An Economic Evaluation of Pharmacist Intervention on Older Adults with Chronic Disease: A Systematic Review
Keywords:
geriatri, pharmacy service, pharmacoeconomic study, polypharmacy
Abstract
Background: Several pharmacist interventions were carried out to enhance medication safety and effectiveness, but not all are cost-effective. Objective: this review aimed to assess the economic impact of pharmacist intervention for older adults with chronic disease. Method: Articles published from January 2013 to June 2023 were retrieved from PubMed, Science Direct, and Clinical Key. After applying the PICO strategy, a total of 13 studies (8599 participants) were included, and the studies without cost evaluation were excluded. The quality of the studies was assessed using the Bias in Economic Evaluation (ECOBIAS) checklist Part A. Results: Pharmacist intervention for geriatric patients included medication review, patient-centered care approach intervention, and multidisciplinary collaboration care. The follow-up ranged from 10 days to 36 months. Among the five cost-utility analyses (CUA), four indicated negative incremental total cost, meaning the intervention outperformed the control group. Subsequently, two cost-benefit analyses (CBA) showed benefit-to-cost ratios ranging from 3.3 to 6.2. The cost savings on medication ranged from €37.57 to €232 per patient in a year. This review suggested that pharmacist intervention in both outpatient and inpatient settings could decrease the risk of ADE, enhance clinical outcomes, improve quality of life, and cut down on medication expenditure for older adults patients. Conclusion: Almost all investigations concluded that pharmacist intervention has a beneficial economic impact. Evaluating the economic impact of a large-scale intervention requires further study with more precise estimates of overall intervention cost and rigorous methodology applied to economic evaluations of initiatives.
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Deyo, J. C., Smith, B. H., Biola, H., Ferry, E. M., Orto, V. K., Patel, B., & Stillwell, T. K. (2020). Reducing high-risk medication use through pharmacist-led interventions in an outpatient setting. https://doi.org/10.1016/j.japh.2020.01.013
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Gallagher, J., McCarthy, S., & Byrne, S. (2014). Economic evaluations of clinical pharmacist interventions on hospital inpatients: a systematic review of recent literature. International Journal of Clinical Pharmacy, 36(6), 1101–1114. https://doi.org/10.1007/s11096-014-0008-9
Gallagher, J., O’Sullivan, D., McCarthy, S., Gillespie, P., Woods, N., O’Mahony, D., & Byrne, S. (2016). Structured Pharmacist Review of Medication in Older Hospitalised Patients: A Cost-Effectiveness Analysis. Drugs & Aging, 33(4), 285–294. https://doi.org/10.1007/s40266-016-0348-3
Gervais, F., Novais, T., Goutelle, S., Chappuy, M., Parat, S., Cabelguenne, D., & Mouchoux, C. (2021). Drug-related problems among older patients: Analysis of 8 years of pharmacist’s interventions. Annales Pharmaceutiques Françaises, 79(5), 511–521. https://doi.org/10.1016/j.pharma.2021.02.002
Hoel, R. W., Giddings Connolly, R. M., & Takahashi, P. Y. (2021). Polypharmacy Management in Older Patients. Mayo Clinic Proceedings, 96(1), 242–256. https://doi.org/10.1016/j.mayocp.2020.06.012
Hu, Q., Tian, F., Jin, Z., Lin, G., Teng, F., & Xu, T. (2023). Developing a Warning Model of Potentially Inappropriate Medications in Older Chinese Outpatients in Tertiary Hospitals: A Machine-Learning Study. Journal of Clinical Medicine, 12(7). https://doi.org/10.3390/JCM12072619
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Published
2024-05-31
How to Cite
Farida, Y. (2024). An Economic Evaluation of Pharmacist Intervention on Older Adults with Chronic Disease: A Systematic Review. Indonesian Journal of Pharmacy. https://doi.org/10.22146/ijp.10341
Issue
Section
Review Article
