Lluís Campins1, Mateu Serra-Prat2, Elisabet Palomera3, Ignasi Bolibar4, Miquel Àngel Martínez5, Pedro Gallo6. 1. Pharmacy Department, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró (Barcelona), Spain. 2. Research Unit, Consorci Sanitari del Maresme, Mataró (Barcelona), Spain; CIBER de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain. Electronic address: mserra@csdm.cat. 3. Research Unit, Consorci Sanitari del Maresme, Mataró (Barcelona), Spain. 4. Public Health and Clinical Epidemiology Department, Institut de Recerca Biomèdica Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain. 5. Argentona Primary Care Centre, Consorci Sanitari del Maresme, Argentona (Barcelona), Spain. 6. Department of Sociology, Faculty of Economics and Business, University of Barcelona, Barcelona, Spain.
Abstract
OBJECTIVE: To assess the monetary savings resulting from a pharmacist intervention on the appropriateness of prescribed drugs in community-dwelling polymedicated (≥8 drugs) elderly people (≥70 years). METHOD: An evaluation of pharmaceutical expenditure reduction was performed within a randomised, multicentre clinical trial. The study intervention consisted of a pharmacist evaluation of all drugs prescribed to each patient using the "Good Palliative-Geriatric Practice" algorithm and the "Screening Tool of Older Persons Prescriptions/Screening Tool to Alert doctors to Right Treatment" criteria (STOPP/START). The control group followed the routine standard of care. A time horizon of one year was considered and cost elements included human resources and drug expenditure. RESULTS:490 patients (245 in each group) were analysed. Both groups experienced a decrease in drug expenditure 12 months after the study started, but this decrease was significantly higher in the intervention group than in the control group (-14.3% vs.-7.7%; p=0.041). Total annual drug expenditure decreased 233.75 €/patient (95% confidence interval [95%CI]: 169.83-297.67) in the intervention group and 169.40 €/patient (95%CI: 103.37-235.43) in the control group over a one-year period, indicating that 64.30 € would be the drug expenditure savings per patient a year attributable to the study intervention. The estimated return per Euro invested in the programme would be 2.38 € per patient a year on average. CONCLUSIONS: The study intervention is a cost-effective alternative to standard care that could generate a positive return of investment.
RCT Entities:
OBJECTIVE: To assess the monetary savings resulting from a pharmacist intervention on the appropriateness of prescribed drugs in community-dwelling polymedicated (≥8 drugs) elderly people (≥70 years). METHOD: An evaluation of pharmaceutical expenditure reduction was performed within a randomised, multicentre clinical trial. The study intervention consisted of a pharmacist evaluation of all drugs prescribed to each patient using the "Good Palliative-Geriatric Practice" algorithm and the "Screening Tool of Older Persons Prescriptions/Screening Tool to Alert doctors to Right Treatment" criteria (STOPP/START). The control group followed the routine standard of care. A time horizon of one year was considered and cost elements included human resources and drug expenditure. RESULTS: 490 patients (245 in each group) were analysed. Both groups experienced a decrease in drug expenditure 12 months after the study started, but this decrease was significantly higher in the intervention group than in the control group (-14.3% vs.-7.7%; p=0.041). Total annual drug expenditure decreased 233.75 €/patient (95% confidence interval [95%CI]: 169.83-297.67) in the intervention group and 169.40 €/patient (95%CI: 103.37-235.43) in the control group over a one-year period, indicating that 64.30 € would be the drug expenditure savings per patient a year attributable to the study intervention. The estimated return per Euro invested in the programme would be 2.38 € per patient a year on average. CONCLUSIONS: The study intervention is a cost-effective alternative to standard care that could generate a positive return of investment.
Authors: Audrey Rankin; Cathal A Cadogan; Susan M Patterson; Ngaire Kerse; Chris R Cardwell; Marie C Bradley; Cristin Ryan; Carmel Hughes Journal: Cochrane Database Syst Rev Date: 2018-09-03
Authors: Natalie Kennie-Kaulbach; Rachel Cormier; Olga Kits; Emily Reeve; Anne Marie Whelan; Ruth Martin-Misener; Fred Burge; Sarah Burgess; Jennifer E Isenor Journal: Med Access Point Care Date: 2020-06-03