General practitioner practice-based pharmacist input to medicines optimisation in the UK: pragmatic, multicenter, randomised, controlled trial

Syafhan, Nadia Farhanah; Al Azzam, Sayer; Williams, Steven D.; Wilson, Wendy; Brady, Jayne; Lawrence, Peter; McCrudden, Mark; Ahmed, Mustafa; Scott, Michael G.; Fleming, Glenda; Hogg, Anita; Scullin, Claire; Horne, Robert; Ahir, Harblas; McElnay, James C.

doi:10.1186/s40545-020-00279-3

Journal of Pharmaceutical Policy and Practice

Table 4 Cost of healthcare resource utilisation in control and intervention group patients at baseline and at 6-month follow-up

From: General practitioner practice-based pharmacist input to medicines optimisation in the UK: pragmatic, multicenter, randomised, controlled trial

Outcome measures	Control			Intervention			p value
	Baseline (6 months pre-study)	6-month follow-up	Difference^#	Baseline (6 months pre-study)	6-month follow-up	Difference^#
	n = 161* (48.8%)	n = 161* (48.8%)	Difference^#	n = 169* (51.2%)	n = 169* (51.2%)	Difference^#
Cost of unplanned hospital admissions^a (total)	83,483	65,853		64,873	43,425
Mean ± SD	518.5 ± 1438.0	409.0 ± 1446.6	109.5 ± 2027.7	383.9 ± 1224.1	257.0 ± 979.9	126.9 ± 1453.7	0.305^g 0.230^h 0.743ⁱ
Median [IQR]	0 [0–0]	0 [0–0]	0 [0–0]	0 [0–0]	0 [0–0]	0 [0–0]	0.305^g 0.230^h 0.743ⁱ
Cost of A&E attendances^b (total)	6525	8265		6235	5365
Mean ± SD	40.5 ± 86.1	51.3 ± 112.8	− 10.8 ± 127.2	36.9 ± 77.6	31.7 ± 64.2	5.2 ± 86.5	0.326^g 0.433^h 0.333ⁱ
Median [IQR]	0 [0–0]	0 [0–0]	0 [0–0]	0 [0–0]	0 [0–0]	0 [0–0]	0.326^g 0.433^h 0.333ⁱ
Cost of face-to-face consultations in General practice^c (total)	21,865	21,101		21,752	19,361
Mean ± SD	135.8 ± 102.2	131.1 ± 106.2	4.8 ± 111.7	128.7 ± 101.2	114.6 ± 94.1	14.2 ± 103.4	0.511^g 0.081^h 0.467ⁱ
Median [IQR]	112 [66–186]	108 [56–182]	10 [− 56–56]	108 [46–200]	87 [36–174]	10 [− 40–72]	0.511^g 0.081^h 0.467ⁱ
Cost of telephone consultations in general practice^d (total)	4919.0	4916.0		5262.0	3564.5
Mean ± SD	30.6 ± 52.4	30.5 ± 47.8	0.0 ± 43.6	31.1 ± 47.4	21.1 ± 32.0	10.0 ± 38.5	0.619^g < 0.001^h 0.007ⁱ
Median [IQR]	18.0 [0.0–36.0]	18.0 [0.0–39.8]	0.0 [− 18.0–16.8]	18.0 [0.0–52.5]	7.5 [0.0–28.0]	0.0 [0.0–19.5]	0.619^g < 0.001^h 0.007ⁱ
Cost of total general practice consultation (total)	26,784.0	26,017.0		27,014.0	22,925.5
Mean ± SD	166.4 ± 130.3	161.6 ± 131.1	4.8 ± 127.8	159.8 ± 125.8	135.7 ± 106	24.2 ± 115.7	0.551^g 0.014^h 0.194ⁱ
Median [IQR]	138.0 [73.0–218.0]	133.0 [72.0–222.0]	10.0 [− 59.0–65.5]	136.0 [56.0–236.5]	107.5 [52.0–200.0]	15.0 [− 43.5–90.0]	0.551^g 0.014^h 0.194ⁱ
Cost of outpatient visits^e (total)	72,480	72,480		77,920	68,800
Mean ± SD	450.2 ± 465.9	450.2 ± 467.2	0.0 ± 360.9	461.1 ± 496.8	407.1 ± 488.8	54.0 ± 418.57	0.934^g 0.074^h 0.136ⁱ
Median [IQR]	320 [160–640]	320 [0–640]	0 [− 160–160]	320 [160–640]	320 [0–640]	0 [− 160–320]	0.934^g 0.074^h 0.136ⁱ
Total healthcare resource utilisation cost^f (total)	189,272	172,615		176,042	145,184
Mean ± SD	1175.6 ± 1619.3	1072.1 ± 1635.0	103.5 ± 2104.6	1041.7 ± 1446.7	859.1 ± 1235.2	182.6 ± 1579.2	0.276^g 0.032^h 0.491ⁱ
Median [IQR]	552 [313.5–1251.0]	572 [208.0–1168.3]	21.0 [− 267.5–416.5]	618 [279.0–1124.0]	477 [232.3–927.3]	95.5 [− 241.8–472.0]	0.276^g 0.032^h 0.491ⁱ

Bold values denote statistical significance at the p < 0.05 level
*From 356 patients, 14 patients’ healthcare resource utilisation data were not available, seven patients were deceased, five patients had 20 or more days of length of stay at baseline or 6-month follow-up
^#Calculated as utilisation at baseline minus utilisation at end of study
^aCost of non-elective inpatient stay (short stay) i.e. 1–2 days £608, 3–6 days £3079, non-elective excess bed day (long stay more than 6 days, attracted cost for every day over of £437)
^bA&E attendances £145
^cGP £36, Pharmacist £15, nurse practitioner £10
^dGP £18, pharmacist £7.5, nurse practitioner £5
^eOutpatient visit £160
^fAll healthcare resource utilisation cost including intervention cost. The 1st, 2nd, 3rd appointment costs were £15, £8.5 and £7.5
^gWilcoxon signed rank test (within control group, between baseline and 6-month follow-up),
^hWilcoxon signed rank test (within intervention group, between baseline and 6-month follow-up)
ⁱMann–Whitney U test (between control vs intervention for the cost difference from baseline).

Back to article page

ISSN: 2052-3211

Contact us

Submission enquiries: Access here and click Contact Us
General enquiries: info@biomedcentral.com