HUMANISTIC AND ECONOMIC OUTCOMES OF PHARMACIST-PROVIDED MEDICATION REVIEWS IN THE ELDERLY- A SYSTEMATIC REVIEW AND META-ANALYSIS
Author(s)
Loh ZW1, Cheen HH2, Wee HL1
1National University of Singapore, Singapore, Singapore, 2Singapore General Hospital, Singapore, Singapore
OBJECTIVES: Published studies have focused on the clinical outcomes of pharmacist-provided medication review in the elderly. This review aims to assess its humanistic and economic outcomes. METHODS: A systematic search of MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane Library for studies published in English from inception till 28th August 2015 was conducted. The review included studies lasting at least three months that randomly assigned elderly participants (i.e. age≥ 65 years) to receive either pharmacist-provided medication review or usual care. Meta-analysis of the effects of medication review on health-related quality of life (HRQoL) was performed, while a narrative summary was conducted for economic outcomes. RESULTS: The review identified 26 trials that included 15,440 participants, with follow-up ranging from three to 36 months. Twenty-one studies reported HRQoL, with 11 using the EuroQol-5D (EQ-5D) and visual analogue scale (EQ-VAS), and 10 using the 36-item short form health survey (SF-36). Sixteen studies evaluated economic outcomes, with 13 reporting healthcare costs, and three reporting incremental cost-effectiveness ratios (ICERs). Meta-analyses of HRQoL measures showed that pharmacist-provided medication reviews had largely similar effects compared with usual care. Nonetheless, the SF-36 bodily pain (mean difference 2.94, p= 0.02) and general health perception (mean difference 1.83, p= 0.03) domains significantly favored usual care. Medication reviews did not result in significant cost savings, and the ICERs reported varied widely. CONCLUSIONS: Humanistic and economic outcomes of pharmacist-provided medication review were similar to those of usual care. Careful thoughts should be given to the capturing of relevant outcomes that reflect the potential benefits of this intervention.
Conference/Value in Health Info
2016-09, ISPOR Asia Pacific 2016, Singapore
Value in Health, Vol. 19, No. 7 (November 2016)
Code
HT4
Topic
Health Service Delivery & Process of Care, Health Technology Assessment
Topic Subcategory
Decision & Deliberative Processes, Health Care Research
Disease
Geriatrics, Multiple Diseases