Evaluation of the Diabetes Pilot Program

Project Type - Program evaluation and review

Description

The Department of Health and Ageing (the Department) engaged Health Outcomes International (HOI) to undertake an evaluation of the Diabetes Pilot Program which involved the delivery of a Diabetes Medication Assistance Service by credentialed community pharmacists. The Diabetes Pilot Program was funded under the Fourth Community Pharmacy Agreement (Fourth Agreement) between the Department and the Pharmacy Guild of Australia (the Guild) to be implemented by the Guild in 2 stages. HOI completed the evaluation of Stage 1 in June 2008 and will evaluate Stage 2 from July 2008 to March 2010. This document presents the Project Plan for Stage 2.

 

The over-arching objective of the evaluation was to assess the cost and affordability of the DMAS, including the financial impact on the health system.  

The evaluation also assessed whether the clinical outcomes achieved through the PDCP under the Third Agreement’s Research and Development Program could be replicated when implementing the DMAS in a broader community pharmacy setting. There were three perspectives from which the project was evaluated:

  • participating pharmacies and other health professionals
  • people with type-2 diabetes participating in the program
  • the broader health system.

 

To address the objectives of the evaluation, process, impact and economic evaluation approaches were used.

 

The primary methodological components of this Review included:

  • HOI developed a web-based database for the on-line reporting of information by pharmacists on a quarterly basis. This data includes implementation processes, (limited to throughput and activity levels), program costs and impacts. To avoid an excessive reporting impost on pharmacies, some information was requested only once (at 6 months) or twice (at 6 months and program completion) with the remainder submitted on a quarterly basis.
  • A patient survey was developed for administration at the sampled patients’ first and last visits to the pharmacist in the DMAS. The survey sought patients’ perspectives on their participation in the program (including their willingness to pay for the service) and the extent to which they (a) reported an improvement in health and (b) attributed it to their participation in the DMAS. 
  • Case studies were conducted among a sample of 20 participating pharmacies to further investigate particular trends in the data associated with issues such as:
    • the geographic location of the pharmacy
    • patient recruitment and withdrawal patterns
    • patient clinical impact (or lack thereof)
    • program costs
    • other trends identified through the analysis of evaluation data.

In line with the overarching objective of this Review, HOI produced a comprehensive and evidence based final Review report providing an assessment of:

  • the impact on pharmacies including but not limited to:
    • Registration and training
    • Participation by pharmacists and patients
    • Factors contributing to Patients not participating
    • Operational aspects of DMAS
  • the impact on patients
  • economic impacts on patients, pharmacies and the health system