Supporting patients with long-term conditions in the community: Evaluation of the Greater Manchester Community Pharmacy Care Plan Service.
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.
['Seston|Elizabeth M|EM|0000-0002-6672-8622', 'Magola|Esnath|E|0000-0002-0584-2798', 'Bower|Peter|P|0000-0001-9558-3349', 'Chen|Li-Chia|LC|0000-0002-6158-6645', 'Jacobs|Sally|S|0000-0002-6199-5748', 'Lewis|Penny J|PJ|0000-0002-3976-5807', 'Steinke|Douglas|D|0000-0001-8917-2674', 'Willis|Sarah C|SC|0000-0002-0368-0684', 'Schafheutle|Ellen I|EI|0000-0001-7072-0888']
D000368:Aged D001794:Blood Pressure D015992:Body Mass Index D002908:Chronic Disease D003157:Community Pharmacy Services D004739:England D005260:Female D005102:Health Expenditures D006295:Health Resources D006801:Humans D008055:Lipids D008297:Male D055118:Medication Adherence D008875:Middle Aged D010358:Patient Participation D017060:Patient Satisfaction D011788:Quality of Life D000073278:Self-Management D013222:State Medicine D011795:Surveys and Questionnaires
community pharmacy patient activation care planning and management chronic/long-term conditions pharmacy practice research