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Health economic evaluation of the Lund Integrated Medicines Management Model (LIMM) in elderly patients admitted to hospital
OBJECTIVE: To evaluate the cost effectiveness of a multidisciplinary team including a pharmacist for systematic medication review and reconciliation from admission to discharge at hospital among elderly patients (the Lund Integrated Medicines Management (LIMM)) in order to reduce drug-related readmi...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3553390/ https://www.ncbi.nlm.nih.gov/pubmed/23315436 http://dx.doi.org/10.1136/bmjopen-2012-001563 |
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author | Ghatnekar, Ola Bondesson, Åsa Persson, Ulf Eriksson, Tommy |
author_facet | Ghatnekar, Ola Bondesson, Åsa Persson, Ulf Eriksson, Tommy |
author_sort | Ghatnekar, Ola |
collection | PubMed |
description | OBJECTIVE: To evaluate the cost effectiveness of a multidisciplinary team including a pharmacist for systematic medication review and reconciliation from admission to discharge at hospital among elderly patients (the Lund Integrated Medicines Management (LIMM)) in order to reduce drug-related readmissions and outpatient visits. METHOD: Published data from the LIMM project group were used to design a probabilistic decision tree model for evaluating tools for (1) a systematic medication reconciliation and review process at initial hospital admission and during stay (admission part) and (2) a medication report for patients discharged from hospital to primary care (discharge part). The comparator was standard care. Inpatient, outpatient and staff time costs (Euros, 2009) were calculated during a 3-month period. Dis-utilities for hospital readmissions and outpatient visits due to medication errors were taken from the literature. RESULTS: The total cost for the LIMM model was €290 compared to €630 for standard care, in spite of a €39 intervention cost. The main cost offset arose from avoided drug-related readmissions in the Admission part (€262) whereas only €66 was offset in the Discharge part as a result of fewer outpatient visits and correction time. The reduced disutility was estimated to 0.005 quality-adjusted life-years (QALY), indicating that LIMM was a dominant alternative. The probability that the intervention would be cost-effective at a zero willingness to pay for a gained QALY compared to standard care was estimated to 98%. CONCLUSIONS: The LIMM medication reconciliation (at admission and discharge) and medication review was both cost-saving and generated greater utility compared to standard care, foremost owing to avoided drug-related hospital readmissions. When implementing such a review process with a multidisciplinary team, it may be important to consider a learning curve in order to capture the full advantage. |
format | Online Article Text |
id | pubmed-3553390 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-35533902013-01-24 Health economic evaluation of the Lund Integrated Medicines Management Model (LIMM) in elderly patients admitted to hospital Ghatnekar, Ola Bondesson, Åsa Persson, Ulf Eriksson, Tommy BMJ Open Health Economics OBJECTIVE: To evaluate the cost effectiveness of a multidisciplinary team including a pharmacist for systematic medication review and reconciliation from admission to discharge at hospital among elderly patients (the Lund Integrated Medicines Management (LIMM)) in order to reduce drug-related readmissions and outpatient visits. METHOD: Published data from the LIMM project group were used to design a probabilistic decision tree model for evaluating tools for (1) a systematic medication reconciliation and review process at initial hospital admission and during stay (admission part) and (2) a medication report for patients discharged from hospital to primary care (discharge part). The comparator was standard care. Inpatient, outpatient and staff time costs (Euros, 2009) were calculated during a 3-month period. Dis-utilities for hospital readmissions and outpatient visits due to medication errors were taken from the literature. RESULTS: The total cost for the LIMM model was €290 compared to €630 for standard care, in spite of a €39 intervention cost. The main cost offset arose from avoided drug-related readmissions in the Admission part (€262) whereas only €66 was offset in the Discharge part as a result of fewer outpatient visits and correction time. The reduced disutility was estimated to 0.005 quality-adjusted life-years (QALY), indicating that LIMM was a dominant alternative. The probability that the intervention would be cost-effective at a zero willingness to pay for a gained QALY compared to standard care was estimated to 98%. CONCLUSIONS: The LIMM medication reconciliation (at admission and discharge) and medication review was both cost-saving and generated greater utility compared to standard care, foremost owing to avoided drug-related hospital readmissions. When implementing such a review process with a multidisciplinary team, it may be important to consider a learning curve in order to capture the full advantage. BMJ Publishing Group 2013-01-10 /pmc/articles/PMC3553390/ /pubmed/23315436 http://dx.doi.org/10.1136/bmjopen-2012-001563 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode. |
spellingShingle | Health Economics Ghatnekar, Ola Bondesson, Åsa Persson, Ulf Eriksson, Tommy Health economic evaluation of the Lund Integrated Medicines Management Model (LIMM) in elderly patients admitted to hospital |
title | Health economic evaluation of the Lund Integrated Medicines Management Model (LIMM) in elderly patients admitted to hospital |
title_full | Health economic evaluation of the Lund Integrated Medicines Management Model (LIMM) in elderly patients admitted to hospital |
title_fullStr | Health economic evaluation of the Lund Integrated Medicines Management Model (LIMM) in elderly patients admitted to hospital |
title_full_unstemmed | Health economic evaluation of the Lund Integrated Medicines Management Model (LIMM) in elderly patients admitted to hospital |
title_short | Health economic evaluation of the Lund Integrated Medicines Management Model (LIMM) in elderly patients admitted to hospital |
title_sort | health economic evaluation of the lund integrated medicines management model (limm) in elderly patients admitted to hospital |
topic | Health Economics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3553390/ https://www.ncbi.nlm.nih.gov/pubmed/23315436 http://dx.doi.org/10.1136/bmjopen-2012-001563 |
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