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.
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.
Malone
D C
DC
University of Colorado Health Sciences Center, School of Pharmacy, Denver, USA. Malone@pharmacy.arizona.edu
Carter
B L
BL
Billups
S J
SJ
Valuck
R J
RJ
Barnette
D J
DJ
Sintek
C D
CD
Okano
G J
GJ
Ellis
S
S
Covey
D
D
Mason
B
B
Jue
S
S
Carmichael
J
J
Guthrie
K
K
Sloboda
L
L
Dombrowski
R
R
Geraets
D R
DR
Amato
M G
MG
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