Maintaining Adherence Programme: evaluation of an innovative service model

Abstract

Aims and method The Maintaining Adherence Programme (MAP) is a new model of care for patients with schizophrenia, schizoaffective disorder and bipolar affective disorder which aims to encourage adherence and prevent relapse. This evaluation, conducted by retrospective and prospective data collection (including patient questionnaires and staff interviews), aimed to describe MAP's impact on healthcare resource use, clinical measures and patient and staff satisfaction, following its implementation in a university National Health Service (NHS) foundation trust in England. We included 143 consenting patients who entered MAP before 31 March 2012.Results In-patient bed days and non-MAP NHS costs reduced significantly in the 18 months post-MAP entry. At 15–18 months post-MAP, Medication Adherence Rating Scale scores had improved significantly from baseline and there was a shift towards less severe clinician-rated disease categories. Based on patient surveys, 96% would recommend MAP to friends, and staff were also overwhelmingly positive about the service.Clinical implications MAP was associated with reduced cost of treatment, improvements in clinical outcomes and very high patient and staff satisfaction.

An intensive multimodal group programme for patients with psychotic disorders at risk of rehospitalization: a controlled intervention study

“…Comparison of our study with the studies in Germany and England [10, 12] reveals similarities and differences regarding the programmes themselves and their study designs. First, the content of each programme was very similar, focusing on psychoeducation on the psychiatric condition, and also on adherence and preventing rehospitalization.…”

“…This German programme was also adopted and implemented in England as the Maintaining Adherence Programme, where, in a pre-post design, it significantly reduced in-patient bed days by 42% in the intention-to-treat analysis and by 51% reduction in the completer analysis [12]. The same study also showed a significant cost reduction and very high patient and staff satisfaction.…”

What is the impact of healthcare innovation on measurable outcomes of healthcare organisation performance? A systematic review

“…New practices were described by 20 (28.6%) of the included studies, consisting of disease management programmes (eg, heart failure disease management programme38, maintaining adherence programme for patients with schizophrenia39), introduction of additional assessments (eg, comprehensive geriatric screening in the emergency department40 41) and the use of novel forms (eg, inpatient order set for therapeutic-dose dalteparin,42 Physician Orders for Life-Sustaining Treatment (POLST) form43).…”