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Whilst reducing cardiovascular disease risk was the focus through intensive behaviour change sessions, importantly holistic support was also provided (seeing the patient as a whole person), so the service also included things like signposting to additional services if needed, such as to help with financial worries for example.
This all sounds great, but the key question was: does Primrose work?
To try to answer this question, the researchers compared Primrose to the care patients would normally get when they had high cardiovascular risk and severe mental illness across 76 GP practices in England. Patients would usually be provided with leaflets made by the British Heart Foundation. This was done in a way that was rigorous – a national randomised control trial - where half the GP practices provided patients with Primrose, and half provided patients with care as usual.
The headline findings: people saw the need for Primrose and therefore healthcare staff were engaged, sessions well attended, and patients liked it. Importantly, patients who were supported through Primrose were less likely to be admitted to inpatient hospital care, which may indicate that these patients were staying well or making better use of other support. Researchers found that building positive relationships between patients and staff, involving supportive others, and using what was already available to patients to help them reach their goals supported engagement and success with Primrose. Plus, when looking at how much care costed, Primrose was estimated to save the NHS £895 per patient per year through mental health costs compared to if they received usual care.