NMS Record Form – use to document details from consultation
NMS Engagement
New Medicine Prescribed:
Patient name and address (Stick Bag label
here)
Patient Telephone number
Engagement Notes (detail any advice given):
NMS Intervention (7 days after engagement) Date __________________
Discuss the following with the patient and record on PharmOutcomes:
-
Have they started taking their new medicine yet
o
If no, why not?
-
How have they found taking it?
-
Do they think their medicine is working?
-
Any side effects?
-
o
If yes, give advice on how to combat them
o
If side effects are not manageable and cannot be mitigated – Refer to GP
Any concerns about remembering to take the new medicine?
o
-
If so, discuss coping strategies
Any issues with using the medicine due to its pharmaceutical form?
o
If so, give advice on how to mitigate
o
If cannot be mitigated – Refer to GP
Intervention Notes:
Has this patient given consent to receive a follow up call? Yes / No
Has this been recorded on PharmOutcomes? Yes / No
NMS Follow-up (14 days after Intervention) Date ___________________
Discuss the following with the patient and record on PharmOutcomes:
-
Have they started taking their new medicine yet
o
If no, why not?
-
How have they found taking it?
-
Do they think their medicine is working?
-
Any side effects?
-
o
If yes, give advice on how to combat them
o
If side effects are not manageable and cannot be mitigated – Refer to GP
Any concerns about remembering to take the new medicine?
o
-
If so, discuss coping strategies
Any issues with using the medicine due to its pharmaceutical form?
o
If so, give advice on how to mitigate
o
If cannot be mitigated – Refer to GP
Follow up Notes:
Has this been recorded on PharmOutcomes? Yes / No
Has this NMS been recorded on e-log and processed through the till? Yes / No