Residents and Fellows Research in Progress
Monday, October 14, 2024
01:00 PM–02:30 PM
Abstract
Introduction: Our objective was to identify, evaluate, and synthesize evidence on the economic impact of clinical pharmacy services (CPS).
Research Question or Hypothesis: What is the economic impact of clinical pharmacy services compared to usual or alternative care in the United States?
Study Design: Systematic Review
Methods: We searched PubMed, IPA, Embase, Ovid, and CINAHL in September 2023 for US-based pharmacist-led clinical interventions published between January 2018 - December 2022. We excluded articles with a team-based intervention where the pharmacist’s individual economic impact couldn’t be determined. Risk-of-bias was assessed using the Quality of Health Economic Studies (QHES) instrument for full economic evaluations. Descriptive statistics were used to summarize CPS characteristics.
Results: A total of 106 articles met inclusion criteria. Of these, 27.4% (N= 29) were general pharmacotherapy monitoring, 35.8% (N=38) disease state management, and 27.4% (N=29) targeted drug programs. Intervention settings included 33.9% (N=36) hospital sites, 29.2% (N=31) ambulatory care, and 9.4% (N=10) community pharmacies. Nearly half 45.3% (N=48) of the interventions were medication therapy management or comprehensive medication management. According to ACCP’s process of care components, 58.5% (N=62) included assessment of the patient, evaluation of medication therapy, development and implementation of a care plan, and follow-up evaluation. The types of economic evaluations varied, with 33.0% (N=35) being descriptive studies, 41.5% (N=44) partial economic evaluations with a comparator, and 16.9% (N=18) full economic evaluations. The median (range) QHES score for full evaluations was 68 (8-99) out of 100. Seven studies reported the CPS as being cost-effective.
Conclusion: Few included articles were full economic evaluations. While some partial economic evaluations reasonably assessed billing or return on investment, others were incomplete assessments without control groups and with substantial bias. Using these partial reports to justify clinical services is not recommended. Future studies should better adhere to standards like the Second Panel on Cost-Effectiveness Research.
Other: This review was investigator-initiated and PROSPERO-registered (CRD42023449047).
Presenting Author
Bertha De Los Santos MS, PharmDUniversity of Illinois Chicago School of Pharmacy
Authors
Abdullah Alsharif PharmD
University of Nova Southeastern College of Pharmacy
Benson Binu PharmD Candidate
University of Nova Southeastern College of Pharmacy
Jordan Calabrese PharmD Candidate
University of Illinois Chicago College of Pharmacy
Ahmed Gharib PharmD Candidate
University of Illinois at Chicago College of Pharmacy
Jessica Kim PharmD Candidate
University of Illinois Chicago College of Pharmacy
Michael Kim PharmD
University of Illinois Chicago College of Pharmacy
Alexandra Perez MS, PharmD
Nova Southeastern University, College of Pharmacy
Daniel Touchette PharmD, MA, FCCP
University of Illinois at Chicago College of Pharmacy