can prescribe for some medical conditions. They also carry out Structured Medication Reviews.

What is a Structured Medication Review (SMR)?

This is a NHS approved service which helps people with complex medicine needs. Research has shown that people who have a SMR often get better results with their medicine. You can ask at the practice if you are eligible for this service.

The practice pharmacist will discuss all the medicines you take for your different conditions, and check that they are working well individually and together. This appointment aims to help you get the most out of your medicines and, if necessary, you may be referred to another health professional. 

Discharge Medication Service

You may be eligible for this service if you have been admitted to hospital and changes are needed with your medication. In this case, the hospital pharmacist will refer you to your community pharmacist. 

Medication for Epilepsy

Your pharmacist can give you information about how your medication works, how to get the best seizure control and what versions of your anti-seizure medication (ASM) are available.

Most people do not have any problems taking their medication, but some may find it difficult to swallow tablets. Your pharmacist can tell you if your ASM comes in different strengths. For example you might be able to take more tablets at a lower strength (2 x 500mg) instead of one large tablet (1 x 1000mg). Some drugs are also available in different forms, such as capsules, syrups or granules. Your pharmacist can advise you what might be available for you, and may offer to contact your doctor if a change needs to be written on your prescription.

Our booklet medication for epilepsy has lots of information about taking ASM and managing your treatment.

Medication aids

Your pharmacist may suggest using a drug wallet, or pill box, to help you keep track of when you have taken your medication. Most drug wallets have containers for each day of the week to keep medication in. Each container is divided into sections for the morning, afternoon and evening. These don't suit everyone, and not every medicine can be stored in a drug wallet. The pharmacist can help you decide if one may benefit you.

Getting the same medication every time

All ASM has a generic, or drug name (for example Levetiracetam). Some also have a brand or trade name given by the manufacturer (for example Keppra). Some ASM comes in more than one generic version (because they are made by different manufacturers). Manufacturers of generics may give their generic version its own name.  For some ASM, different versions of the generic drug can vary slightly and this could affect seizure control, for some people.

This difference has been highlighted by the Medicines and Healthcare Regulatory Authority (MHRA) who issue guidelines for doctors prescribing ASM. This helps them to decide whether it is important for people with epilepsy to have the same version of their particular ASM each time.

Taking the same version of your ASM

Even if your ASM is not highlighted in the MHRA guidance, it is generally recommended that people with epilepsy take the same version of their ASM all the time, whether generic or branded, wherever possible. This is called ‘consistency of supply’.

If your prescription only has the generic name of the drug, your pharmacist can give you any version of the drug with that generic name. However, if your prescription has the brand name of the drug, your pharmacist has to give you that brand. Going to the same pharmacy each time to collect your prescription and getting to know your pharmacist may help make sure you get a consistent supply of your medication.

Your pharmacist will keep a record of any medicines they have dispensed to you and if you ask, will try to ensure consistency of supply. It can be helpful to check that you have the correct ASM while you are at the counter, as a pharmacist will not be able to change it once you have left the pharmacy.

Information produced: April 2022