基于试验的药物优化干预与老年人标准护理的成本效益分析
Eirin Guldsten Robinson1, Hanna Gyllensten2, Jeanette Schultz Johansen3
1Department of Pharmacy, University of Oslo, 1068 Blindern, 0316 Oslo, Norway. e.g.robinson@farmasi.uio.no.
Drugs & aging
|November 22, 2023
概括
对所有住院的老年人来说,药物优化干预并非具有成本效益. 然而,对于住院时间较短的患者来说,它被证明是具有成本效益的,在这个子组中显示出显著的价值.
科学领域:
- 老年医学 老年医学
- 卫生经济学 卫生经济学
- 药物经济学 药物经济学
背景情况:
- 老年人面临更高的药物相关伤害风险.
- 综合药物管理 (IMM) 模式旨在优化药物治疗,改善老年患者的治疗结果.
- 在IMMENSE试验中,评估了药物优化干预措施的成本效益.
研究的目的:
- 评估药物优化干预与急性住院老年人的标准护理之间的成本效益.
- 分析对质量调整寿命年 (QALYs) 和医疗保健成本的影响.
- 根据住院时间进行子组分析.
主要方法:
- 除了IMMENSE研究,还进行了成本效益分析,包括285名70岁及以上的成年人.
- 经质量调整的寿命年 (QALYs) 用EQ-5D-3L问卷进行测量.
- 医疗保健利用率和成本是从行政登记处获得的,从医疗保健的角度进行分析.
主要成果:
- 在全人口分析中,干预组的平均QALY (0.023) 和医疗费用 (€4429) 较高,ICER为€192,565/QALY.
- 对于非长期逗留 (<14天) 的人来说,干预主导了标准护理,QALY增加了0.067,成本降低了824.4欧元.
- 对于长期逗留 (≥14天) 的人来说,干预导致了较低的QALY (-0.101) 和更高的成本 (1992欧元). 住院和再接收是关键的成本驱动因素.
结论:
- 与急性住院老年人整体人口的标准护理相比,药物优化干预措施的成本效益并不高.
- 该干预措施证明了成本效益,并主导了短期停留者的小组的标准护理.
- 这些发现强调了在药物管理干预中考虑患者子组的重要性.
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