Reduction of pharmaceutical expenditure by a drug appropriateness intervention in polymedicated elderly subjects in Catalonia (Spain) Reducción del gasto farmacéutico mediante una intervención de adecuación de medicamentos en ancianos polimedicados de Cataluña (España)
Campins, Lluís (Hospital de Mataró. Consorci Sanitari del Maresme)
Serra Prat, Mateu (Hospital de Mataró. Consorci Sanitari del Maresme)
Palomera, Elisabet (Hospital de Mataró. Consorci Sanitari del Maresme)
Bolibar i Ribas, Ignasi (Institut d'Investigació Biomèdica Sant Pau)
Martínez, Miquel Àngel (CAP Argentona. Consorci Sanitari del Maresme)
Gallo, Pedro (Universitat de Barcelona. Departament de Sociologia)
Universitat Autònoma de Barcelona

Fecha:	2019
Resumen:	Objective: 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). Method: 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. Results: 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. Conclusions: The study intervention is a cost-effective alternative to standard care that could generate a positive return of investment.
Nota:	Altres ajuts: This project was funded by a grant from the Catalan Government Health Service (SLT/682/2012).
Nota:	Altres ajuts: MSCBS/EC11-313
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Castellà
Documento:	Article ; recerca ; Versió publicada
Materia:	Aged ; Ancianos ; Atención primaria de salud ; Costes de medicamentos ; Drug costs ; Inappropriate prescribing ; Pharmaceutical services ; Polifarmacia ; Polypharmacy ; Prescripción inadecuada ; Primary health care ; Servicios farmacéuticos
Publicado en:	Gaceta sanitaria, Vol. 33 Núm. 2 (marzo 2019) , p. 106-111, ISSN 1578-1283

DOI: 10.1016/j.gaceta.2017.09.002
PMID: 29162290

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