Supporting patients with long-term conditions in the community: Evaluation of the Greater Manchester Community Pharmacy Care Plan Service

Health Soc Care Community. 2020 Sep;28(5):1671-1687. doi: 10.1111/hsc.12992. Epub 2020 Apr 14.

Abstract

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.

Keywords: care planning and management; chronic/long-term conditions; community pharmacy; patient activation; pharmacy practice research.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Blood Pressure
  • Body Mass Index
  • Chronic Disease / economics
  • Chronic Disease / therapy*
  • Community Pharmacy Services / economics
  • Community Pharmacy Services / organization & administration*
  • England
  • Female
  • Health Expenditures / statistics & numerical data
  • Health Resources / statistics & numerical data*
  • Humans
  • Lipids / blood
  • Male
  • Medication Adherence
  • Middle Aged
  • Patient Participation / psychology
  • Patient Satisfaction
  • Quality of Life
  • Self-Management / economics
  • Self-Management / methods*
  • State Medicine
  • Surveys and Questionnaires

Substances

  • Lipids