+ Patient helplines research: an update June 2015 Diane Bramley Research Lead – London & SE England Alison Innes Research Lead – London (NPH)

+ Patient Helpline research projects: an update Small study of telephone interviews with 38 patients (2011) 87% found advice helpful 84% followed advice 26% directly led to improved health 29% avoided potentially harmful situation 82% reassured by advice Patients did not have the clinical knowledge/experience required to assess outcomes / risks

+ Patient Helpline research projects: an update (continued) Follow-on study involving questionnaires to 67 patients (2012) & expert panel 93% followed advice 72% found advice very useful & it solved their problem 16% found advice quite useful & it partly solved their problem 80% reassured by advice Limitations Full impact not captured by rating scale No benefits on adherence reported / captured

+ Patient Helpline research projects: next steps AdherenceRating scale Develop questionnaires More specific questions about impact of MI advice on medicines adherence Develop rating scale with descriptors that apply to patient helpline enquiries Studies to measure patients’ self- reported adherence Incorporate impact on adherence into rating scales

+ Patient Helpline research projects: an update (continued) Two studies to assess impact on adherence involving questionnaires to 17 & 66 patients (2013/4) % reported always taking their medicines before contacting the helpline Concerns that led to them contacting the helpline are known risk- factors for non-adherence (some already non-adherent) Advice from helpline improved risk factors for non-adherence: Reassured Improved confidence with medicines More likely to take regularly Less like to miss doses Taking more suitable medicines Improved medicines administration Further follow-up study to be completed

+ How can impact rating improve our services to benefit patients? Useful tool to measure of impact of MI services on patient care & safety used to demonstrate value of clinical pharmacy services developed and used in research into impact of MI Vision To shift focus further towards improving patient care, outcomes & safety -> -> more patient-centred advice Tool to help improve quality of enquiry answering Helps identify enquiries where we can have an impact & how we can maximise impact Can help to focus on where we can improve our advice Can help to promote service so more patients benefit

+ Impact rating scales: development & further validation Development additional examples added Validation study (2014/15) 12 MI pharmacists & 2 investigators rating and re-rating a sample

+ Impact Rating Scales: implementation Implementation in London (NPH) Peer Review Internal QA (region & some local centres) Regional audits of local centres Future developments incorporation in new national MI QA processes

+ Internal QA Practicalities Easy to use peer review team exercise to ensure consistent rating Reports Report number & % in each impact category Advantages Changed focus -> more patient-focussed Follow-up more important Negative impacts –> IRMIS &/or DATIX Caveats Impact depends on the types of enquiries & enquirers using an MI service

+ Patient Helpline research around the UK Wessex Scotland (discussed at 1 st R&D Group research surgery Nov 2014)

+ Impact rating workshop