dc.contributor.author | Gillespie, Paddy | |
dc.contributor.author | Clyne, Barbara | |
dc.contributor.author | Raymakers, Adam | |
dc.contributor.author | Fahey, Tom | |
dc.contributor.author | Hughes, Carmel M. | |
dc.contributor.author | Smith, Susan M. | |
dc.date.accessioned | 2018-09-20T16:09:11Z | |
dc.date.available | 2018-09-20T16:09:11Z | |
dc.date.issued | 2017-10-11 | |
dc.identifier.citation | Gillespie, Paddy; Clyne, Barbara; Raymakers, Adam; Fahey, Tom; Hughes, Carmel M. Smith, Susan M. (2017). Reducing potentially inappropriate prescribing for older people in primary care: cost-effectiveness of the opti-script intervention. International Journal of Technology Assessment in Health Care 33 (4), 494-503 | |
dc.identifier.issn | 0266-4623,1471-6348 | |
dc.identifier.uri | http://hdl.handle.net/10379/11644 | |
dc.description.abstract | Objectives: This study examines the cost-effectiveness of the OPTI-SCRIPT intervention on potentially inappropriate prescribing in primary care.
Methods: Economic evaluation, using incremental cost-effectiveness and cost utility analyses, conducted alongside a cluster randomized controlled trial of twenty-one general practices and 196 patients, to compare a multifaceted intervention with usual practice in primary care in Ireland. Potentially inappropriate prescriptions (PIPs) were determined by a pharmacist. Incremental costs, PIPs, and quality-adjusted life-years (QALYs) at 12-month follow-up were estimated using multilevel regression. Uncertainty was explored using cost-effectiveness acceptability curves.
Results: The intervention was associated with a nonsignificant mean cost increase of Euro407 (95 percent CIs, -357-1170), a significant mean reduction in PIPs of 0.379 (95 percent CI, 0.092-0.666), and a nonsignificant mean increase in QALYs of 0.013 (95 percent CIs, -0.016-0.042). The incremental cost per PIP avoided was Euro1,269 (95 percent CI, -1400-6302) and the incremental cost per QALY gained was Euro30,535 (95 percent CI, -334,846-289,498). The probability of the intervention being cost-effective was 0.602 at a threshold value of Euro45,000 per QALY gained and was at least 0.845 at threshold values of Euro2,500 per PIP avoided and higher.
Conclusions: While the OPTI-SCRIPT intervention was effective in reducing potentially inappropriate prescribing in primary care in Ireland, our findings highlight the uncertainty with respect to its cost-effectiveness. Further studies are required to explore the health and economic implications of interventions targeting potentially inappropriate prescribing. | |
dc.publisher | Cambridge University Press (CUP) | |
dc.relation.ispartof | International Journal of Technology Assessment in Health Care | |
dc.rights | Attribution-NonCommercial-NoDerivs 3.0 Ireland | |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/3.0/ie/ | |
dc.subject | cost-effectiveness | |
dc.subject | randomized controlled trial | |
dc.subject | potentially inappropriate prescribing | |
dc.subject | primary care | |
dc.subject | randomized controlled-trial | |
dc.subject | multifaceted intervention | |
dc.subject | prospective cohort | |
dc.subject | outcomes | |
dc.title | Reducing potentially inappropriate prescribing for older people in primary care: cost-effectiveness of the opti-script intervention | |
dc.type | Article | |
dc.identifier.doi | 10.1017/s0266462317000782 | |
dc.local.publishedsource | https://pure.qub.ac.uk/portal/files/148198769/OPTI_SCRIPT_Manuscript_May_18_.pdf | |
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