Cost avoidance of pharmacist-led deprescribing using STOPPFrail for older adults in nursing homes

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dc.contributor.authorHurley, Eoinen
dc.contributor.authorByrne, Stephenen
dc.contributor.authorWalsh, Elaineen
dc.contributor.authorFoley, Tonyen
dc.contributor.authorWoods, Noelen
dc.contributor.authorDalton, Kieranen
dc.contributor.funderIrish Research Councilen
dc.date.accessioned2024-07-24T15:18:08Z
dc.date.available2024-07-24T15:18:08Z
dc.date.issued2024-07-05en
dc.description.abstractBackground: The Screening Tool of Older Persons Prescriptions in Frail adults with limited life expectancy (STOPPFrail) criteria aim to reduce inappropriate/unnecessary medications in frail older adults, which should minimise adverse drug events and additional healthcare expenditure. Little is known about the economic outcomes of applying these criteria as an intervention. Aim: To evaluate cost avoidance of pharmacist-led application of STOPPFrail to frail older nursing home residents with limited life expectancy. Method: Pharmacist-identified STOPPFrail-defined potentially inappropriate medications that were deprescribed by patients’ general practitioners were assigned a rating by a multidisciplinary panel, i.e. the probability of an adverse drug event occurring if the medication was not deprescribed. The intervention’s net cost benefit and cost–benefit ratio were then determined by factoring in adverse drug event cost avoidance (calculated from probability of adverse drug event ratings), direct cost savings (deprescribed medication costs/reimbursement fees), and healthcare professionals’ salaries. Results: Of the 176 potentially inappropriate medications deprescribed across 69 patients, 65 (36.9%) were rated as having a medium or high probability of an adverse drug event occurring if not deprescribed. With €27,162 for direct cost savings, €61,336 for adverse drug event cost avoidance, and €2,589 for healthcare professionals' salary costs, there was a net cost benefit of €85,909 overall. The cost–benefit ratio was 33.2 and remained positive in all scenarios in sensitivity analyses. Conclusion: Pharmacist-led application of STOPPFrail to frail older nursing home residents is associated with significant cost avoidance. Wider implementation of pharmacist interventions in frail older nursing home residents should be considered to reduce potentially inappropriate medications and patient harm, alongside substantial cost savings for healthcare systems.en
dc.description.sponsorshipIrish Research Council (GOIPG/2020/1070)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationHurley, E., Byrne, S., Walsh, E., Foley, T., Woods, N. and Dalton, K. (2024) 'Cost avoidance of pharmacist-led deprescribing using STOPPFrail for older adults in nursing homes', International Journal of Clinical Pharmacy. https://doi.org/10.1007/s11096-024-01749-3en
dc.identifier.doihttps://doi.org/10.1007/s11096-024-01749-3en
dc.identifier.eissn2210-7711en
dc.identifier.issn2210-7703en
dc.identifier.journaltitleInternational Journal of Clinical Pharmacyen
dc.identifier.urihttps://hdl.handle.net/10468/16148
dc.language.isoenen
dc.publisherSpringer Natureen
dc.rights© 2024, the Authors, under exclusive licence to Springer Nature Switzerland AG. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.en
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subjectFrailtyen
dc.subjectMedication reviewen
dc.subjectNursing homeen
dc.subjectPharmacisten
dc.subjectPharmacoeconomicen
dc.subjectSTOPPFrailen
dc.titleCost avoidance of pharmacist-led deprescribing using STOPPFrail for older adults in nursing homesen
dc.typeArticle (peer-reviewed)en
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