making the most of your pharmacist
What can my pharmacist do for me?
Along with dispensing medication, most pharmacists 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 (this allows you to 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- Safely disposing of unused or out of date medication.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 (some pharmacists can organise your medication into blister packs, marked with the day and time of day when different tablets should be taken).
- Performing medicines use reviews.
- Carrying out ‘new medicine’ appointments.
- Referring you to other services or sources of support to help you to manage your condition.
... I had a chat with my Pharmacist and [they gave] great feedback and info. They even phoned [my] surgery to suggest alternative medication to avoid a repeat episode, so perhaps a chat with the pharmacist ... would be of benefit because it’s immediate, they seem to have a better knowledge of drug interactions and they’re easier to get to see.
Watch Dr Trudy Thomas' presentation below from our annual conference 2014 about how pharmacy services can help people with epilepsy. Trudy is Director of Taught Graduate Studies at Medway School of Pharmacy. She is also a locum community pharmacist and is working with Epilepsy Society to help pharmacists in primary care support people with epilepsy.
What is a medicines use review?
A medicines use review (MUR – sometimes called a medicines MOT, or medicines check-up) is a free NHS service available in most pharmacies throughout England and Wales. Similar schemes are available in Scotland and Northern Ireland.
The aim of an MUR, for those who take medication for a long-term condition, is to have an opportunity to talk to your pharmacist about how to get the best out of your medicines and to discuss any concerns. You can ask your pharmacist questions about your medication at any time, particularly if you have an urgent query, but an MUR is an ideal opportunity to have an in-depth conversation about your medication in a private area of the pharmacy.
How do I arrange an MUR?
You can ask to have an MUR at the pharmacy where you normally pick up your prescription, or your pharmacist may write to you about this service, or suggest it to you, when you collect your prescription.
What happens at the MUR?
You can use the MUR to discuss anything about your medication. You might like to talk about how you are getting on with your medication or whether you have any concerns, such as side effects. You may want to ask specific questions, for example whether your usual medication will interact with any other medicines you take, or if they will still be effective if you are sick or have diarrhoea. It can be helpful to have a list of your medication with you, what you take it for, how much and how often you take it. You can give permission for the pharmacy to have access to your medical records so they can see all the medicine you are taking, but this may not be available in all areas of the country yet.
What happens after the MUR?
After the MUR your pharmacist will draw up an action plan for you, recording information from the meeting and what you have agreed together.
The pharmacist can give you a copy of the action plan.You can also ask them to send a copy to your GP, specialist, epilepsy specialist nurse or carer. If your pharmacist recommends a change to your prescription this will need to be agreed by you and the person who usually prescribes your medication. No changes will be made unless you agree.
New medicine service
Some pharmacists offer a free NHS ‘new medicine service’ for people starting to take medicines for certain long-term health conditions, such as asthma, type 2 diabetes and high blood pressure.
The service can help people with problems early on when they start taking a medicine. Unfortunately, at the moment, this service isn't available for people taking anti-epileptic medicines, but many people with epilepsy have other health conditions too, so may find this service helpful.
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-epileptic drugs (AEDs) 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 AEDs come 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 AEDS and managing your treatment.
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 go in these aids. The pharmacist can help you decide if one may benefit you.
Getting the same medication every time
All AEDs have a generic, or drug name (for example carbamazepine). Some also have a brand or trade name given by the manufacturer (for example Tegretol). Some AEDs come 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 AEDs, 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 AEDs. This helps them to decide whether it is important for people with epilepsy to have the same version of their particular AED each time.
Consistency of supply
Even if your AED is not highlighted in the MHRA guidance, it is generally recommended that people with epilepsy take the same version of their AED all the time, whether generic or branded, where ever 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 AEDs while you are at the counter, as a pharmacist will not be able to change them once you have left the pharmacy.