REDUCING POTENTIALLY INAPPROPRIATE PRESCRIBING FOR OLDER PEOPLE IN PRIMARY CARE: COST-EFFECTIVENESS OF THE OPTI-SCRIPT INTERVENTION.
Int J Technol Assess Health Care
; 33(4): 494-503, 2017 Jan.
Article
en En
| MEDLINE
| ID: mdl-29019297
ABSTRACT
OBJECTIVES:
This study examines the cost-effectiveness of the OPTI-SCRIPT intervention on potentially inappropriate prescribing in primary care.METHODS:
Economic evaluation, using incremental cost-effectiveness and cost utility analyses, conducted alongside a cluster randomized controlled trial of twenty-one general practices and 196 patients, to compare a multifaceted intervention with usual practice in primary care in Ireland. Potentially inappropriate prescriptions (PIPs) were determined by a pharmacist. Incremental costs, PIPs, and quality-adjusted life-years (QALYs) at 12-month follow-up were estimated using multilevel regression. Uncertainty was explored using cost-effectiveness acceptability curves.RESULTS:
The intervention was associated with a nonsignificant mean cost increase of 407 (95 percent CIs, -357-1170), a significant mean reduction in PIPs of 0.379 (95 percent CI, 0.092-0.666), and a nonsignificant mean increase in QALYs of 0.013 (95 percent CIs, -0.016-0.042). The incremental cost per PIP avoided was 1,269 (95 percent CI, -1400-6302) and the incremental cost per QALY gained was 30,535 (95 percent CI, -334,846-289,498). The probability of the intervention being cost-effective was 0.602 at a threshold value of 45,000 per QALY gained and was at least 0.845 at threshold values of 2,500 per PIP avoided and higher.CONCLUSIONS:
While the OPTI-SCRIPT intervention was effective in reducing potentially inappropriate prescribing in primary care in Ireland, our findings highlight the uncertainty with respect to its cost-effectiveness. Further studies are required to explore the health and economic implications of interventions targeting potentially inappropriate prescribing.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Atención Primaria de Salud
/
Pautas de la Práctica en Medicina
/
Prescripción Inadecuada
Tipo de estudio:
Clinical_trials
/
Health_economic_evaluation
/
Prognostic_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País/Región como asunto:
Europa
Idioma:
En
Revista:
Int J Technol Assess Health Care
Asunto de la revista:
PESQUISA EM SERVICOS DE SAUDE
Año:
2017
Tipo del documento:
Article