Division of Pharmacy & Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
Division of Population Health, Health Services Research and Primary Care, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
Health Soc Care Community. 2020 Sep;28(5):1671-1687. doi: 10.1111/hsc.12992. Epub 2020 Apr 14.
The Greater Manchester Community Pharmacy Care Plan (GMCPCP) service provided tailored care plans to help adults with one or more qualifying long-term condition (hypertension, asthma, diabetes and COPD) to achieve health goals and better self-management of their long-term conditions. The service ran between February and December 2017. The aim of this study was to investigate the impact of the service on patient activation, as measured by the PAM measure (primary outcome). Secondary outcomes included quality of life (EQ-5D-5L, EQ-VAS), medication adherence (MARS-5), NHS resource use and costs, systolic and diastolic blood pressure, HDL cholesterol ratio levels and body mass index (BMI). A before and after design was used, with follow-up at 6-months. A questionnaire was distributed at follow-up and telephone interviews with willing participants were used to investigate patient satisfaction with the service. The study was approved by the University of Manchester Research Ethics Committee. Quantitative data were analysed in SPSS v22 (IBM). A total of 382 patients were recruited to the service; 280 (73%) remained at follow-up. Ten patients were interviewed and 43 completed the questionnaire. A total of 613 goals were set; mean of 1.7 goals per patient. Fifty percent of goals were met at follow-up. There were significant improvements in PAM, EQ-5D-5L and EQ-VAS scores and significant reductions in systolic blood pressure, BMI and HDL cholesterol ratio at follow-up. Mean NHS service use costs were significantly lower at follow-up; with a mean decrease per patient of £236.43 (±SD £968.47). The mean cost per patient for providing the service was £203.10, resulting in potential cost-savings of £33.33 per patient (SD ± 874.65). Questionnaire respondents reported high levels of satisfaction with the service. This study suggests that the service is acceptable to patients and may lead to improvements in health outcomes and allows for modest cost savings. Limitations of the study included the low response rate to the patient questionnaire.
大曼彻斯特社区药房护理计划(GMCPCP)服务提供定制的护理计划,帮助患有一个或多个符合条件的长期疾病(高血压、哮喘、糖尿病和 COPD)的成年人实现健康目标,并更好地管理自己的长期疾病。该服务于 2017 年 2 月至 12 月运行。本研究的目的是调查该服务对患者激活的影响,使用 PAM 量表(主要结果)进行测量。次要结果包括生活质量(EQ-5D-5L、EQ-VAS)、药物依从性(MARS-5)、NHS 资源使用和成本、收缩压和舒张压、HDL 胆固醇比值水平和体重指数(BMI)。使用前后设计,随访时间为 6 个月。在随访时发放问卷,并对愿意参与的患者进行电话访谈,以调查他们对该服务的满意度。该研究得到了曼彻斯特大学研究伦理委员会的批准。定量数据使用 SPSS v22(IBM)进行分析。共有 382 名患者被招募到该服务中;280 名(73%)患者在随访时仍在接受治疗。对 10 名患者进行了访谈,43 名患者完成了问卷。共设定了 613 个目标;每个患者平均 1.7 个目标。50%的目标在随访时得到了实现。在随访时,PAM、EQ-5D-5L 和 EQ-VAS 评分显著提高,收缩压、BMI 和 HDL 胆固醇比值显著降低。随访时 NHS 服务使用成本显著降低;每名患者平均减少 236.43 英镑(±SD 968.47 英镑)。提供服务的每名患者的平均成本为 203.10 英镑,因此每名患者可节省 33.33 英镑(SD ± 874.65 英镑)。问卷调查的回复者报告对该服务的满意度很高。本研究表明,该服务可被患者接受,并且可能会改善健康结果,并允许适度的成本节约。研究的局限性包括患者问卷的回复率较低。