Economic evaluation of a randomized controlled trial of pharmacist-supervized patient self-testing of warfarin therapy

Hdl Handle:
http://hdl.handle.net/10147/333143
Title:
Economic evaluation of a randomized controlled trial of pharmacist-supervized patient self-testing of warfarin therapy
Authors:
Gallagher, J.; Mc Carthy, S.; Woods, N.; Ryan, F.; O' Shea, S.; Byrne, S.
Citation:
Gallagher, J. et al., 2014. Economic evaluation of a randomized controlled trial of pharmacist-supervized patient self-testing of warfarin therapy. Journal of Clinical Pharmacy and Therapeutics [first published online 8 October 2014]
Publisher:
Journal of Clinical Pharmacy and Therapeutics
Journal:
Journal of Clinical Pharmacy and Therapeutics
Issue Date:
Oct-2014
URI:
http://hdl.handle.net/10147/333143
DOI:
10.1111/jcpt.12215
Additional Links:
http://doi.wiley.com/10.1111/jcpt.12215
Language:
en
Description:
What is known and objective: The increase in numbers of patients requiring oral anti-coagulation testing in outpatient clinics has focused attention on alternative fl exible systems of anti-coagulation management. One option is pharmacist led patient self-testing (PST) of international normalised ratio (INR) levels. PST has demonstrated improvements in anti-coagulation control, but its cost-effectiveness is inconclusive. This study reports the fi rst cost-effectiveness evaluation of a randomized controlled trial of an automated direct-to-patient expert system, enabling remote and effective management of patients on oral anti-coagulation therapy. Methods: We conducted an economic evaluation alongside a randomised controlled trial investigating a pharmacist led PST method. The primary outcome was to determine the cost effectiveness of PST in comparison with usual care (manage- ment in a hospital based anti-coagulation clinic). Long term anti- coagulation patients were recruited to a 6 month cross over study between PST and routine care in an anti-coagulation clinic. Economic evaluation was from the healthcare payer perspective. Results and discussion: On a per patient basis over a 6 month period, PST resulted in an incremental cost of € 59 08 in comparison with routine care. Patients achieved a signi fi cantly higher time in therapeutic range (TTR) during the PST arm in comparison with routine care, (72 19 7% vs. 59 13 5%). Overall cost of managing a patient through pharmacist super- vised PST for a 6 month period is € 226 45. Additional analysis of strategies from a societal perspective indicated that PST was the dominant strategy.
Keywords:
MEDICINES; PHARMACIST
Local subject classification:
ANTI-COAGULANTS
ISSN:
02694727

Full metadata record

DC FieldValue Language
dc.contributor.authorGallagher, J.en_GB
dc.contributor.authorMc Carthy, S.en_GB
dc.contributor.authorWoods, N.en_GB
dc.contributor.authorRyan, F.en_GB
dc.contributor.authorO' Shea, S.en_GB
dc.contributor.authorByrne, S.en_GB
dc.date.accessioned2014-10-24T10:58:56Z-
dc.date.available2014-10-24T10:58:56Z-
dc.date.issued2014-10-
dc.identifier.citationGallagher, J. et al., 2014. Economic evaluation of a randomized controlled trial of pharmacist-supervized patient self-testing of warfarin therapy. Journal of Clinical Pharmacy and Therapeutics [first published online 8 October 2014]en_GB
dc.identifier.issn02694727-
dc.identifier.doi10.1111/jcpt.12215-
dc.identifier.urihttp://hdl.handle.net/10147/333143-
dc.descriptionWhat is known and objective: The increase in numbers of patients requiring oral anti-coagulation testing in outpatient clinics has focused attention on alternative fl exible systems of anti-coagulation management. One option is pharmacist led patient self-testing (PST) of international normalised ratio (INR) levels. PST has demonstrated improvements in anti-coagulation control, but its cost-effectiveness is inconclusive. This study reports the fi rst cost-effectiveness evaluation of a randomized controlled trial of an automated direct-to-patient expert system, enabling remote and effective management of patients on oral anti-coagulation therapy. Methods: We conducted an economic evaluation alongside a randomised controlled trial investigating a pharmacist led PST method. The primary outcome was to determine the cost effectiveness of PST in comparison with usual care (manage- ment in a hospital based anti-coagulation clinic). Long term anti- coagulation patients were recruited to a 6 month cross over study between PST and routine care in an anti-coagulation clinic. Economic evaluation was from the healthcare payer perspective. Results and discussion: On a per patient basis over a 6 month period, PST resulted in an incremental cost of € 59 08 in comparison with routine care. Patients achieved a signi fi cantly higher time in therapeutic range (TTR) during the PST arm in comparison with routine care, (72 19 7% vs. 59 13 5%). Overall cost of managing a patient through pharmacist super- vised PST for a 6 month period is € 226 45. Additional analysis of strategies from a societal perspective indicated that PST was the dominant strategy.en_GB
dc.language.isoenen
dc.publisherJournal of Clinical Pharmacy and Therapeuticsen_GB
dc.relation.urlhttp://doi.wiley.com/10.1111/jcpt.12215en_GB
dc.rightsArchived with thanks to Journal of Clinical Pharmacy and Therapeuticsen_GB
dc.subjectMEDICINESen_GB
dc.subjectPHARMACISTen_GB
dc.subject.otherANTI-COAGULANTSen_GB
dc.titleEconomic evaluation of a randomized controlled trial of pharmacist-supervized patient self-testing of warfarin therapyen_GB
dc.identifier.journalJournal of Clinical Pharmacy and Therapeuticsen_GB
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