Cost-Effectiveness of Comprehensive Medication Reviews Versus Noncomprehensive Medication Review Interventions and Subsequent Successful Medication Changes in a Medicare Part D Population

Chinthammit, Chanadda; Armstrong, Edward P.; Boesen, Kevin; Martin, Rose; Taylor, Ann M.; Warholak, Terri

doi:10.18553/jmcp.2015.21.5.381

Cited by 13 publications

(21 citation statements)

References 44 publications

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“…A total of 47 (41%) economic evaluations focused on general pharmacotherapeutic management (Table S1). Most studies used study designs with a high risk of bias—38% were single‐group posttest, 15% were nonrandomized posttest using a historical control group, and 11% were single‐group pretest‐posttest. Study designs with a medium risk of bias comprised the rest of the studies: 15% were nonrandomized pretest‐posttest and 11% were nonrandomized posttest.…”

Section: Resultsmentioning

confidence: 99%

Economic evaluations of clinical pharmacy services in the United States: 2011‐2017

Talon

Pérez

Yan

et al. 2019

J Am Coll Clin Pharm

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Studies evaluating the cost-effectiveness of clinical pharmacy services (CPS) are needed to justify implementation and reimbursement. Through a systematic review, we describe services provided by pharmacists and their economic outcomes. We conducted a literature search of published studies in PubMed, Ovid, and Embase from January 2011 through December 2017. Manuscripts evaluating a CPS with patient-level economic outcomes and conducted in the United States were included. Study risks of bias were classified by study design characteristics. Economic evaluations were classified according to the presence of a comparator, and cost and outcome measures included. The quality of full economic evaluations was assessed using the Quality of Health Economic Studies (QHES) instrument. Descriptive statistics were used to summarize CPS characteristics. After screening, 115 studies wereincluded. Type of service provided included general pharmacotherapy (41%), disease management (30%), and targeted drug program (17%). Settings included hospital (34%), ambulatory care (28%), and community pharmacy (17%). Study designs were considered high risk of bias (use of a historical control group or no control group) in 69% of cases while 25% were medium risk of bias (non-randomized with a concurrent control group) and 6% were low risk of bias (randomized experimental or multigroup interrupted time series). Economic evaluation types were descriptive studies that measured cost and/or outcomes of a CPS (55%), comparative studies that measured cost or outcomes of a CPS and a comparator (37%), and full evaluations that measured cost and outcomes of a CPS and a comparator (8%). Among nine full evaluations, the median (range) QHES score was 74 (59-95) and four reported the CPS as being more effective at a lower cost. Few full economic evaluations were conducted, but supported the cost-effectiveness of CPS. Use of a comparator group and measurement of economic inputs and outcomes would strengthen the body of evidence. K E Y W O R D Scost-benefit analysis, health services research, pharmacoeconomics, pharmacy

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Section: Resultsmentioning

confidence: 99%

Economic evaluations of clinical pharmacy services in the United States: 2011‐2017

Talon

Pérez

Yan

et al. 2019

J Am Coll Clin Pharm

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“…Recently, Houle et al (2014) presented the costs of pharmacotherapy review services in different countries demonstrating costs from US$ 42.16 to 150.00 per encounter depending on the complexity of the case and the location of the service. In the same context, Chinthammit et al (2015) asserted that the probability of avoiding a preventable adverse drug effect (ADE) is 0.93 (95% CI 0.91-0.95), and the cost of treating a preventable ADE is between US$ 116.87 and US$ 10,056.44. To these authors, the ADE can be the ineffective action of medicines.…”

Section: Discussionmentioning

confidence: 99%

Pharmacotherapy review: a proposal to improve medication adherence among hypertensive patients

Rigoni

Brito

Alano

et al. 2015

Braz. J. Pharm. Sci.

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Pharmacotherapy review is a structured assessment of medicines, which aims to obtain a partnership with patients to achieve drug treatment goals and agreement about drug dosage, as well as when and how the drugs should be administered. The objective was to analyze the influence of pharmacotherapy review, by scheduling drug administration to improve medication adherence among antihypertensive patients. This study was an uncontrolled intervention developed in three distinct stages. The first stage included data collection on the profile of patients and their medications, and a preliminary assessment of medication adherence. In the second stage, the review report was delivered to patients. In the third stage, the results of blood pressure and medication adherence were assessed. The influence of the revision was measured through statistical tests (p<0.05). The study included 40 patients with a mean age of 58.0 (SD:11.3) years; 72.5% were women. Thirty-three (82.5 %) patients required some intervention, after when there was a significant increase in the number of daily doses (p=0.039) and drug intakes (p=0.025). There was a significant increase in the adherence rate, according to both the Morisky-Green test (p<0.001) and self-reported assessment (p=0.004). There was also an improvement in the levels of systolic (p<0.001) and diastolic (p=0.002) blood pressure and in the number of patients with controlled hypertension (p=0.006). The pharmaceutical service enhanced medication adherence and control of systemic blood pressure; however, it increased the complexity of treatment.Uniterms: Pharmacotherapy review. Drugs/administration schedule. Hypertension/medication adherence. Medication adherence. Pharmaceutical assistance.A revisão da farmacoterapia é uma avaliação estruturada dos medicamentos com o objetivo de proporcionar aos pacientes o alcance dos objetivos terapêuticos por meio da forma adequada de administração dos medicamentos. O objetivo foi analisar a influência da revisão da farmacoterapia, por meio do aprazamento dos medicamentos, na adesão à medicação e no controle da hipertensão arterial sistêmica. Trata-se de um estudo de intervenção não controlado desenvolvido em três momentos distintos. No primeiro, realizou-se a coleta de dados sobre o perfil dos pacientes e de suas medicações e a avaliação da adesão; no segundo momento, realizou-se a entrega do relatório da revisão aos pacientes e na terceira etapa avaliou-se o resultado da adesão e pressão arterial. A influência da revisão foi medida por meio de testes estatísticos (p<0,05). Participaram deste estudo 40 pacientes, com média de idade de 58,0 anos (SD:11,3), sendo 72,5% mulheres. Dos pacientes, 33 (82,5%) necessitaram intervenções. Após estas se verificou aumento significativo no número de doses (p=0,039) e no número de tomadas (p=0,025). Houve aumento significativo no número de aderentes tanto pelo teste de Morisky-Green (p<0,001) quanto na avaliação autorreferida (p=0,004). Também, houve melhora nos níveis de pressão sistólica (p<0,001) e diastólica (p=...

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“…Drug-related problems cost approximately $42 billion a year worldwide [1] and can be better managed and reduced by pharmaceutical care implementation in health care services [2][3][4][5]. Clinical Pharmaceutical services prevent adverse reactions and hospitalizations by decreasing drug-related morbidity [2] and they can improve quality of life, especially in older adult patients with chronic conditions [6].…”

Section: Introductionmentioning

confidence: 99%

“…The decrease in expenses resulting from pharmaceutical care implementation can generate savings of US$ 5377 per adverse event avoided [5] and $421,810 per year per pharmacist carrying out clinical practice [9] . Strand and Cipolle (2004) identified a decrease of $1, 134,162 in total expenditures over 3 years [8].…”

Section: Introductionmentioning

confidence: 99%

Implementation of pharmaceutical care for older adults in the brazilian public health system: a case study and realistic evaluation

Silva

Fegadolli

2020

BMC Health Serv Res

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Background: Pharmaceutical care services have been recognized as the most highly regarded professional pharmacy practice model that allows the identification, intervention, and resolution of drug related problems. This practice provides significant clinical outcomes and can reduce direct and indirect costs for health systems. However, its implementation can be complex and challenging, needing study experiences that aims at overcoming obstacles, especially in free and universal healthcare systems. The objective of this study is to evaluate the implementation of Ambulatory Care Pharmacy services for older adults at Paulista Institute of Geriatrics and Gerontology (IPGG), which is recognized in the city of São Paulo for offering pharmaceutical care services for over 10 years continuously. This initiative and process is independent of external academic interventions or educational institutions. It is hoped that the results may also contribute to advancing the implementation of pharmaceutical care service in similar health systems. Design: This is a case study using multiple sources of data. Qualitative and quantitative data were collected from institutional documents, by participant observation and interviews. Initial themes were identified by content analysis and analyzed under the context-mechanism-outcome configurations (CMO Configurations) in realistic evaluation. Setting: Geriatrics and Gerontology Institute of São Paulo (known as IPGG). Participants: Eleven health professionals and three pharmaceutical care service users.Results: Three CMO configurations were identified and accepted: "Scenario Construction mediated by educational processes", "Contribution to complex needs resolution", and "Organizational Visibility". The CMO (Context-Mechanism-Outcomes) configuration "Logistic activities discourage clinical pharmaceutical services implantation" was denied due to the influence of accepted CMOs. Conclusions: Educational processes which value transdisciplinary knowledge exchanges provide resources required to overcome important obstacles present during pharmaceutical care implementation. Thus, providing and seeking knowledge to build and offer context-consistent clinical health services as well as fulfilling organizational environment requirements can be the key to implement pharmaceutical care service.

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Cost-Effectiveness of Comprehensive Medication Reviews Versus Noncomprehensive Medication Review Interventions and Subsequent Successful Medication Changes in a Medicare Part D Population

Cited by 13 publications

References 44 publications

Economic evaluations of clinical pharmacy services in the United States: 2011‐2017

Economic evaluations of clinical pharmacy services in the United States: 2011‐2017

Pharmacotherapy review: a proposal to improve medication adherence among hypertensive patients

Implementation of pharmaceutical care for older adults in the brazilian public health system: a case study and realistic evaluation

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