The Economic Impact of Pharmacotherapeutic Follow-Up in Copd Patients at a Health Care Institution in Medellin-Colombia

Abstract

Context: several studies show that missing doses and an incorrect inhalation technique, are the most common pharmacological risks in patients with Chronic Obstructive Pulmonary Disease diagnosis. These are associated with an increase in Health-related costs, mainly due to an increase in the number of emergency visits, hospitalizations and switches of medication as a consequence of therapeutic failures.Objective: to determinate the median cost per month of each patient stratified by type of pharmacological risks, after pharmacotherapeutic follow-up assessment.Method: Follow-up cohort, in Chronic Obstructive Pulmonary Disease patients. The observation period was from January 2012 to June 2014 [n:108]. The pharmacological risks assessed were incorrect inhalation technique and missing doses. The main outcome was the median cost per month in each patient before and after having received Health-related education by a Pharmacist, stratified by having or not pharmacological risks [1 USD=1.906,9COP information to august 2014]. Wilcoxon test for paired sample and U de Mann-Whitney test for independent sample were used for this purpose. Results:The median cost per month was 165, 3[104,0-277,8], a patient without pharmacological risks was 119,2 [88,4] USD and a patient with pharmacological risks was 186,7 [123,7-307,9] [p= 0,033]. On the other hand, a patient with missing doses was 195,1 [131,6], in comparison with a patient with incorrect inhalation technique, that was 143,0 [96,0]. The cost before the Pharmacotherapeutic Follow-up implementation was 169,8 [110,8-253,8] and after that it was 150,7 [106,1], with an important decrease of 11,25% [p= 0,517]. Conclusion:Having pharmacological risks was related with a higher median cost per patient. The median cost per patient was lower after giving Health-related education to patients by Pharmacotherapeutic Follow-up.