Publicação
Cost-effectiveness and cost-utility of hypertension and hyperlipidemia collaborative management between pharmacies and primary care in portugal alongside a trial compared with usual care (USFarmácia®)
| Resumo: | Background: There is little experience in the economic evaluation of pharmacy/primary care collaborative health interventions using interprofessional technology-driven communication under real-world conditions. This study aimed to conduct cost-effectiveness and cost-utility analyses of a collaborative care intervention in hypertension and hyperlipidemia management between pharmacies and primary care versus usual (fragmented) care alongside a trial. Methods: An economic evaluation was conducted alongside a 6-month pragmatic quasi-experimental controlled trial. Data sources included primary care clinical software; pharmacy dispensing software; patient telephone surveys; and published literature. The target population was adult patients on hypertension and/or lipid-lowering medication. The perspective was societal. We collected patient-level data on resource use to estimate trial costs. Effect outcomes included blood pressure (BP) and quality-adjusted life years (QALYs). Bootstrapping was used to estimate uncertainty around the incremental cost-effectiveness and cost-utility ratios. Cost-effectiveness planes and acceptability curves were estimated. Results: The intervention was not shown to have reasonable levels of cost-effectiveness or cost-utility when compared to usual care as denoted by the levels of uncertainty expressed in wide confidence intervals. The probability of the intervention being cost-effective is 28% at the threshold of €20,000 per QALY gained and 57% at the threshold of €500 per mmHg systolic BP decrease. Conclusion: Considering the limitations of the trial which affected effectiveness and economic outcomes, our results are not generalizable for community pharmacy and primary care in Portugal. This research offers, however, valuable lessons on methods and strategies that can be used in future economic evaluations of collaborative public health interventions with the potential for reimbursement. |
|---|---|
| Autores principais: | Costa, Suzete |
| Outros Autores: | Guerreiro, José; Teixeira, Inês; Helling, Dennis K.; Pereira, João; Mateus, Céu |
| Assunto: | Community pharmacy Cost-effectiveness Cost-utility Economic Hyperlipidemia Hypertension Primary care Real-world |
| Ano: | 2022 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| _version_ | 1866810899747045376 |
|---|---|
| author | Costa, Suzete |
| author2 | Guerreiro, José Teixeira, Inês Helling, Dennis K. Pereira, João Mateus, Céu |
| author2_role | author author author author author |
| author_facet | Costa, Suzete Guerreiro, José Teixeira, Inês Helling, Dennis K. Pereira, João Mateus, Céu |
| author_role | author |
| contributor_name_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Costa, Suzete\",\"Person.identifier.orcid\":\"0000-0002-4521-5473\"},{\"Person.name\":\"Guerreiro, José\"},{\"Person.name\":\"Teixeira, Inês\"},{\"Person.name\":\"Helling, Dennis K.\"},{\"Person.name\":\"Pereira, João\"},{\"Person.name\":\"Mateus, Céu\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| datacite.creators.creator.creatorName.fl_str_mv | Costa, Suzete Guerreiro, José Teixeira, Inês Helling, Dennis K. Pereira, João Mateus, Céu |
| datacite.date.Accepted.fl_str_mv | 2022-01-01T00:00:00Z |
| datacite.date.available.fl_str_mv | 2022-10-13T11:27:33Z |
| datacite.date.embargoed.fl_str_mv | 2022-10-13T11:27:33Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | Community pharmacy Cost-effectiveness Cost-utility Economic Hyperlipidemia Hypertension Primary care Real-world |
| datacite.titles.title.fl_str_mv | Cost-effectiveness and cost-utility of hypertension and hyperlipidemia collaborative management between pharmacies and primary care in portugal alongside a trial compared with usual care (USFarmácia®) |
| dc.contributor.none.fl_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| dc.creator.none.fl_str_mv | Costa, Suzete Guerreiro, José Teixeira, Inês Helling, Dennis K. Pereira, João Mateus, Céu |
| dc.date.Accepted.fl_str_mv | 2022-01-01T00:00:00Z |
| dc.date.available.fl_str_mv | 2022-10-13T11:27:33Z |
| dc.date.embargoed.fl_str_mv | 2022-10-13T11:27:33Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10451/54762 |
| dc.language.none.fl_str_mv | eng |
| dc.publisher.none.fl_str_mv | Frontiers |
| dc.rights.cclincense.fl_str_mv | http://creativecommons.org/licenses/by/4.0/ |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.subject.none.fl_str_mv | Community pharmacy Cost-effectiveness Cost-utility Economic Hyperlipidemia Hypertension Primary care Real-world |
| dc.title.fl_str_mv | Cost-effectiveness and cost-utility of hypertension and hyperlipidemia collaborative management between pharmacies and primary care in portugal alongside a trial compared with usual care (USFarmácia®) |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_6501 |
| description | Background: There is little experience in the economic evaluation of pharmacy/primary care collaborative health interventions using interprofessional technology-driven communication under real-world conditions. This study aimed to conduct cost-effectiveness and cost-utility analyses of a collaborative care intervention in hypertension and hyperlipidemia management between pharmacies and primary care versus usual (fragmented) care alongside a trial. Methods: An economic evaluation was conducted alongside a 6-month pragmatic quasi-experimental controlled trial. Data sources included primary care clinical software; pharmacy dispensing software; patient telephone surveys; and published literature. The target population was adult patients on hypertension and/or lipid-lowering medication. The perspective was societal. We collected patient-level data on resource use to estimate trial costs. Effect outcomes included blood pressure (BP) and quality-adjusted life years (QALYs). Bootstrapping was used to estimate uncertainty around the incremental cost-effectiveness and cost-utility ratios. Cost-effectiveness planes and acceptability curves were estimated. Results: The intervention was not shown to have reasonable levels of cost-effectiveness or cost-utility when compared to usual care as denoted by the levels of uncertainty expressed in wide confidence intervals. The probability of the intervention being cost-effective is 28% at the threshold of €20,000 per QALY gained and 57% at the threshold of €500 per mmHg systolic BP decrease. Conclusion: Considering the limitations of the trial which affected effectiveness and economic outcomes, our results are not generalizable for community pharmacy and primary care in Portugal. This research offers, however, valuable lessons on methods and strategies that can be used in future economic evaluations of collaborative public health interventions with the potential for reimbursement. |
| dirty | 0 |
| eu_rights_str_mv | openAccess |
| format | article |
| fulltext.url.fl_str_mv | https://repositorio.ulisboa.pt/bitstreams/7f514b9e-4543-48a2-9a39-d33b678502a8/download |
| id | ul_a92e2d7a0c1ec1ffef35ccfe858e8dde |
| identifier.url.fl_str_mv | http://hdl.handle.net/10451/54762 |
| instacron_str | ul |
| institution | Universidade de Lisboa |
| instname_str | Universidade de Lisboa |
| language | eng |
| network_acronym_str | ul |
| network_name_str | Repositório da Universidade de Lisboa |
| oai_identifier_str | oai:repositorio.ulisboa.pt:10451/54762 |
| organization_str_mv | urn:organizationAcronym:ul |
| person_str_mv | Costa, Suzete Costa, Suzete http://orcid.org/0000-0002-4521-5473 0000-0002-4521-5473 Guerreiro, José Teixeira, Inês Helling, Dennis K. Pereira, João Mateus, Céu |
| publishDate | 2022 |
| publisher.none.fl_str_mv | Frontiers |
| reponame_str | Repositório da Universidade de Lisboa |
| repository_id_str | urn:repositoryAcronym:ul |
| service_str_mv | urn:repositoryAcronym:ul |
| spelling | engFrontierspt_PTBackground: There is little experience in the economic evaluation of pharmacy/primary care collaborative health interventions using interprofessional technology-driven communication under real-world conditions. This study aimed to conduct cost-effectiveness and cost-utility analyses of a collaborative care intervention in hypertension and hyperlipidemia management between pharmacies and primary care versus usual (fragmented) care alongside a trial. Methods: An economic evaluation was conducted alongside a 6-month pragmatic quasi-experimental controlled trial. Data sources included primary care clinical software; pharmacy dispensing software; patient telephone surveys; and published literature. The target population was adult patients on hypertension and/or lipid-lowering medication. The perspective was societal. We collected patient-level data on resource use to estimate trial costs. Effect outcomes included blood pressure (BP) and quality-adjusted life years (QALYs). Bootstrapping was used to estimate uncertainty around the incremental cost-effectiveness and cost-utility ratios. Cost-effectiveness planes and acceptability curves were estimated. Results: The intervention was not shown to have reasonable levels of cost-effectiveness or cost-utility when compared to usual care as denoted by the levels of uncertainty expressed in wide confidence intervals. The probability of the intervention being cost-effective is 28% at the threshold of €20,000 per QALY gained and 57% at the threshold of €500 per mmHg systolic BP decrease. Conclusion: Considering the limitations of the trial which affected effectiveness and economic outcomes, our results are not generalizable for community pharmacy and primary care in Portugal. This research offers, however, valuable lessons on methods and strategies that can be used in future economic evaluations of collaborative public health interventions with the potential for reimbursement.application/pdfpt_PTCost-effectiveness and cost-utility of hypertension and hyperlipidemia collaborative management between pharmacies and primary care in portugal alongside a trial compared with usual care (USFarmácia®)PersonalCosta, SuzeteDSpacehttp://dspace.org/items/44ded07d-217a-4c1d-bd60-934fa4097aacDSpacehttp://dspace.org/items/44ded07d-217a-4c1d-bd60-934fa4097aacCostaSuzeteORCIDhttp://orcid.org0000-0002-4521-5473Guerreiro, JoséTeixeira, InêsHelling, Dennis K.Pereira, JoãoMateus, CéuHostingInstitutionOrganizationalRepositório Científico de Acesso Aberto da ULisboae-mailmailto:repositorio@reitoria.ulisboa.ptrepositorio@reitoria.ulisboa.ptDOIIsPartOf10.3389/fphar.2022.9032702022-10-13T11:27:33Z20222022-01-01T00:00:00ZHandlehttp://hdl.handle.net/10451/54762http://purl.org/coar/access_right/c_abf2open accessCommunity pharmacyCost-effectivenessCost-utilityEconomicHyperlipidemiaHypertensionPrimary careReal-world2525006 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal article2022http://creativecommons.org/licenses/by/4.0/http://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://repositorio.ulisboa.pt/bitstreams/7f514b9e-4543-48a2-9a39-d33b678502a8/downloadFrontiers in Pharmacology13 |
| spellingShingle | Cost-effectiveness and cost-utility of hypertension and hyperlipidemia collaborative management between pharmacies and primary care in portugal alongside a trial compared with usual care (USFarmácia®) Costa, Suzete Community pharmacy Cost-effectiveness Cost-utility Economic Hyperlipidemia Hypertension Primary care Real-world |
| status | SINGLETON |
| subject.fl_str_mv | Community pharmacy Cost-effectiveness Cost-utility Economic Hyperlipidemia Hypertension Primary care Real-world |
| title | Cost-effectiveness and cost-utility of hypertension and hyperlipidemia collaborative management between pharmacies and primary care in portugal alongside a trial compared with usual care (USFarmácia®) |
| title_full | Cost-effectiveness and cost-utility of hypertension and hyperlipidemia collaborative management between pharmacies and primary care in portugal alongside a trial compared with usual care (USFarmácia®) |
| title_fullStr | Cost-effectiveness and cost-utility of hypertension and hyperlipidemia collaborative management between pharmacies and primary care in portugal alongside a trial compared with usual care (USFarmácia®) |
| title_full_unstemmed | Cost-effectiveness and cost-utility of hypertension and hyperlipidemia collaborative management between pharmacies and primary care in portugal alongside a trial compared with usual care (USFarmácia®) |
| title_short | Cost-effectiveness and cost-utility of hypertension and hyperlipidemia collaborative management between pharmacies and primary care in portugal alongside a trial compared with usual care (USFarmácia®) |
| title_sort | Cost-effectiveness and cost-utility of hypertension and hyperlipidemia collaborative management between pharmacies and primary care in portugal alongside a trial compared with usual care (USFarmácia®) |
| topic | Community pharmacy Cost-effectiveness Cost-utility Economic Hyperlipidemia Hypertension Primary care Real-world |
| topic_facet | Community pharmacy Cost-effectiveness Cost-utility Economic Hyperlipidemia Hypertension Primary care Real-world |
| url | http://hdl.handle.net/10451/54762 |
| visible | 1 |