[Cost-effectiveness and cost calculation in an intervention on medication-related problems in primary care]

Abstract

Objectives: To assess the effectiveness of an intervention on medication-related problems (MRPs) detected in chronic patients with multiple medication at an urban primary care centre (PCC). Direct costs of the intervention were calculated.

Design: Prospective and longitudinal intervention study.

Setting: Primary care centre of Barceloneta. Barcelona, Spain.

Participants: 155 patients receiving multiple medication over 8 months.

Interventions: The PCC pharmacist informed the doctors in writing of the MRPs detected, the change in therapy recommended and the follow-up to the decision.

Main measurements: Number of MRPs, number of patients involved, age, number of drugs prescribed, and therapy groups involved.

Results: 161 MRPs were detected, with 92 patients involved of whom 57% were women. Average age was 72 and the average number of drugs prescribed was 8. 60% of the MRPs detected were within the safety category. There was an intervention in 100% of the MRPs detected and 32.3% were sorted out. The main limitation on doctors accepting the pharmacist's recommendation was that the MRPs detected were potential rather than real. The programme s saving was calculated at 2,588 euros (for direct costs only). The direct costs saved were 53.92 euros per MRP avoided.

Conclusions: The intervention on the MRPs detected in the PCC with the methodology used was effective. The direct costs saved per MRP sorted out exceeded the cost of investment in the programme.