title: An economic analysis of a randomized, controlled, multicenter study of clinical pharmacist interventions for high-risk veterans: the IMPROVE study. Impact of Managed Pharmaceutical Care Resource Utilization and Outcomes in Veterans Affairs Medical Centers.
abstract: OBJECTIVE
  To determine if clinical pharmacists could affect economic resource use and humanistic outcomes in an ambulatory, high-risk population.
  
  
  METHODS
  Prospective, randomized, controlled study.
  
  
  METHODS
  Nine Veterans Affairs medical centers.
  
  
  METHODS
  Patients who were at high risk for medication-related problems.
  
  
  METHODS
  Patients were randomized to usual medical care with input from a clinical pharmacist (intervention group) or just usual medical care (control group).
  
  
  RESULTS
  Of 1,054 patients enrolled, 523 were randomized to the intervention group and 531 to the control group. The number of clinic visits increased in the intervention group (p=0.003), but there was no difference in clinic costs. Mean increases in total health care costs were $1,020 for the intervention group and $1,313 for the control group (p=0.06).
  
  
  CONCLUSIONS
  Including the cost of pharmacist interventions, overall health care expenditures were similar for patients randomized to see a clinical pharmacist versus usual medical care.
authors.affiliation: University of Colorado Health Sciences Center, School of Pharmacy, Denver, USA. Malone@pharmacy.arizona.edu
authors.forename: D C
authors.initials: DC
authors.lastname: Malone
authors.forename: B L
authors.initials: BL
authors.lastname: Carter
authors.forename: S J
authors.initials: SJ
authors.lastname: Billups
authors.forename: R J
authors.initials: RJ
authors.lastname: Valuck
authors.forename: D J
authors.initials: DJ
authors.lastname: Barnette
authors.forename: C D
authors.initials: CD
authors.lastname: Sintek
authors.forename: G J
authors.initials: GJ
authors.lastname: Okano
authors.forename: S
authors.initials: S
authors.lastname: Ellis
authors.forename: D
authors.initials: D
authors.lastname: Covey
authors.forename: B
authors.initials: B
authors.lastname: Mason
authors.forename: S
authors.initials: S
authors.lastname: Jue
authors.forename: J
authors.initials: J
authors.lastname: Carmichael
authors.forename: K
authors.initials: K
authors.lastname: Guthrie
authors.forename: L
authors.initials: L
authors.lastname: Sloboda
authors.forename: R
authors.initials: R
authors.lastname: Dombrowski
authors.forename: D R
authors.initials: DR
authors.lastname: Geraets
authors.forename: M G
authors.initials: MG
authors.lastname: Amato
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000191:economics; D002908:Chronic Disease; D015986:Confounding Factors, Epidemiologic; D016903:Drug Monitoring / Q000379:methods*; D005260:Female; D006787:Hospitals, Veterans / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D017060:Patient Satisfaction; D010595:Pharmacists; D010607:Pharmacy Service, Hospital / Q000191:economics*; D011446:Prospective Studies; D019057:Quality-Adjusted Life Years; D012307:Risk Factors; D016312:Treatment Refusal; D014481:United States