Evidence map›Paper›PMID 38967733›Full record

ArticleInternational journal of clinical pharmacy2024

Cost avoidance of pharmacist-led deprescribing using STOPPFrail for older adults in nursing homes.

Eoin Hurley, Stephen Byrne, Elaine Walsh, Tony Foley, Noel Woods, Kieran Dalton

Abstract read
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In one paragraph

Article in International journal of clinical pharmacy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing 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

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

  1. Pooled it
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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

6 authors.

Eoin HurleyPharmaceutical Care Research Group, University College Cork, Cork, Ireland. eoin.hurley@ucc.ie.ORCID http://orcid.org/0000-0001-6895-8061
Stephen ByrnePharmaceutical Care Research Group, University College Cork, Cork, Ireland.ORCID http://orcid.org/0000-0003-3141-7004
Elaine WalshDepartment of General Practice, University College Cork, Cork, Ireland.ORCID http://orcid.org/0000-0002-0718-4207
Tony FoleyDepartment of General Practice, University College Cork, Cork, Ireland.ORCID http://orcid.org/0000-0003-3205-3871
Noel WoodsCentre for Policy Studies, University College Cork, Cork, Ireland.ORCID http://orcid.org/0000-0003-2795-3576
Kieran DaltonPharmaceutical Care Research Group, University College Cork, Cork, Ireland.ORCID http://orcid.org/0000-0003-1209-8079

Funding

Irish Research Council GOIPG/2020/1070
6 · The paper itself

Abstract

backgroundThe Screening Tool of Older Persons Prescriptions in Frail adults with limited life expectancy (STOPPFrail) criteria aim to reduce inappropriate/unnecessary medications in frail older adults, which should minimise adverse drug events and additional healthcare expenditure. Little is known about the economic outcomes of applying these criteria as an intervention.

aimTo evaluate cost avoidance of pharmacist-led application of STOPPFrail to frail older nursing home residents with limited life expectancy.

methodPharmacist-identified STOPPFrail-defined potentially inappropriate medications that were deprescribed by patients' general practitioners were assigned a rating by a multidisciplinary panel, i.e. the probability of an adverse drug event occurring if the medication was not deprescribed. The intervention's net cost benefit and cost-benefit ratio were then determined by factoring in adverse drug event cost avoidance (calculated from probability of adverse drug event ratings), direct cost savings (deprescribed medication costs/reimbursement fees), and healthcare professionals' salaries.

resultsOf the 176 potentially inappropriate medications deprescribed across 69 patients, 65 (36.9%) were rated as having a medium or high probability of an adverse drug event occurring if not deprescribed. With €27,162 for direct cost savings, €61,336 for adverse drug event cost avoidance, and €2,589 for healthcare professionals' salary costs, there was a net cost benefit of €85,909 overall. The cost-benefit ratio was 33.2 and remained positive in all scenarios in sensitivity analyses.

conclusionPharmacist-led application of STOPPFrail to frail older nursing home residents is associated with significant cost avoidance. Wider implementation of pharmacist interventions in frail older nursing home residents should be considered to reduce potentially inappropriate medications and patient harm, alongside substantial cost savings for healthcare systems.

Indexed as

Cost-Benefit AnalysisDeprescriptionsInappropriate PrescribingNursing HomesAgedAged, 80 and overCost SavingsDrug-Related Side Effects and Adverse ReactionsFemaleFrail ElderlyHomes for the AgedHumansMalePharmacistsPotentially Inappropriate Medication ListPractice Patterns, Pharmacists'FrailtyMedication reviewNursing homePharmacistPharmacoeconomicSTOPPFrail

Identifiers

PMID38967733
PMCPMC11399282

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Registered trials

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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.