Table 3.
Reference and Country | Type of Pharmacist Health Coaching | No. of Sessions | Duration of Session | Training Provided to Health Coaches | Population Being Coached | Outcomes | Cost-Effectiveness Measured | Positives to the Health Coaching Technique | Negatives to the Health Coaching Technique |
---|---|---|---|---|---|---|---|---|---|
MacLean, White, Broughton, Robinson, Shultz, Weeks, Willson23 United States |
Telephone | Weekly | ~10–20 minutes | Trained in motivational interviewing and problem solving. | Diabetes | For participants with HbA1c levels > 7.0% before coaching, the pre to post-test change in HbA1c was 0.5% for control subjects and 1.3% for coaching subjects. 79.2% of coaching participants stated their coach helped better control their diabetes. 50.1% of coaching group participants expressed interest in receiving further coaching. |
Paper concludes that student pharmacist health coaching is a low-cost method to improve self-management of diabetes, but does not actually measure cost effectiveness. | The service is sustainable using students as coaches Improves patient care while providing a teaching environment for students. It provides social affiliation and support for patients, which is valuable for patients living in rural areas. |
Although improvement in patient outcomes were observed at end of study (8 weeks), long term clinical impacts of telephone coaching is unknown. Participants initially wanted to achieve goals for coach. |
Fera, Bluml, Ellis26 United States |
Face-to-face | µ=6 | µ=51 min | Pharmacists required to complete an approved diabetes training program. | Diabetes | Improvements in clinical outcomes. | Yes Average total care costs per patient reduced. |
Employer funded. Involved face-to-face sessions at various sites allowing flexibility in patient care, Done privately. Direct assessment of clinical outcomes. |
Sessions were long. Time-consuming. May require re-engineering of the pharmacy site in order to offer service. |
Luder, Frede, Kirby, King, Heaton34 United States |
Face to face | Monthly for uncontrolled patients Annually for controlled patients |
No mention | No mention | Patients taking at least one medication for diabetes/hypertension. | Patients with controlled conditions had more confidence Patients with uncontrolled conditions had more barriers to managing their health. African American patients had more confidence (4.44) in performing health behaviours than white patients (4.21) p-value 0.28. Patients with uncontrolled conditions were more likely (3.47) to enrol when financial incentives were offered compared to the controlled group (3.23. p-value 0.261). |
No | Employer funded. Patients received financial incentives for participation. |
Patients may have tried to please the coach and responded more favourable to questions. |
Barnett, Flora37 United Kingdom |
Face-to-face | 1 | No mention | Two-day training course delivered by a health psychologist. | All hospital pharmacy patients. | Patients were happy with the consultation. | No | Service provided in hospital pharmacy. Patients coached depending on receptivity to the service. Not a one size fits all approach. |
Lack of privacy during service provision. |
Wertz, Hou, DeVries, Dupclay, McGowan, Malinowski, Cziraky36 United States |
Face-to-Face | µ= 8.1 ± 5.2 | No mention | No mention. | Diabetes/hypertension. | Patients more likely to have additions or changes to their medications. Reductions in blood pressure, lipid levels and HbA1c levels. |
Costs related to hypertension and diabetes were increased. | Employer-sponsored service. Patients received financial incentives for participation. Direct assessment of clinical outcomes. |
Short term increase in costs at the initiation of the service. |
Brook, Van Hout, Nieuwenhuyse, Heerdink24 Denmark |
Face-to-face and take home video | 3 | No mention | Nil. States pharmacists already have the communication skills to health coach. |
Newly diagnosed patients starting on a non-tricyclic antidepressant for the first time. | Improvement in drug attitude inventory (DAI) score. | Cost-effectiveness studies were not performed. Though reports that similar interventions can have significant changes in patient’s drugs which saves more than the cost of the intervention. | Pharmacists were capable of coaching patient’s alongside conventional duties. | Coaching may impact daily routine of the pharmacy. The pharmacist’s busy schedule may make it difficult to make follow-up appointments. The pharmacy setting may hamper confidential conversations. |
Akers, Meer, Kintner, Shields, Dillon-Sumner, Bacci31 United States |
Home visits and telephone | Variable- depended on the mode of referral | M =1.5 hours | No mention | Depended on the mode of referral | Pharmacists identified more drug therapy related problems. | No | Health coaches were reimbursed by community-based organisations. Pharmacist coaches provided high level care outside the traditional pharmacy setting. |
Access to patient history required prior to home visit. Requires travel of the coach to patient’s home. Travel costs will be incurred. Requires laptop, tablets and/or wireless internet connection. |
Engelhard, Lonneman, Warner, Brown44 United States |
Face-to-face and telephone | Variable | No mention | Two-hour online training including motivational interviewing techniques as well as disease state-specific training. | Diabetes | Coaches helped patients reach their goals and patients would recommend the service to their friends/family. | Cost-effectiveness studies not performed Health coaching with pre-med students showed that support to high-risk patients helped to reduce overall health care costs. |
Student coaches learned how to provide support to those managing chronic illnesses. | Training is not generalizable to a broader audience and has not been accredited by an outside body. Coaches and patients felt pressured to please each other. |
Bosmans, Brook, Van Hout, De Bruijne, Nieuwenhuyse, Bouter, Stalman, Van Tulder39 Netherlands |
Face to Face and take home video | 3 | µ= 13 and 20 minutes | No mention | Newly diagnosed patients starting on a non-tricyclic antidepressant for the first time | No significant difference in adherence to antidepressant medication. | The costs in the intervention group were higher. | The intervention was easy to implement. | Coaching may impact the daily routine of the pharmacy. The pharmacist’s busy schedule may make it difficult to make follow-up appointments. The pharmacy setting may hamper confidential conversations. |
Brook, Van Hout, Nieuwenhuysea, De Haan18 Denmark |
Face to Face and take home video | 3 | No mention | Pharmacists already have the communication skills to health coach. | Newly diagnosed patients starting on a non-tricyclic antidepressant for the first time. | Coaching was more effective in patients with lower education levels. | No mention | Pharmacists were capable of coaching patient’s alongside conventional duties. | Coaching may impact the daily routine of the pharmacy. The pharmacist’s busy schedule may make it difficult to make follow-up appointments. The pharmacy setting may hamper confidential conversations. |
Pounds, Offurum, Moultry45 United States |
Face to face, email, texts, and telephone phone calls. | Weekly sessions with student pharmacists | 1 hour | Six hours of training- motivational interviewing techniques as well as disease state-specific training. | Hypertension | Students were confident in their ability to perform coaching (85%), though did not feel comfortable about educating patients about hypertension (86%). | No mention | Students were able to confidently coach patients. | Students may need additional training to prepare them for challenges associated with engaging individuals about making changes to their health. |
Wennberg, Marr, Lang, O’Malley, Bennett38 United States |
Telephone coaching supplemented with web-links, video and print materials. | Variable; 5 sessions for patients in the enhanced support group and 3 sessions for those in the usual support group. | No mention | States training provided. No details on specifics. | Various medical conditions. | The average monthly medical costs was lower in patients in the enhanced support group. | The average monthly medical costs was lower in patients in the enhanced support group. The reduction in costs was mainly attributed to a reduction in annual hospital admissions. |
The telephone sessions were supplemented with additional modes of delivery according to patient needs. | The patient’s required health insurance in order to receive the service. |