Lewis Llewellyn, O'Keeffe Christine, Smyth Ian, Mallalieu Judi, Baldock Laura, Oliver Sam
South Essex Partnership University NHS Foundation Trust, Southend, UK.
Janssen Healthcare Innovation, High Wycombe, UK.
BJPsych Bull. 2016 Feb;40(1):5-11. doi: 10.1192/pb.bp.114.048496.
Aims and method The Maintaining Adherence Programme (MAP) is a new model of care for patients with schizophrenia, schizoaffective disorder and bipolar affective disorder which aims to encourage adherence and prevent relapse. This evaluation, conducted by retrospective and prospective data collection (including patient questionnaires and staff interviews), aimed to describe MAP's impact on healthcare resource use, clinical measures and patient and staff satisfaction, following its implementation in a university National Health Service (NHS) foundation trust in England. We included 143 consenting patients who entered MAP before 31 March 2012. Results In-patient bed days and non-MAP NHS costs reduced significantly in the 18 months post-MAP entry. At 15-18 months post-MAP, Medication Adherence Rating Scale scores had improved significantly from baseline and there was a shift towards less severe clinician-rated disease categories. Based on patient surveys, 96% would recommend MAP to friends, and staff were also overwhelmingly positive about the service. Clinical implications MAP was associated with reduced cost of treatment, improvements in clinical outcomes and very high patient and staff satisfaction.
目的与方法 “维持依从性项目”（MAP）是一种针对精神分裂症、分裂情感性障碍和双相情感障碍患者的新型护理模式，旨在鼓励依从性并预防复发。本评估通过回顾性和前瞻性数据收集（包括患者问卷和员工访谈）进行，目的是描述MAP在英格兰一家大学国民健康服务（NHS）基金会信托机构实施后，对医疗资源使用、临床指标以及患者和员工满意度的影响。我们纳入了143名在2012年3月31日前进入MAP的同意参与的患者。结果 在进入MAP后的18个月内，住院天数和非MAP的NHS费用显著降低。在进入MAP后的15 - 18个月，药物依从性评定量表得分较基线有显著改善，且临床医生评定的疾病类别向较轻程度转变。根据患者调查，96%的患者会向朋友推荐MAP，员工对该服务也给予了压倒性的积极评价。临床意义 MAP与治疗成本降低、临床结局改善以及患者和员工的高度满意度相关。
