OBJECTIVES: To compare the cost-effectiveness of a pharmacotherapy follow-up for elderly nursing home (NH) residents with that of usual care. DESIGN: Prospective observational study with a concurrent control group conducted over 12 months. SETTING: Fifteen NHs in Andalusia assigned to control (n = 6) or intervention (n = 9). PARTICIPANTS: Residents aged 65 and older. INTERVENTION: Pharmacotherapy follow-up. MEASUREMENTS: Negative outcomes associated with medication, health-related quality of life, cost, quality-adjusted life-year (QALY), and incremental cost-effectiveness ratio (ICER). ICERs were estimated for three scenarios: unadjusted cost per QALY (first scenario), costs adjusted for baseline prescribed medication and QALYs adjusted for baseline utility score (second scenario), and costs and QALYs adjusted for a fuller set of baseline characteristics (third scenario). RESULTS: Three hundred thirty-two elderly residents were enrolled: 122 in the control group and 210 in the intervention group. The general practitioner accepted 88.7% (274/309) of pharmacist recommendations. Pharmacist interventions reduced the average number of prescribed medication by 0.47 drugs (P < .001), whereas the average prescribed medication increased by 0.94 drugs in the control group (P < .001). Both groups reported a lower average EuroQol-5D utility score after 12 months (intervention, -0.0576, P = .002; control, -0.0999, P = .003). For the first scenario, usual care dominated pharmacotherapy follow-up (was less effective and more expensive). Adjusted ICERs were € 3,899/QALY ($5,002/QALY) for the second scenario and € 6,574/QALY ($8,433/QALY) for the third scenario. For a willingness to pay of € 30,000/QALY ($38,487/QALY), the probabilities of the pharmacotherapy follow-up being cost-effective were 35% for the first scenario, 78% for the second, and 76% for the third. CONCLUSION: Pharmacotherapy follow-up is considered cost-effective for elderly NH residents in Spain.
OBJECTIVES: To compare the cost-effectiveness of a pharmacotherapy follow-up for elderly nursing home (NH) residents with that of usual care. DESIGN: Prospective observational study with a concurrent control group conducted over 12 months. SETTING: Fifteen NHs in Andalusia assigned to control (n = 6) or intervention (n = 9). PARTICIPANTS: Residents aged 65 and older. INTERVENTION: Pharmacotherapy follow-up. MEASUREMENTS: Negative outcomes associated with medication, health-related quality of life, cost, quality-adjusted life-year (QALY), and incremental cost-effectiveness ratio (ICER). ICERs were estimated for three scenarios: unadjusted cost per QALY (first scenario), costs adjusted for baseline prescribed medication and QALYs adjusted for baseline utility score (second scenario), and costs and QALYs adjusted for a fuller set of baseline characteristics (third scenario). RESULTS: Three hundred thirty-two elderly residents were enrolled: 122 in the control group and 210 in the intervention group. The general practitioner accepted 88.7% (274/309) of pharmacist recommendations. Pharmacist interventions reduced the average number of prescribed medication by 0.47 drugs (P < .001), whereas the average prescribed medication increased by 0.94 drugs in the control group (P < .001). Both groups reported a lower average EuroQol-5D utility score after 12 months (intervention, -0.0576, P = .002; control, -0.0999, P = .003). For the first scenario, usual care dominated pharmacotherapy follow-up (was less effective and more expensive). Adjusted ICERs were € 3,899/QALY ($5,002/QALY) for the second scenario and € 6,574/QALY ($8,433/QALY) for the third scenario. For a willingness to pay of € 30,000/QALY ($38,487/QALY), the probabilities of the pharmacotherapy follow-up being cost-effective were 35% for the first scenario, 78% for the second, and 76% for the third. CONCLUSION: Pharmacotherapy follow-up is considered cost-effective for elderly NH residents in Spain.
Authors: Francisco Jódar-Sánchez; Amaia Malet-Larrea; José J Martín; Leticia García-Mochón; M Puerto López Del Amo; Fernando Martínez-Martínez; Miguel A Gastelurrutia-Garralda; Victoria García-Cárdenas; Daniel Sabater-Hernández; Loreto Sáez-Benito; Shalom I Benrimoj Journal: Pharmacoeconomics Date: 2015-06 Impact factor: 4.981
Authors: Arim Kwak; Yoo Jin Moon; Yun-Kyoung Song; Hwi-Yeol Yun; Kyungim Kim Journal: Int J Environ Res Public Health Date: 2019-08-16 Impact factor: 3.390
Authors: David John Wright; Vivienne Maskrey; Annie Blyth; Nigel Norris; David P Alldred; Christine M Bond; James Desborough; Carmel M Hughes; Richard Charles Holland Journal: Int J Pharm Pract Date: 2019-11-12
Authors: Raquel Varas-Doval; Miguel A Gastelurrutia; Shalom I Benrimoj; Maria Jose Zarzuelo; Victoria Garcia-Cardenas; Beatriz Perez-Escamilla; Fernando Martínez-Martínez Journal: BMJ Open Date: 2020-09-29 Impact factor: 2.692