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The four or more medicines (FOMM) support service: results from an evaluation of a new community pharmacy service aimed at over-65s

Twigg, Michael J.; Wright, David; Barton, Garry R.; Thornley, Tracey; Kerr, Clare


Michael J. Twigg

David Wright

Garry R. Barton

Clare Kerr


Objective: Inappropriate prescribing and nonadherence have a significant impact on hospital admissions and patient quality of life. The English government has identified that community pharmacy could make a significant contribution to reducing nonadherence and improving the quality of prescribing, reducing both hospital admissions and medicines wastage. The objective of this study is to evaluate a community pharmacy service aimed at patients over the age of 65 years prescribed four or more medicines. Methods: Patients were invited to participate in the service by the community pharmacy team. The pharmacist held regular consultations with the patient and discussed risk of falls, pain management, adherence and general health. They also reviewed the patient's medication using STOPP/START criteria. Data were analysed for the first 6 months of participation in the service. Key findings: Six hundred twenty patients were recruited with 441 (71.1%) completing the 6-month study period. Pharmacists made 142 recommendations to prescribers in 110 patients largely centred on potentially inappropriate prescribing of NSAIDs, PPIs or duplication of therapy. At follow-up, there was a significant decrease in the total number of falls (mean −0.116 (−0.217–−0.014)) experienced and a significant increase in medicine adherence (mean difference in Morisky Measure of Adherence Scale-8: 0.513 (0.337–0.689)) and quality of life. Cost per quality-adjusted life year estimates ranged from £11 885 to £32 466 depending on the assumptions made. Conclusion: By focussing on patients over the age of 65 years with four or more medicines, community pharmacists can improve medicine adherence and patient quality of life.


Twigg, M. J., Wright, D., Barton, G. R., Thornley, T., & Kerr, C. (2015). The four or more medicines (FOMM) support service: results from an evaluation of a new community pharmacy service aimed at over-65s. International Journal of Pharmacy Practice, 23(6), 407-414.

Journal Article Type Article
Acceptance Date Mar 1, 2015
Online Publication Date Apr 6, 2015
Publication Date 2015-12
Deposit Date Jan 16, 2023
Publicly Available Date Jan 20, 2023
Journal International Journal of Pharmacy Practice
Print ISSN 0961-7671
Electronic ISSN 2042-7174
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 23
Issue 6
Pages 407-414
Public URL
Publisher URL


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