Why don't confused patients call medicines helplines after discharge from hospital?

July 01, 2020

Leaving hospital can be a confusing and sometimes risky time for patients who take medication, with an estimated 44% experiencing medicine-related problems once they get home. New research from the University of Bath suggests the most helpful and timely medicine-related support is provided by hospital pharmacists, yet few patients are aware that they can turn to their NHS Trust to allay confusion and stay safe.

The Bath study explored the experiences of 40 patients or their carers using various hospital-based telephone medicines information services. It found that patients who have called a service regard it as uniquely placed to answer medication queries arising after hospital discharge. After using the service, patients said the helpline service was quicker to access than their GP and often more helpful.

But although 52% of NHS Trusts currently provide a medicines helpline, few discharged patients seem to know of their existence, resulting in extremely low usage.

Matt Williams, the Bath PhD student who led the research said: "A typical hospital that discharges over 100 patients every day will have 30 to 40 patients with a potential need to call the helpline, yet they might get just one call a day.

"If people don't know the service exists, they either do nothing when problems arise or they go to their GP, use the emergency services or turn to the people around them or Google for non-expert and potentially unreliable advice. Yet they could resolve their problem with a simple phone call, which is quicker and easier for both the person and the NHS."

Dr Matthew Jones, lecturer in pharmacy practice at the university, explained that patients often experience big changes to their medicine regimen when they are discharged from hospitals, and it's common for them to find there are gaps in their knowledge.

He said: "They might have questions about side effects, correct dosage or potential interactions between medications. Getting the right information can help them avoid harm. It can also draw attention to mistakes that have been made with their medicines."

Helplines have been established to help meet the NHS's priority to improve patients' transitions of care, so people can better manage their own health. Study participants called for their local helpline to be extended to cover evenings and weekends.

A second study from the Bath team finds that hospital pharmacists who provide a hospital medicines helpline service are aware that it is a valuable resource for patients but regard it as under-resourced.

"There is concern among pharmacists that if they advertise the service more widely, they will not be able to cope with the influx of enquiries. This is completely understandable at a time when NHS staff are so stretched. To benefit as many patients as possible, pharmacists need guarantees they will be given time to help everyone who calls" said Dr Jones.

According to the results of research commissioned in 2018 by the UK Department of Health and Social Care, 237 million medication errors occur in the NHS in England every year. Of these, 66 million are of potential clinical significance. Avoidable adverse drug reactions cause around 700 deaths per year and cost the NHS an estimated £98.5-million per year.

A study in 2017 found that discharged patients were not reliably warned of possible problems that could arise from their medications. Of the people involved in the NHS Patient Survey Programme, 43% said a member of staff did not tell them about any side effects to look out for.

Some discharged patients also experience medicines-related errors, such as prescribing mistakes and incorrect or missing information on discharge summary documents. As a result, 26% of discharged patients seek help relating to their medication, mainly from their GP.

Dr Jones said: "It's important that all patients discharged from hospital can easily get timely and expert advice about their medicines. Different areas currently do this in different ways, which is one reason why the public doesn't know about the services that are there to help them. In addition, the government recently announced a new Discharge Medicines Service, which will allow people to seek help from their community pharmacy. The NHS should decide what is the best way to help discharged patients and then ensure that this is provided and advertised by every hospital."
Dr Matthew Jones explains medicines helplines: https://vimeo.com/433921777

University of Bath

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