|PPSs components||Health outcomes|
 Al Hamarneh|
|Assessment of patient’s therapies and laboratory results, individualized CV risk assessment, adjustment of treatment regimen, prescribing and ordering laboratory tests to meet treatment targets, and self-report of adverse events. Regular communication after each contact with the patients and regular follow-up visits every 4 weeks for 3 months.||Improvement of: CV risk (absolute reduction 5.38%; 95%CI, 4.24–6.52; P < 0.001), (HbA1c (0.9%; 95%CI, 0.70–1.10; P < 0.001), systolic blood pressure (8.6 mmHg; 95%CI, 6.70–10.40; P < 0.001), diastolic blood pressure (2.7 mmHg; 95%CI, 1.30–4.10; P < 0.001), LDL-cholesterol, (0.2 mmol/L; 95%CI, 0.10–0.30; P = 0.004) and Tobacco use (24.2% P < 0.001).|
Brief health education tips. Inhalation technical instruction.|
Letter written to the doctor for the action plan. Asthma control and spirometry performed at every visit measured using questionnaires and spirometers.
|Improvement of: percentage of patients achieving a good/fair control in both groups 4-visit service: from 21 to 59%; 3-visit service: from 29 to 61% (mean = 0.57 for the three-visit group, 0.56 for the four-visit group, P < .001). Improvement of the health-related quality of life (Three visit 4.13 ± 1.41 to 3.39 ± 1.19; P < .001- versus Four-visit 4.45 ± 1.49 to 3.57 ± 1.48; P < .001). No significant differences of asthma control between patients receiving 4 visits compared to patients receiving 3 visits.|
|Pharmacist – led behavioural counselling combined with nicotine replacement therapy (NRT). 1 (Group B) to 3 (Group A) face-to-face sessions for behaviour change to quit smoking. On-line control surveys at 7 days, and 5 and 12 weeks. Phone calls to those who did not attend the visits or respond.||There were statistically significant differences between each of the two groups receiving the service and the group of patients that only received NTR by mail (control group) 3-session service (× 2 = 217.30, P < 0.001; ITT: × 2 = 149.60, P < 0.001); 1-session service (× 2 = 93.90, P < 0.001; ITT: × 2 = 19.00, P < 0.001).|
|Pharmacist and GP service offering to the patient. The pharmacist asks about adherence and medicines. One-to-one consultation 7–14 days after the presentation of the prescription with a ‘follow-up’ of 14–21 days via telephone.||Improvement of the percentage of adherent patients 1.67 (95%CI, 1.06–2.62; P = 0.027). Non-significant reductions of health system costs (£21; 95%CI, £59 - £150; P = 0.1281).|
|Pharmaceutical care Process (PCP) in cooperation between patient’s pharmacist and GP, and agreed to by the patient: (1) assessment of potential DRPs and pharmaceutical care issues (PCIs), (2) proposal of interventions to reach treatment goals, and (3) implementation of the interventions. Two measurements were performed, (t = 0) at the beginning and (t = 1) after 1-year follow up.||Decrease of diastolic BP (95%CI, 79.80–76.80 mmHg; P = 0.008) and increase of HDL-cholesterol: IG (IG: 95%CI, 1.29–1.37 mmol/L; P = 0.021; IG patients not receiving the whole service: 95%CI, 1.26–1.37 mmol/L; P = 0.039); and GC: (95%CI, 1.30–1.36 mmol/L; P = 0.074). Non-significant decrease of LDL-cholesterol: IG (IG: 95%CI, 2.72–2.63 mmol/L; P = 0.337; IG patients not receiving the whole service: 95%CI, 2.98–2.67 mmol/L; P = 0.740); and CG: (95%CI, 2.61–2.58 mmol/L; P = 0.032).|
1-h face to face interview on a monthly basis (IG) and 30 min face to face interview at 3- month intervals (CG).|
IG: 1) Provision of written patient education materials. 2) Diabetes education, coaching on self-management skills and medication adherence. 3) Assessment of medications and DRP. 4) Contact with GP via fax or telephone to recommend treatment adjustments.
|Improvement of the percentage of patients achieving the control of their health problem: HbA1c (IG: 46.70% vs. CG: 9.10%, P < 0.002), blood pressure (IG: 53.30% vs. CG: 22.70%, P < 0.020). Non-statistically significant higher percentage of patients achieving the LDL target levels (IG: 50.00% vs. CG: 46.70%, P = 0.460).|
Dispensing/ Adherence service
|First visit: educational intervention centred on improving patients’ knowledge of antidepressants and awareness of the importance of adherence and quality of life. Subsequent visits: short review of some points covered in the first visit and checking of patient progress.||Improvement of the health-related quality of life (0.25 vs. 0.14) - effect size 0.31 vs 0.33 -. No statistically significant differences in adherence, satisfaction or clinical severity depression.|
Home BP monitor. Training on BP self-monitoring (3–6-month follow-ups). Motivational interviewing and education to medication adherence. Medication use review. Referral to a GP|
Prescription refill reminders.
|Improvement of the proportion of adherent patients although there were not significant differences between groups (57.2 to 63.6% CG vs 60.0 to 73.5% IG, P = 0.23). Reduction of systolic BP was significantly greater in the IG (7.2 mmHg 95%CI 1.6 12.8 mmHg; P = 0.001). Reductions in BP of 10.00 mmHg (IG) vs. 4.60 mmHg (CG); P = 0.050. Improvement of percentage of non-adherent patients becoming adherent 22.60% (95%CI, 5.10–40.00%) in the IG compared to CG (IG: 61.80% vs. CG: 39.20%; P = 0.007).|
Educational intervention (two sessions of 15–25 min).|
Electronically recorded medication, inhalation technique and questionnaires about behavioural issues, etc.
Letter to the patient’s GP.
|Significantly lower estimated annual severe exacerbation rate in the IG compared with the CG (0.27 (IG) vs. 0.61 (IC): RR = 0.45; 95%CI, 0.25–0.80; P < 0.007). Also, significantly 72% lower estimated annual hospitalization rate in IG vs CG (0.10 vs. 0.40; RR = 0.28; 95% CI, 0.12–0.64; P = 0.003) and a statistically significant 73% lower rate of hospitalization days (0.87 vs. 3.51; RR, 0.27; 95%CI, 0.21–0.35; P < 0.0001).|
Assessment of BP and cardiovascular risk. Education on arterial hypertension. Prescribing of antihypertensive medications.|
Laboratory monitoring and monthly follow-up visits for 6 months. Provision of a wallet card for BP recording.
|Greater reduction of systolic BP in the IG of 6.60 (1.90) mmHg (P = 0.0006) and proportion of patients achieving target BP 58% (IG) vs. 37% (CG), P = 0.020); OR = 2.32 (95%CI, 1.17–4.15).|
|First visit: a patient interview for gathering information (health problems, preferences, and all medications used). Identify potential DRPs and propose recommendations to solve them. Subsequent visits: face-to-face meeting with the patient’s GP to discuss all health-related goals and DRPs. Two follow up appointments.||Improvement of the health-related quality of life: 3 months 1.70 points (95% CI, 0.47–2.90; P = 0.006) and 6 months 3.40 points (95% CI, 0.94–5.80; P = 0.006).|
Home episodic skilled nursing care. Medication information was faxed from nurse to the provider. Initial phone call by a pharmacy technician to verify active drugs. Pharmacist-provided telephone MTM.|
Follow - up pharmacist phone calls at 7-day and as needed for 30 day of the 60-day home health care episodes.
|Significant less probability of hospital readmission in patients with a low baseline risk (adjusted OR: 3.79; 95%CI, 1.35–10.57; P = 0.01). No significant differences in the 60- day probability of hospitalizations adjusted OR: 1.26; (95%CI, 0.89–1.77; P = 0.190).|