Evidence map›Paper›PMID 31179514›Full record

SynthesisPharmacoEconomics2019

Cost Effectiveness of Advanced Pharmacy Services Provided in the Community and Primary Care Settings: A Systematic Review.

Dalia M Dawoud, Alexander Haines, David Wonderling, Joanna Ashe, Jennifer Hill, Mihir Varia, Philip Dyer, Julian Bion

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in PharmacoEconomics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
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  10. Review
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  15. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Dalia M DawoudClinical Pharmacy Department, Faculty of Pharmacy, Cairo University, Kasr El Aini Street, Cairo, Egypt. ddawoud@hotmail.com.ORCID 0000-0002-2105-1937
Alexander HainesToronto Health Economics and Technology Assessment Collaborative, Toronto, ON, Canada.
David WonderlingNational Guideline Centre, Royal College of Physicians, London, UK.
Joanna AsheNational Guideline Centre, Royal College of Physicians, London, UK.
Jennifer HillNational Guideline Centre, Royal College of Physicians, London, UK.
Mihir VariaNHS Herts Valleys Clinical Commissioning Group, Hertfordshire, UK.
Philip DyerDiabetes, Endocrinology and Acute Internal Medicine, Diabetes Centre, University Hospitals Birmingham NHS Foundation Trust, Heartlands Hospital, Birmingham, UK.
Julian BionIntensive Care Medicine, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPharmacists working in community and primary care are increasingly developing advanced skills to provide enhanced services, particularly in dealing with minor acute illness. These services can potentially free-up primary care physicians' time; however, it is not clear whether they are sufficiently cost effective to be recommended for wider provision in the UK.

objectiveThe aim of this study was to review published economic evaluations of enhanced pharmacy services in the community and primary care settings.

methodsWe undertook a systematic review of economic evaluations of enhanced pharmacy services to inform NICE guidelines for emergency and acute care. The review protocol was developed and agreed with the guideline committee. The National Health Service Economic Evaluation Database, Health Technology Assessment Database, Health Economic Evaluations Database, MEDLINE and EMBASE were searched in December 2016 and the search was updated in March 2018. Studies were assessed for applicability and methodological quality using the NICE Economic Evaluation Checklist.

resultsOf 3124 records, 13 studies published in 14 papers were included. The studies were conducted in the UK, Spain, The Netherlands, Australia, Italy and Canada. Settings included community pharmacies, primary care/general practice surgeries and patients' homes. Most of the studies were assessed as partially applicable with potentially serious limitations. Services provided in community and primary care settings were found to be either dominant or cost effective, at a £20,000 per quality-adjusted life-year threshold, compared with usual care. Those delivered in the patient's home were not found to be cost effective.

conclusionsAdvanced pharmacy services appear to be cost effective when delivered in community and primary care settings, but not in domiciliary settings. Expansion in the provision of these services in community and primary care can be recommended for wider implementation.

Indexed as

Community Pharmacy ServicesCost-Benefit AnalysisHumansPharmacistsPractice Guidelines as TopicPrimary Health CareProfessional RoleQuality-Adjusted Life YearsTechnology Assessment, Biomedical

Identifiers

PMID31179514

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.