Economic evaluations of adult critical care pharmacy services: a scoping review

Abstract

Objectives To summarise the extent and type of evidence available regarding economic evaluations of adult critical care pharmacy services in the context of UK practice. Methods A literature search was conducted in eight electronic databases and hand searching of full-text reference lists. Of 2409 journal articles initially identified, 38 were included in the final review. Independent literature review was undertaken by two investigators in a two-step process against the inclusion and exclusion criteria; title and abstract screening were followed by full-text screening. Included studies were taken from high-income economy countries that contained economic data evaluating any key aspect of adult critical care pharmacy services. Grey literature and studies that could not be translated into the English language were excluded. Results The majority were before-and-after studies (18, 47%) or other observational studies (17, 45%), and conducted in North America (25, 66%). None of the included studies were undertaken in the UK. Seven studies (18%) included cost-benefit analysis; all demonstrated positive cost-benefit values for clinical pharmacist activities. Conclusions Further high-quality primary research focussing on the economic evaluation of UK adult critical care pharmacy services is needed, before undertaking a future systematic review. There is an indication of a cost-benefit value for critical care pharmacist activities. The lack of UK-based economic evaluations is a limitation to further development and standardisation of critical care pharmacy services nationally.

Cost-effectiveness analysis of pharmaceutical care in adult critically ill patients: based on a prospective cohort study

“…The European Society of Critical Care Medicine highlighted the need for pharmacy professionals in the ICU through an article published in Intensive Care Medicine, citing ten reasons, including the promotion of rational drug use and the benefits of pharmacovigilance ( McKenzie et al, 2024 ). Although the economic value of ICU pharmaceutical care is widely acknowledged, comprehensive economic evaluations remain scarce, with most studies focusing solely on cost-benefit analyses and lacking cost-effectiveness assessments ( Bosma et al, 2018 ; Crosby et al, 2023 ). Our research addresses this gap by demonstrating improvements in both health outcomes and economic indicators in the pharmaceutical care group compared to the control group.…”