The pharmacy care plan service: Evaluation and estimate of cost-effectiveness

Twigg, Michael J.; Wright, David; Barton, Garry; Kirkdale, Charlotte L.; Thornley, Tracey

Abstract

Background: The UK Community Pharmacy Future group developed the Pharmacy Care Plan (PCP) service with a focus on patient activation, goal setting and therapy management.

Objective: To estimate the effectiveness and cost-effectiveness of the PCP service from a health services perspective.

Methods: Patients over 50 years of age prescribed one or more medicines including at least one for cardiovascular disease or diabetes were eligible. Medication review and person-centred consultation resulted in agreed health goals and actions towards achieving them. Clinical, process and cost-effectiveness data were collected at baseline and 12-months between February 2015 and June 2016. Mean differences are reported for clinical and process measures. Costs (NHS) and quality-adjusted life year scores were estimated and compared for 12 months pre- and post-baseline.

Results: Seven hundred patients attended the initial consultation and 54% had a complete set of data obtained. There was a significant improvement in patient activation score (mean difference 5.39; 95% CI 3.9–6.9; p < 0.001), systolic (mean difference −2.90 mmHg; 95% CI -4.7 to −1; p = 0.002) and diastolic blood pressure (mean difference −1.81 mmHg; 95% CI -2.8 to −0.8; p < 0.001), adherence (mean difference 0.26; 95% CI 0.1–0.4; p < 0.001) and quality of life (mean difference 0.029; 95% CI 0.015–0.044; p < 0.001). HDL cholesterol reduced significantly and QRisk2 scores increased significantly over the course of the 12 months. The mean incremental cost associated with the intervention was estimated to be £202.91 (95% CI 58.26 to £346.41) and the incremental QALY gain was 0.024 (95% CI 0.014 to 0.034), giving an incremental cost per QALY of £8495.

Conclusions: Enrolment in the PCP service was generally associated with an improvement over 12 months in key clinical and process metrics. Results also suggest that the service would be cost-effective to the health system even when using worst case assumptions.

Citation

Twigg, M. J., Wright, D., Barton, G., Kirkdale, C. L., & Thornley, T. (2019). The pharmacy care plan service: Evaluation and estimate of cost-effectiveness. Research in Social and Administrative Pharmacy, 15(1), 84-92. https://doi.org/10.1016/j.sapharm.2018.03.062

• Journal Article Type: Article
• Online Publication Date: Dec 10, 2018
• Publication Date: Jan 1, 2019
• Deposit Date: Jan 14, 2023
• Publicly Available Date: Jan 17, 2023
• Print ISSN: 1551-7411
• Electronic ISSN: 1934-8150
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 15
• Issue: 1
• Pages: 84-92
• DOI: https://doi.org/10.1016/j.sapharm.2018.03.062
• Public URL: https://nottingham-repository.worktribe.com/output/15939809
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S1551741117308380?via%3Dihub