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Opinion: Why is depression not in the NMS?


Opinion: Why is depression not in the NMS?

The expansion of the New Medicine Service is welcome but the omission of a key therapeutic area is a cause for concern, writes PM editor Richard Thomas

Contractors in England were left bitterly disappointed to see no uplift in core funding in year three of the contractual framework. The Government and PSNC are not so much on different pages but barely in the same library. There are, however, some small shafts of light regarding service development.

Although one could justifiably quibble at the unnecessary complexity of the new smoking cessation and hypertension case-finding services, the expansion of the New Medicine Service to include conditions such as coronary heart disease, epilepsy and Parkinson’s disease is long overdue. However, there is one egregious omission – depression. What a missed opportunity at a time when antidepressant prescribing is rocketing due to the Covid-19 pandemic.

The figures are frightening. According to a NHSBSA report published this month, around 107 million antidepressant items were prescribed between March 2020 and June this year, some 1.24 million more than expected based on historical trends. Antidepressant prescribing has been rapidly increasing anyway over the past five years, with 4.33 million more items prescribed in the first quarter of this year compared with 2016-17. The additional cost in 2020 alone amounted to £139m.

The experiences of patients on antidepressants have a significant impact on adherence, continuity of therapy and outcomes. Indeed, lack of information about antidepressant use and adverse effects is frequently cited as a reason for treatment failure. Pharmacists are perfectly placed to support often anxious patients prescribed these medications for the first time and the evidence shows that this can be an effective intervention.

Pharmacy bodies and especially RPS president Claire Anderson have long called for the NMS to include depression. It is time to right this wrong for this vulnerable and growing patient group.

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