Title |
Reduction of pharmaceutical expenditure by a drug appropriateness intervention in polymedicated elderly subjects in Catalonia (Spain)
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Published in |
Gaceta Sanitaria, November 2017
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DOI | 10.1016/j.gaceta.2017.09.002 |
Pubmed ID | |
Authors |
Lluís Campins, Mateu Serra-Prat, Elisabet Palomera, Ignasi Bolibar, Miquel Àngel Martínez, Pedro Gallo |
Abstract |
To assess the monetary savings resulting from a pharmacist intervention on the appropriateness of prescribed drugs in community-dwelling polymedicated (≥8 drugs) elderly people (≥70 years). An evaluation of pharmaceutical expenditure reduction was performed within a randomised, multicentre clinical trial. The study intervention consisted of a pharmacist evaluation of all drugs prescribed to each patient using the "Good Palliative-Geriatric Practice" algorithm and the "Screening Tool of Older Persons Prescriptions/Screening Tool to Alert doctors to Right Treatment" criteria (STOPP/START). The control group followed the routine standard of care. A time horizon of one year was considered and cost elements included human resources and drug expenditure. 490 patients (245 in each group) were analysed. Both groups experienced a decrease in drug expenditure 12 months after the study started, but this decrease was significantly higher in the intervention group than in the control group (-14.3% vs.-7.7%; p=0.041). Total annual drug expenditure decreased 233.75 €/patient (95% confidence interval [95%CI]: 169.83-297.67) in the intervention group and 169.40 €/patient (95%CI: 103.37-235.43) in the control group over a one-year period, indicating that 64.30 € would be the drug expenditure savings per patient a year attributable to the study intervention. The estimated return per Euro invested in the programme would be 2.38 € per patient a year on average. The study intervention is a cost-effective alternative to standard care that could generate a positive return of investment. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Spain | 2 | 50% |
Unknown | 2 | 50% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 4 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 137 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 17 | 12% |
Student > Master | 17 | 12% |
Student > Ph. D. Student | 13 | 9% |
Student > Bachelor | 12 | 9% |
Student > Doctoral Student | 7 | 5% |
Other | 29 | 21% |
Unknown | 42 | 31% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 32 | 23% |
Pharmacology, Toxicology and Pharmaceutical Science | 24 | 18% |
Nursing and Health Professions | 15 | 11% |
Unspecified | 5 | 4% |
Engineering | 3 | 2% |
Other | 12 | 9% |
Unknown | 46 | 34% |