No conclusive evidence for SAPs
There is no conclusive evidence that patients who self administer their drugs during a hospital stay have improved compliance, or make fewer errors when taking their medicines after discharge, according to Julia Wright, head of clinical pharmacy at Southampton University Hospitals NHS Trust. However, having self-administration programmes (SAPs) in place is included as an indicator in the recent Healthcare Commissions' medicines management review.
Presenting the research to participants at the United Kingdom Clinical
Pharmacy Association’s autumn symposium held last weekend in Leicestershire,
Mrs Wright explained that she and colleagues had undertaken a full retrospective
review of 51 research papers. These were chosen on the basis that they
described the SAP involved and evaluated it objectively. Patient compliance
was assessed in 12 papers, with statistical evaluation being carried
out in seven. Of these, four found improved compliance scores in the
patient group participating in SAPs, compared with a control group, but
three showed there to be no significant difference. Only two papers statistically
evaluated the effect of SAPs on medication errors after discharge, with
one of them showing a beneficial effect. Both the papers that statistically
evaluated patient satisfaction found that patients who had experienced
an SAP would choose to participate again.
Mrs Wright commented that most of the papers reviewed contained methodological
flaws and that it is difficult to know whether the benefits attributed
to SAPs would also have been realised just from teaching patients about
their drugs. Moreover, none of the papers statistically evaluated the
effect of SAPs on nursing and pharmacy staff time and so it is unclear
whether the benefits of SAPs are greater than the resources required
to implement and maintain them. |
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