Arnaud Pagès1,2,3,4, Nadège Costa5,6, Michaël Mounié5,6, Philippe Cestac7,5, Philipe De Souto Barreto8,5, Yves Rolland8,5, Bruno Vellas8,5, Laurent Molinier5,6, Blandine Juillard-Condat7,5. 1. Department of Pharmacy, Toulouse University Hospital, Toulouse, France. pages.ar@chu-toulouse.fr. 2. Institute of Aging, Gérontopôle, INSPIRE Project, Toulouse University Hospital, Toulouse, France. pages.ar@chu-toulouse.fr. 3. CERPOP, UMR 1295, Inserm, University of Toulouse (UPS), Toulouse, France. pages.ar@chu-toulouse.fr. 4. Pharmacie, Hôpital Paule de Viguier, 330, avenue de Grande Bretagne-TSA 70034, 31059, Toulouse cedex 9, France. pages.ar@chu-toulouse.fr. 5. CERPOP, UMR 1295, Inserm, University of Toulouse (UPS), Toulouse, France. 6. Economic Evaluation Unit, Medical Information Department, Toulouse University Hospital, Toulouse, France. 7. Department of Pharmacy, Toulouse University Hospital, Toulouse, France. 8. Institute of Aging, Gérontopôle, INSPIRE Project, Toulouse University Hospital, Toulouse, France.
Abstract
INTRODUCTION: Potentially inappropriate medication prescribing (PIP) among older patients is associated with an increased risk of adverse events and hospitalization, and sometimes increased healthcare costs. OBJECTIVE: The aim of this study was to explore the association between healthcare costs and PIP exposure among older patients. METHODS: Analyses were conducted using data from the Multidomain Alzheimer Preventive Trial (MAPT). A computer algorithm was constructed to detect PIP based on various different explicit criteria-based tools, and the results were expressed in number of medication-related potential non-compliances (MRNCs). A prescription was considered potentially inappropriate if there were one or more MRNCs. We performed a cost analysis from the French National Health Insurance perspective, and also performed a multivariate analysis to identify the association between healthcare costs and PIP (number of MRNCs). RESULTS: The computer algorithm analyzed medication prescribing from included patients (N = 1525 aged 75.3 ± 4.4 years; 64% women [n = 978]). PIP was associated with increased total healthcare costs and non-medication healthcare costs after adjusting for potential confounders. We also noted that healthcare costs tended to increase with the number of MRNCs. The mean additional healthcare costs were €517, €921, and €1669 per patient and year for patients with one or two MRNCs, three or four MRNCs, and five or more MRNCs, respectively, in comparison with patients with appropriate medication prescriptions. CONCLUSION: These observations led us to conclude that interventions focused on reducing PIP could result in savings. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00672685.
INTRODUCTION: Potentially inappropriate medication prescribing (PIP) among older patients is associated with an increased risk of adverse events and hospitalization, and sometimes increased healthcare costs. OBJECTIVE: The aim of this study was to explore the association between healthcare costs and PIP exposure among older patients. METHODS: Analyses were conducted using data from the Multidomain Alzheimer Preventive Trial (MAPT). A computer algorithm was constructed to detect PIP based on various different explicit criteria-based tools, and the results were expressed in number of medication-related potential non-compliances (MRNCs). A prescription was considered potentially inappropriate if there were one or more MRNCs. We performed a cost analysis from the French National Health Insurance perspective, and also performed a multivariate analysis to identify the association between healthcare costs and PIP (number of MRNCs). RESULTS: The computer algorithm analyzed medication prescribing from included patients (N = 1525 aged 75.3 ± 4.4 years; 64% women [n = 978]). PIP was associated with increased total healthcare costs and non-medication healthcare costs after adjusting for potential confounders. We also noted that healthcare costs tended to increase with the number of MRNCs. The mean additional healthcare costs were €517, €921, and €1669 per patient and year for patients with one or two MRNCs, three or four MRNCs, and five or more MRNCs, respectively, in comparison with patients with appropriate medication prescriptions. CONCLUSION: These observations led us to conclude that interventions focused on reducing PIP could result in savings. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00672685.
Authors: A Clara Drenth-van Maanen; Anne J Leendertse; Paul A F Jansen; Wilma Knol; Carolina J P W Keijsers; Michiel C Meulendijk; Rob J van Marum Journal: J Eval Clin Pract Date: 2017-08-04 Impact factor: 2.431
Authors: Anne Spinewine; Kenneth E Schmader; Nick Barber; Carmel Hughes; Kate L Lapane; Christian Swine; Joseph T Hanlon Journal: Lancet Date: 2007-07-14 Impact factor: 79.321
Authors: Denis O'Mahony; David O'Sullivan; Stephen Byrne; Marie Noelle O'Connor; Cristin Ryan; Paul Gallagher Journal: Age Ageing Date: 2014-10-16 Impact factor: 10.668