Medication management services (MMS) is a pharmacist-led service of optimizing the medication use and health outcomes, by promoting medication safety and enhancing the ability in self-management of health and diseases of patients and their caregivers. Yet, only limited evidence on the implementation of MMS service in Hong Kong is available. The goal of this clinical trial is to evaluate the cost effectiveness and effects of implementing MMS in community pharmacies owned by 8 non-government organizations (NGOs) in Hong Kong on humanistic and clinical outcomes in patients with hypertension and/or type II diabetes mellitus. The clinical trial aims to look into the following aspects:
* To evaluate the perception and satisfaction of patients on MMS service * To investigate whether MMS could improve patients' adherence to their medication regimen, health-related quality of life, health outcomes and health service utilization, as well as their ability to understand and cope with their illness and drug-related problems * To identify and categorize the types of drug-related problems identified during MMS * To evaluate the cost-effectiveness of implementing MMS in community pharmacies
MMS services will be rolled out in a total of 8 NGO community pharmacies progressively (2 pharmacies per phase) in 4 successive phases. Participants will complete the questionnaires at the following time points throughout the trial, namely 1) during recruitment, 2) baseline (1 month before MMS), 3) 3 months after MMS begins, 4) 12 months after MMS begins, and 5) 24 months after MMS begins. Researchers will compare the results of questionnaires conducted at different time points to identify the potential changes in the effects of MMS. Furthermore, researchers will link up the electronic health records of the participants and identify the potential changes in the health outcomes and health service utilizations after receiving MMS.
aged 18 years or above
diagnosed with Type 2 diabetes mellitus and/or hypertension
having regular follow-up on Type 2 diabetes mellitus and/or hypertension at Hospital Authority
no A&E admission/hospitalization in the past 3 months
aged below 18
unable to give informed consent
unable to communicate in Cantonese and/or English
Parallel
Medication Management Service (MMS)
BehavioralMedication Management Service (MMS) is a service delivered by community pharmacists aiming at helping patients resolve their medication therapy problems (MTPs) by carrying out medication reconciliation, provision of education about their medication regimen, and also providing professional pharmacological advice to patients.
Medication adherence
Medication adherence will be assessed by the Medication Adherence Report Scale (MARS-5) which consists of a total of 5 items and is used to assess patient's adherence to their medications. Participants rate items on a 5-point scale. The score range for MARS-5 is 5-25, higher score indicates better adherence to take medications.
Additional health service utilization
Changes in health service utilization (e.g. A\&E admission, hospitalization) before and after receiving medication management service will be assessed using record linkage to the electronic health records from the Hospital Authority.
Patient perception and satisfaction
Patient perception and satisfaction will be assessed by the Pharmacy Services Questionnaire (PSQ). The PSQ consists of 20 items and will be rated by participants on a 5-point scale. (5-Excellent, 4- Very good, 3-Good, 2-Fair and 1-Poor). The maximum score is 100 and the minimum score is 20. Higher scores indicate high levels of satisfaction.
Patient perceived sensitivity to medicines
Perceived Sensitivity to Medicines Scale (PSM-5) will be used to assess the patient's perception on their sensitivity to medicines. Patients will rate the items on a 5-point scale. (5-Strongly agree, 4- Agree, 3-Neutral, 2-Disagree and 1-Strongly disagree).The maximum score is 25 and the minimum score is 5. Higher scores indicate stronger perceived sensitivity to medicines.
Social impact
Social impact will be assessed by the Patient Enablement Index (PEI). The PEI is a 6-item questionnaire and is used to assess patient enablement. The maximum score of PEI is 12 and minimum score is 0. Higher scores indicate greater levels of enablement and a score of 0 indicates no enablement.
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The University of Hong Kong
Lead sponsor
The Hong Kong Jockey Club Charities Trust
Collaborator
Hong Kong Sheng Kung Hui Welfare Council Limited
Collaborator
Hong Kong Young Women's Christian Association
Collaborator
Haven of Hope Hospital
Collaborator
Pok Oi Hospital
Collaborator
St. James' Settlement
Collaborator
Aberdeen Kai-fong Welfare Association
Collaborator
Health In Action
Collaborator
Lok Sin Tong Benevolent Society, Kowloon
Collaborator
