Economic impact of pharmaceutical services on polymedicated patients: A systematic review

Bezerra, Herlanny Santana; Costa, Anna Luiza Brasileiro; Pinto, Rodrigo Silveira; Resende, Pedro Ernesto de; Freitas, Gabriel Rodrigues Martins de

doi:10.1016/j.sapharm.2022.03.005

Cited by 6 publications

(3 citation statements)

References 40 publications

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“…A prospective study demonstrated that MTM services contributed to a 57.9% reduction in facility costs and an 11.1% reduction in professional claims, despite a 19.7% increase in prescription drug expenditures ( Isetts et al, 2008 ). Though many same conclusions were reported to demonstrate the efficacy of saving partial cost by MTM services ( Campbell et al, 2018 ; Ni et al, 2018 ; Chung et al, 2020 ; Bezerra et al, 2022 ), several other costs apart from the medication cost might be increased by delivering MTM services, which diluted the efficacy in reducing total cost.…”

Section: Discussionmentioning

confidence: 98%

Clinical, economic and humanistic outcomes of medication therapy management services: A systematic review and meta-analysis

et al. 2023

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Background: Medication therapy management (MTM) services is a method that can effectively improve patients’ conditions, but the efficacy of economic and humanistic outcomes remain unclear. This systematic review and meta-analysis aim to use economic, clinical and humanistic outcomes to evaluate the multi-benefits of MTM services.Method: A systematic review and meta-analysis was conducted by retrieving PubMed, EMBASE, the Cochrane Library and ClinicalTrial.gov from the inception to April 2022. There were two reviewers screening the records, extracting the data, and assessing the quality of studies independently.Results: A total of 81 studies with 60,753 participants were included. MTM services were more effective in clinical outcomes with decreasing the rate of readmission (OR: 0.78; 95% CI: 0.73 to 0.83; I2 = 56%), emergency department visit (OR: 0.88; 95% CI: 0.81 to 0.96; I2 = 32%), adverse drug events (All-cause: OR: 0.68; 95% CI: 0.56 to 0.84; I2 = 61%; SAE: OR: 0.51; 95% CI: 0.33 to 0.79; I2 = 35%) and drug-related problems (MD: −1.37; 95% CI: −2.24 to −0.5; I2 = 95%), reducing the length of stay in hospital (MD: −0.74; 95% CI: −1.37 to −0.13; I2 = 70%), while the economic and humanistic outcomes were less effective.Conclusion: Our systematic review and meta-analysis demonstrated that MTM services had great ability to improve patients’ clinical conditions while the efficacy of economic and humanistic outcomes, with some of the outcomes showing high degree of heterogeneity and possible publication bias, required more future studies to provide stronger evidence.Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=349050], identifier [CRD42022349050].

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Section: Discussionmentioning

confidence: 98%

Clinical, economic and humanistic outcomes of medication therapy management services: A systematic review and meta-analysis

et al. 2023

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“…A recent study showed that medication monitoring optimized pharmacotherapy in polymedicated patients and contributed to health promotion, reducing medication spending and expenses related to emergency care and hospitalizations. 11 However, the use of clinical pharmacists in the care of older adults with Aspergillus spondylitis is never studied. In the present report, clinical pharmacists determined all actual and potential drug-related problems.…”

Section: Discussionmentioning

confidence: 99%

Individualized Pharmaceutical Care for Antifungal Therapy in a Patient with Aspergillus tubingensis Spondylitis After Discontinuation of Rifampicin: A Case Report

Li¹,

Cai²,

Xu³

et al. 2023

IDR

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Aspergillus tubingensis spondylitis (AS) is a rare spinal infectious disease with severe clinical symptoms and a challenging diagnosis. Treatment of AS is challenging due to its prolonged duration, substantial side effects, and complex drug–drug interactions. However, there is a lack of experience in individualized pharmaceutical care of AS by clinical pharmacists, especially in the presence of rifampicin, which has sustained liver enzyme induction after discontinuation. Our case described an immunocompetent patient infected with Aspergillus tubingensis spondylitis. Clinical pharmacists proposed an individualized treatment regimen for AS, after considering the effects of sustained liver enzyme induction of rifampicin (after discontinuation) on voriconazole, and utilized caspofungin as a bridge-connection scheme. We also paid attention to changes in indicators during treatment and managed adverse reactions. Therapeutic drug monitoring of voriconazole was also used to optimize the dosing regimen. With the individualized pharmaceutical care of clinical pharmacists and the efforts of clinicians, the patient’s incision healed well after 33 days of hospitalization, and she was discharged with significant improvement. Therefore, individualized pharmaceutical care by a clinical pharmacist can help optimize the treatment of Aspergillus tubingensis spondylitis. In clinical practice, drug–drug and drug–diet interactions may affect voriconazole efficacy, and individualized dose adjustment using therapeutic drug monitoring (TDM) is critical to improve efficacy and reduce adverse reactions.

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“…For all these reasons, regular monitoring and evaluation of the risks and drug-related aberrant behaviors are necessary. 19 Community pharmacists are one of the most accessible health care providers 20 and they are a strategic point to promote effective opioid stewardship due to both their central role in healthcare teams and frequent interaction with patients 14 , 21 , 22 …”

Section: Introductionmentioning

confidence: 99%

Impact of a Community Pharmacy Pharmacotherapy Follow-up (PTF) service in patients using opioid analgesic

Hernández-García,

Rubio-Armendáriz,

Alberto-Armas

et al. 2024

Exploratory Research in Clinical and Social Pharmacy

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Economic impact of pharmaceutical services on polymedicated patients: A systematic review

Cited by 6 publications

References 40 publications

Clinical, economic and humanistic outcomes of medication therapy management services: A systematic review and meta-analysis

Clinical, economic and humanistic outcomes of medication therapy management services: A systematic review and meta-analysis

Individualized Pharmaceutical Care for Antifungal Therapy in a Patient with Aspergillus tubingensis Spondylitis After Discontinuation of Rifampicin: A Case Report

Impact of a Community Pharmacy Pharmacotherapy Follow-up (PTF) service in patients using opioid analgesic

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