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Lloyds boosts adherence with 'clinical contact centre'

The clinical contact centre pharmacists: Sukhvinder Sandhu, Ikhlaq Hussain, Radu Juverdeanu
The clinical contact centre pharmacists: Sukhvinder Sandhu, Ikhlaq Hussain, Radu Juverdeanu

Installing three Lloydspharmacists in a "clinical contact centre" to provide "virtual" support to diabetes patients saw medicines adherence improve by "up to 61%", Celesio UK has said.

A diabetes pilot – which ran from October 2016 to April 2017 – saw three pharmacists placed in Celesio’s new contact centre in Coventry, Lloydspharmacy's parent company explained.

A total of 225 patients with type 2 diabetes, who tend to have “really poor adherence”, were chosen, the pilot's design manager Laura Southall told C+D last month (June 21).

During the pilot, the contact centre pharmacists phoned patients for up to 45 minutes at a time and sent "motivational" texts designed to encourage adherence (see examples below).

"It wasn't just a reminder to take your medicine," Ms Southall said. Instead, the messages were designed to encourage "behaviour change" when it comes to diabetes management.

The regularity of calls and texts depended on whether the patient was deemed at high, medium or low risk of non-adherence, she added.

One conversation was not sufficient to improve adherence, Ms Southall stressed. "It had to be a follow-up in an ongoing effort over that period of six months to make a change."

The pharmacists received "extensive training in motivational interviewing", so that "they have strategies to be able to change patient behaviour", she said.

The programme received "such good engagement from the patients" because "the content was being personalised for them", Ms Southall said.

61% adherence boost

The 74 patients identified as having the worst adherence saw an improvement of 61%, while the 38 patients in the 'medium' risk group saw an improvement of 28%, Celesio UK reported.

The improvements in adherence would have a positive impact on patients’ glucose control and prevention of hypoglycaemic attacks, as well reducing pressures on A&E, she said.

The method “could be replicated” across community pharmacy, Ms Southall said, “as we move away from transactional to a more service-led focus”.

“It would require time from the pharmacist in the consultation room, but there's no reason why they couldn't do it," she added.

Example texts from pharmacists to patients

Pharmacists in the clinical contact centre had a bank of 19 messages they could send to diabetes patients, to choose from depending on each patient’s circumstances. See two examples below:

For a patient with “therapy burden” issues:

"Hi, Lloydspharmacy here. Some diabetes patients tell us they fear they might be taking too many medicines. If this is you, talk to your doctor, or feel free to visit us at your local Lloydspharmacy! We’ll be happy to explain to you the purpose of each medicine, and help you work out a strategy to stay on top of what to take when and how."

For a patient held back by “perceived efficacy”:

"Hi, Lloydspharmacy here. You have been diagnosed with type 2 diabetes that means there is too much sugar in your blood. Since diabetes can be a "silent" disease without noticeable symptoms at first, any steps you take to lower your blood sugar might not make you feel different in the beginning. Even so, it is very important that you take your medications exactly the way your doctor prescribed for you, so that they can work properly."

Source: Celesio UK

How do you improve adherence among your patients?

John Cleese, Production & Technical

What a bunch of ruddy moaners. Very well done to Lloyds (hate "Lloydspharmacy...") for taking the initiative here. If you keep clinging on to the old ways of doing things, and moaning at people trying to change things for the better, you're ultimately doomed.

Pharmacist Pharmacist, Community pharmacist

Many flaws in this research. Biased. How can the patient responses be verified? Were they telling the truth? Lloyds just wishing to increase their profile

Ilove Pharmacy, Non Pharmacist Branch Manager

Adherence to drugs you'll never come off and some of which make you worse. Listen to a Pharma rep tell you what you all know already but want to keep out the public domain as much as possible.

Valentine Trodd, Community pharmacist

This doesn't sound very scientific, does it? It sounds more like a publicity stunt. Has this 'research' been published in any peer-reviewed journals? How exactly did they measure non-compliance? What kind of ongoing support, if any, has been put in place for these non-compliant patients? One would assume they will just regress. What kind of nonsense is it to suggest this exercise can be replicated across the country? There's no funding in place and no independent assessment of any claimed positive outcomes. More free services! This is the last thing we should be doing. Well done Loyds... great publicity stunt!

Pharmacist Pharmacist, Community pharmacist

I agree with all your comments 100%!

Freelance Chemist, Pre-reg Pharmacist

biased research

Ari Butt, Community pharmacist

Excellent work by Lloydspharmacy ! 

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