Economic impact of clinical pharmacist interventions in a general tertiary hospital in Qatar

Abstract

Background With an increasingly strained health system budgets, healthcare services need to continually demonstrate evidence of economic benefits. This study sought to evaluate the economic impact of interventions initiated by clinical pharmacists in an adult general tertiary hospital. Methods A retrospective review of clinical pharmacist interventions was carried out throughout follow-up durations in March 2018, July/August 2018, and January 2019 in Hamad General Hospital (HGH) at Hamad Medical Corporation (HMC) in Qatar. The study included clinical pharmacy interventions data of patients admitted to the internal medicine, critical care, and emergency wards. Included interventions were documented by clinical pharmacists or clinical pharmacy specialists, and approved by physicians. Interventions by non-clinical pharmacists or with missing data were excluded. Adopting the perspective of HMC, we calculated the total economic benefit, which is the sum of the cost savings and the cost avoidance associated with the interventions. Cost savings was defined as the reduced cost of therapy associated with therapy changes minus the cost of intervention and cost avoidance was the cost avoided by eliminating the occurrence of adverse drug events (ADEs). Sensitivity analyses were performed to assess the robustness of results against uncertainties. Results A total of 852 interventions, based on 340 patients, were included. The analysis projected an annual total benefit of QAR 2,267,036 (USD 621,106) based on a negative cost-savings of QAR-175,139 (USD-47,983) and a positive cost avoidance of QAR741,898 (USD203,260) over the 3-month follow-up period. The uncertainty analysis demonstrated the robustness of outcomes, including a 100% probability of positive economic benefit. Conclusions The clinical pharmacist intervention was associated with an increased cost of resource use, which was overtaken by the cost avoidance generated. The pharmacy intervention, therefore, is an overall economically beneficial practice in HGH, reducing ADEs with considerable consequential positive economic savings.

Clinical pharmacists’ interventions for preventing adverse events in critically ill neonates in Qatar: an economic impact analysis

“…In line with our previous studies (Abushanab, Atchan, et al, 2023 ; Abushanab, Gulied, et al, 2023 ; Al-Badriyeh et al, 2023 ), to account for any potential variations in pharmacist vigilance during the institutional review process of pharmacists’ performance, the sample size included the first month after the annual staff performance evaluation in the NICU, the last month of the year before the evaluation, and a middle month of the year.…”

“…The cost of an ADE was estimated based on a conservative assumption that it would result in an additional two days of hospital stay in the corresponding unit, in accordance with relevant literature studies (Abushanab, Atchan, et al, 2023 ; Abushanab, Gulied, et al, 2023 ; Al-Badriyeh et al, 2023 ; Chen et al, 2017 ).…”

“…This study is not a comparative study, where the sample size used in similar literature studies varies based on factors such as the size of the setting and the prevalence of underlying conditions (Walsh et al, 2017 ). Local studies in Qatar (Abushanab, Atchan, et al, 2023 ; Abushanab, Gulied, et al, 2023 ; Al-Badriyeh et al, 2023 ), as well as international studies (Gallagher et al, 2014 ; Malani et al, 2013 ; Sebaaly et al), in secondary/tertiary care settings have reported sample sizes ranging from <100 to <2000, but predominantly <500. Considering the anticipated incidence of interventions in the study setting, a preliminary investigation indicated that a 3-month duration would be sufficient to include over 500 interventions for analysis.…”

“…Several studies have shown the critical role of the pharmacist in reducing medication errors, shortening the duration of stay, and minimising the overall cost in different healthcare settings, including the ICU (Arredondo et al, 2021 ; Houso et al, 2022 ; Menezes et al, 2020 ). Studies have been conducted in Qatar to assess the economic impact of pharmacists’ interventions in a general tertiary hospital (Abushanab, Atchan, et al, 2023 ), cardiology (Al-Badriyeh et al, 2023 ), and cancer care settings (Abushanab, Gulied, et al, 2023 ). These studies found that pharmacists’ interventions were associated with a positive annual total benefit, including a positive cost avoidance.…”

Validation and testing of the O-PALM mono-dimensional tool for evaluating the economic impact of pharmacist interventions in a Teaching Hospital

“…A variety of methods and number of studies of evaluation which investigated the economic impacts of pharmacist's interventions have been established has been reported for recording of PIs [18,19,20,21] To determine the pharmacoeconomic signi cance of (PIs), a variety of methods, tools, and instruments are utilized. The development of both new and old tools are based on a review of previous models and tools for the assessment of PIs [22,23,24,25,26]. However, most of these tools indicated are created and utilized in the developed world, with a sophisticated system of approach that is impractical in the developing world with signi cant resource constraints…”