Evidence map›Paper›PMID 34729007›Full record

ArticlePatient preference and adherence2021

Cost-Utility Analysis of a Medication Adherence Management Service Alongside a Cluster Randomized Control Trial in Community Pharmacy.

Maria-Isabel Valverde-Merino, Fernando Martinez-Martinez, Leticia Garcia-Mochon, Shalom I Benrimoj, Amaia Malet-Larrea, Beatriz Perez-Escamilla, Maria Jose Zarzuelo, Andrea Torres-Robles, Miguel Angel Gastelurrutia, Raquel Varas-Doval and 2 more

Open access · goldAbstract read
In one paragraph

Article in Patient preference and adherence, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.3field-weighted citation impact, top 21% of its field
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

4 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Article
  3. Development of self-care in Spanish community pharmacies.Exploratory research in clinical and social pharmacy · 2023
    Article
  4. Review
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

12 authors at 5 institutions in 2 countries.

Maria-Isabel Valverde-MerinoPharmaceutical Care Research Group, University of Granada, Granada, Spain.ORCID 0000-0001-8875-1551
Fernando Martinez-MartinezPharmaceutical Care Research Group, University of Granada, Granada, Spain.ORCID 0000-0001-8247-1751
Leticia Garcia-MochonDepartment of Management of Health Services and Professionals, Andalusian School of Public Health, Granada, Spain.ORCID 0000-0002-6300-2738
Shalom I BenrimojPharmaceutical Care Research Group, University of Granada, Granada, Spain.ORCID 0000-0001-9768-7838
Amaia Malet-LarreaMedicines Information Centre, Official Pharmacist Association of Gipuzkoa, Donostia/San Sebastian, Spain.ORCID 0000-0002-2809-6249
Beatriz Perez-EscamillaPharmaceutical Care Research Group, University of Granada, Granada, Spain.ORCID 0000-0002-3209-3147
Maria Jose ZarzueloPharmaceutical Care Research Group, University of Granada, Granada, Spain.ORCID 0000-0001-8635-8094
Andrea Torres-RoblesGraduate School of Health, University of Technology Sydney, Sydney, Australia.ORCID 0000-0002-8751-5706
Miguel Angel GastelurrutiaPharmaceutical Care Research Group, University of Granada, Granada, Spain.ORCID 0000-0003-1019-0234
Raquel Varas-DovalPharmaceutical Care Services Department, General Pharmaceutical Council of Spain, Madrid, Spain.ORCID 0000-0002-0666-9739
Tamara Peiro ZorrillaPharmaceutical Care Services Department, General Pharmaceutical Council of Spain, Madrid, Spain.ORCID 0000-0002-2472-2230
Victoria Garcia-CardenasGraduate School of Health, University of Technology Sydney, Sydney, Australia.ORCID 0000-0003-3770-4557
Universidad de Granada · ESGovernment of Spain · ESUniversity of Technology Sydney · AUCentro de Investigación Biomédica en Red de Epidemiología y Salud Pública · ESOnkologikoa · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt is necessary to determine the cost utility of adherence interventions in chronic diseases due to humanistic and economic burden of non-adherence. PURPOSE: To evaluate, alongside a cluster-randomized controlled trial, the cost-utility of a pharmacist-led medication adherence management service (MAMS) compared with usual care in community pharmacies. MATERIALS AND

methodsThe trial was conducted over six months. Patients with treatments for hypertension, asthma or chronic obstructive pulmonary disease (COPD) were included. Patients in the intervention group (IG) received a MAMS based on a brief complex intervention, whilst patients in the control group (CG) received usual care. The cost-utility analysis adopted a health system perspective. Costs related to medications, healthcare resources and adherence intervention were included. The effectiveness was estimated as quality-adjusted life years (QALYs), using a multiple imputation missing data model. The incremental cost-utility ratio (ICUR) was calculated on the total sample of patients.

resultsA total of 1186 patients were enrolled (IG: 633; CG: 553). The total intervention cost was estimated to be €27.33 ± 0.43 per patient for six months. There was no statistically significant difference in total cost of medications and healthcare resources per patient between IG and CG. The values of EQ-5D-5L at 6 months were significantly higher in the IG [IG: 0.881 ± 0.005 vs CG: 0.833 ± 0.006; p = 0.000]. In the base case, the service was more expensive and more effective than usual care, resulting in an ICUR of €1,494.82/QALY. In the complete case, the service resulted in an ICUR of €2,086.30/QALY, positioned between the north-east and south-east quadrants of the cost-utility plane. Using a threshold value of €20,000/QALY gained, there is a 99% probability that the intervention is cost-effective.

conclusionThe medication adherence management service resulted in an improvement in the quality of life of the population with chronic disease, with similar costs compared to usual care. The service is cost-effective.

Indexed as

chronic diseasecommunity pharmacy servicescost–utility analysishealth-related quality of lifemedication adherencepharmacoeconomics

Identifiers

PMID34729007
PMCPMC8554318
OpenAlexW3210106475

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.