In:
JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY, Wiley, Vol. 2, No. 2 ( 2019-04), p. 123-130
Abstract:
Drug‐related problems are a common complication in the transition from hospital to primary care and are associated with morbidity and increased health care costs. In this study, we evaluated the cost and consequences of a comprehensive pharmaceutical intervention compared with usual care, comprised of a medication review and patient interview before discharge and follow‐up for polypharmacy patients. Methods This economic evaluation was embedded within a randomized clinical trial. Patients were randomized to either the basic intervention group ( n = 493) which received a medication review, the extended intervention group ( n = 476) which received a medication review, discharge interview, and follow‐up, or the control group ( n = 498) which received standard care. Total health care costs were estimated over a period of 180 days at individual patient level from a health sector perspective. Results The mean cost per patient was lower in the intervention groups (basic, €16 748; extended, €15 631) compared with the control group (€17 288), although these differences did not reach statistical significance. The costs of additional time used on medication reviews, patient interviews, and follow‐ups (€88) were outweighed by a decrease in costs of readmissions. The results of the clinical study favored the extended intervention group on clinical outcomes, with statistical significance on a composite of readmissions or emergency department visits within 180 days after inclusion (hazard ratio 0.77, 95% confidence interval 0.64‐0.93). Conclusions This comprehensive pharmaceutical intervention was not costly and positive effects were seen in the clinical outcomes, thereby reaching a decrease in total cost per patient on average. The results thus indicate that the intervention is cost‐effective and that the positive net effects can justify costs of the intervention.
Type of Medium:
Online Resource
ISSN:
2574-9870
,
2574-9870
DOI:
10.1002/jac5.2019.2.issue-2
Language:
English
Publisher:
Wiley
Publication Date:
2019
detail.hit.zdb_id:
2920371-5
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