Cost-effectiveness of a community pharmacist intervention in patients with depression: a randomized controlled trial (PRODEFAR Study).

<h4>Background</h4>Non-adherence to antidepressants generates higher costs for the treatment of depression. Little is known about the cost-effectiveness of pharmacist's interventions aimed at improving adherence to antidepressants. The study aimed to evaluate the cost-effectiveness...

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Autores principales:	Maria Rubio-Valera, Judith Bosmans, Ana Fernández, Maite Peñarrubia-María, Marian March, Pere Travé, Juan A Bellón, Antoni Serrano-Blanco
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/04485262b957421ebe4b6a54bcf9331e
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spelling	oai:doaj.org-article:04485262b957421ebe4b6a54bcf9331e2021-11-18T09:00:18ZCost-effectiveness of a community pharmacist intervention in patients with depression: a randomized controlled trial (PRODEFAR Study).1932-620310.1371/journal.pone.0070588https://doaj.org/article/04485262b957421ebe4b6a54bcf9331e2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23950967/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Non-adherence to antidepressants generates higher costs for the treatment of depression. Little is known about the cost-effectiveness of pharmacist's interventions aimed at improving adherence to antidepressants. The study aimed to evaluate the cost-effectiveness of a community pharmacist intervention in comparison with usual care in depressed patients initiating treatment with antidepressants in primary care.<h4>Methods</h4>Patients were recruited by general practitioners and randomized to community pharmacist intervention (87) that received an educational intervention and usual care (92). Adherence to antidepressants, clinical symptoms, Quality-Adjusted Life-Years (QALYs), use of healthcare services and productivity losses were measured at baseline, 3 and 6 months.<h4>Results</h4>There were no significant differences between groups in costs or effects. From a societal perspective, the incremental cost-effectiveness ratio (ICER) for the community pharmacist intervention compared with usual care was €1,866 for extra adherent patient and €9,872 per extra QALY. In terms of remission of depressive symptoms, the usual care dominated the community pharmacist intervention. If willingness to pay (WTP) is €30,000 per extra adherent patient, remission of symptoms or QALYs, the probability of the community pharmacist intervention being cost-effective was 0.71, 0.46 and 0.75, respectively (societal perspective). From a healthcare perspective, the probability of the community pharmacist intervention being cost-effective in terms of adherence, QALYs and remission was of 0.71, 0.76 and 0.46, respectively, if WTP is €30,000.<h4>Conclusion</h4>A brief community pharmacist intervention addressed to depressed patients initiating antidepressant treatment showed a probability of being cost-effective of 0.71 and 0.75 in terms of improvement of adherence and QALYs, respectively, when compared to usual care. Regular implementation of the community pharmacist intervention is not recommended.<h4>Trial registration</h4>ClinicalTrials.gov NCT00794196.Maria Rubio-ValeraJudith BosmansAna FernándezMaite Peñarrubia-MaríaMarian MarchPere TravéJuan A BellónAntoni Serrano-BlancoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 8, p e70588 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Maria Rubio-Valera Judith Bosmans Ana Fernández Maite Peñarrubia-María Marian March Pere Travé Juan A Bellón Antoni Serrano-Blanco Cost-effectiveness of a community pharmacist intervention in patients with depression: a randomized controlled trial (PRODEFAR Study).
description	<h4>Background</h4>Non-adherence to antidepressants generates higher costs for the treatment of depression. Little is known about the cost-effectiveness of pharmacist's interventions aimed at improving adherence to antidepressants. The study aimed to evaluate the cost-effectiveness of a community pharmacist intervention in comparison with usual care in depressed patients initiating treatment with antidepressants in primary care.<h4>Methods</h4>Patients were recruited by general practitioners and randomized to community pharmacist intervention (87) that received an educational intervention and usual care (92). Adherence to antidepressants, clinical symptoms, Quality-Adjusted Life-Years (QALYs), use of healthcare services and productivity losses were measured at baseline, 3 and 6 months.<h4>Results</h4>There were no significant differences between groups in costs or effects. From a societal perspective, the incremental cost-effectiveness ratio (ICER) for the community pharmacist intervention compared with usual care was €1,866 for extra adherent patient and €9,872 per extra QALY. In terms of remission of depressive symptoms, the usual care dominated the community pharmacist intervention. If willingness to pay (WTP) is €30,000 per extra adherent patient, remission of symptoms or QALYs, the probability of the community pharmacist intervention being cost-effective was 0.71, 0.46 and 0.75, respectively (societal perspective). From a healthcare perspective, the probability of the community pharmacist intervention being cost-effective in terms of adherence, QALYs and remission was of 0.71, 0.76 and 0.46, respectively, if WTP is €30,000.<h4>Conclusion</h4>A brief community pharmacist intervention addressed to depressed patients initiating antidepressant treatment showed a probability of being cost-effective of 0.71 and 0.75 in terms of improvement of adherence and QALYs, respectively, when compared to usual care. Regular implementation of the community pharmacist intervention is not recommended.<h4>Trial registration</h4>ClinicalTrials.gov NCT00794196.
format	article
author	Maria Rubio-Valera Judith Bosmans Ana Fernández Maite Peñarrubia-María Marian March Pere Travé Juan A Bellón Antoni Serrano-Blanco
author_facet	Maria Rubio-Valera Judith Bosmans Ana Fernández Maite Peñarrubia-María Marian March Pere Travé Juan A Bellón Antoni Serrano-Blanco
author_sort	Maria Rubio-Valera
title	Cost-effectiveness of a community pharmacist intervention in patients with depression: a randomized controlled trial (PRODEFAR Study).
title_short	Cost-effectiveness of a community pharmacist intervention in patients with depression: a randomized controlled trial (PRODEFAR Study).
title_full	Cost-effectiveness of a community pharmacist intervention in patients with depression: a randomized controlled trial (PRODEFAR Study).
title_fullStr	Cost-effectiveness of a community pharmacist intervention in patients with depression: a randomized controlled trial (PRODEFAR Study).
title_full_unstemmed	Cost-effectiveness of a community pharmacist intervention in patients with depression: a randomized controlled trial (PRODEFAR Study).
title_sort	cost-effectiveness of a community pharmacist intervention in patients with depression: a randomized controlled trial (prodefar study).
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/04485262b957421ebe4b6a54bcf9331e
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Cost-effectiveness of a community pharmacist intervention in patients with depression: a randomized controlled trial (PRODEFAR Study).

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