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Expert patients programme is bringing health benefits

The expert patients programme does have concrete benefits for health and is cost-effective, a major Government-funded trial has found.

People with long-term conditions taking part in the programme have better outcomes at six months than with usual care, for less overall cost, researchers concluded.

The findings may be key to the future of the sometimes controversial programme, which is reaching the end of its pilot phase at many PCTs.

More than 500 patients took part in the randomised trial, comparing participants on the expert patients programme with usual care. There was little difference in mobility or pain between the two groups, but there were ‘noteworthy' benefits in terms of anxiety and depression and ability to self care.

The gain in quality-adjusted life-years in patients taking part in the programme was 0.02, which the researchers said equated to one extra week of perfect health per year.

Each person taking part in the expert patients programme cost the health service £27 less than those receiving usual care, making it highly likely that the programme would fall under the £20,000 cost per QALY recommended as acceptable by NICE, the researchers concluded.

Study leader Gerry Richardson, a research fellow at the Centre for Health Economics in York, said: ‘Compared with treatment as usual, this particular intervention is likely to improve patient outcome with little impact on costs, and thus provide a cost-effective use of scarce resources.'

He added although it was only possible to carry out the study for six months, a longer trial might have uncovered additional health benefits and increased the likelihood of the scheme being cost-effective.

'There's considerable potential to consider whether self-care programmes improve patients' outcomes still further,' he added.

Although expert programmes are available to anyone with a long-term illness, musculoskeletal and endocrinal conditions were those most heavily represented in the study, published in the Journal of Epidemiology and Community Health.

Dr Dermot Ryan, a GP in Loughborough, said good support for patients was likely to benefit their health: ‘Part of it will be about managing expectations – those who are realistic are likely to feel good even when things don't go completely right.

He added: ‘It's interesting that not only does it improve outcomes but there are financial benefits. It's important because GPs are criticised for not spending enough time with patients but this isn't the sort of time GPs have available.'

Dr Dermot Ryan: 'It's interesting that not only does it improve outcomes but there are financial benefits.' Dr Dermot Ryan What is the Expert Patients Programme? What is the Expert Patients Programme?

The Expert Patients Programme educates patients with chronic illness about their condition, and develops their confidence and motivation to use their own skills, information and professional services

Pilot Expert Patients Programme courses began at 26 PCTs across England in May 2002, and by May 2004 most trusts had joined the scheme or committed to do so

Each PCT hosts four pilot courses with up to 16 patients trained per course

Over 1,000 courses have been run by PCTs and voluntary sector organisations and over 13,000 people have been through the programme

PCTs now reaching end of pilot phase and deciding whether to implement Expert Patients Programmes in the long term

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