Cost-Effectiveness of Reducing Glycaemic Episodes Through Community Pharmacy Management of Patients with Type 2 Diabetes Mellitus

Accessibility, availability and frequent public contact place community pharmacists in an ideal position to provide medically necessary, intensive health education and preventive health services to diabetes patients, thus reducing physician burden. We assessed the cost-effectiveness of reducing glyc...

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Main Authors: Hendrie, Delia, Miller, T., Woodman, R., Hoti, Kreshnik, Hughes, Jeffrey David
Format: Journal Article
Published: Springer 2014
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/31443
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author Hendrie, Delia
Miller, T.
Woodman, R.
Hoti, Kreshnik
Hughes, Jeffrey David
author_facet Hendrie, Delia
Miller, T.
Woodman, R.
Hoti, Kreshnik
Hughes, Jeffrey David
author_sort Hendrie, Delia
building Curtin Institutional Repository
collection Online Access
description Accessibility, availability and frequent public contact place community pharmacists in an ideal position to provide medically necessary, intensive health education and preventive health services to diabetes patients, thus reducing physician burden. We assessed the cost-effectiveness of reducing glycaemic episodes in patients with type 2 diabetes mellitus through a pharmacist-led Diabetes Management Education Program (DMEP) compared to standard care. We recruited eight metropolitan community pharmacies in Perth, Western Australia for the study. We paired them based on geographical location and the socioeconomic status of the population served, and then randomly selected one pharmacy in each pair to be in the intervention group, with the other assigned to the control group. We conducted an incremental cost-effectiveness analysis to compare the costs and effectiveness of DMEP with standard pharmacy care. Cost per patient of implementing DMEP was AU$394 (US$356) for the 6-month intervention period. Significantly greater reductions in number of hyperglycaemic and hypoglycaemic episodes occurred in the intervention relative to the control group [OR 0.34 (95 % CI 0.22, 0.52), p = 0.001; OR 0.54 (95 % CI 0.34, 0.86), p = 0.009], respectively, with a net reduction of 1.86 days with glycaemic episodes per patient per month. The cost-effectiveness of DMEP relative to standard pharmacy care was AU$43 (US$39) per day of glycaemic symptoms avoided. Patients with type 2 diabetes in three surveys were willing to pay an average of 1.9 times that amount to avoid a hypoglycaemic day. We conclude that DMEP decreased days with glycaemic symptoms at a reasonable cost. If a larger-scale replication study confirms these findings, widespread adoption of this approach would improve diabetes health without burdening general practitioners.
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spelling curtin-20.500.11937-314432017-09-13T15:20:30Z Cost-Effectiveness of Reducing Glycaemic Episodes Through Community Pharmacy Management of Patients with Type 2 Diabetes Mellitus Hendrie, Delia Miller, T. Woodman, R. Hoti, Kreshnik Hughes, Jeffrey David Block-randomised Incremental cost-effectiveness ratio Indicated prevention Health education SF36 Accessibility, availability and frequent public contact place community pharmacists in an ideal position to provide medically necessary, intensive health education and preventive health services to diabetes patients, thus reducing physician burden. We assessed the cost-effectiveness of reducing glycaemic episodes in patients with type 2 diabetes mellitus through a pharmacist-led Diabetes Management Education Program (DMEP) compared to standard care. We recruited eight metropolitan community pharmacies in Perth, Western Australia for the study. We paired them based on geographical location and the socioeconomic status of the population served, and then randomly selected one pharmacy in each pair to be in the intervention group, with the other assigned to the control group. We conducted an incremental cost-effectiveness analysis to compare the costs and effectiveness of DMEP with standard pharmacy care. Cost per patient of implementing DMEP was AU$394 (US$356) for the 6-month intervention period. Significantly greater reductions in number of hyperglycaemic and hypoglycaemic episodes occurred in the intervention relative to the control group [OR 0.34 (95 % CI 0.22, 0.52), p = 0.001; OR 0.54 (95 % CI 0.34, 0.86), p = 0.009], respectively, with a net reduction of 1.86 days with glycaemic episodes per patient per month. The cost-effectiveness of DMEP relative to standard pharmacy care was AU$43 (US$39) per day of glycaemic symptoms avoided. Patients with type 2 diabetes in three surveys were willing to pay an average of 1.9 times that amount to avoid a hypoglycaemic day. We conclude that DMEP decreased days with glycaemic symptoms at a reasonable cost. If a larger-scale replication study confirms these findings, widespread adoption of this approach would improve diabetes health without burdening general practitioners. 2014 Journal Article http://hdl.handle.net/20.500.11937/31443 10.1007/s10935-014-0368-x Springer restricted
spellingShingle Block-randomised
Incremental cost-effectiveness ratio
Indicated prevention
Health education
SF36
Hendrie, Delia
Miller, T.
Woodman, R.
Hoti, Kreshnik
Hughes, Jeffrey David
Cost-Effectiveness of Reducing Glycaemic Episodes Through Community Pharmacy Management of Patients with Type 2 Diabetes Mellitus
title Cost-Effectiveness of Reducing Glycaemic Episodes Through Community Pharmacy Management of Patients with Type 2 Diabetes Mellitus
title_full Cost-Effectiveness of Reducing Glycaemic Episodes Through Community Pharmacy Management of Patients with Type 2 Diabetes Mellitus
title_fullStr Cost-Effectiveness of Reducing Glycaemic Episodes Through Community Pharmacy Management of Patients with Type 2 Diabetes Mellitus
title_full_unstemmed Cost-Effectiveness of Reducing Glycaemic Episodes Through Community Pharmacy Management of Patients with Type 2 Diabetes Mellitus
title_short Cost-Effectiveness of Reducing Glycaemic Episodes Through Community Pharmacy Management of Patients with Type 2 Diabetes Mellitus
title_sort cost-effectiveness of reducing glycaemic episodes through community pharmacy management of patients with type 2 diabetes mellitus
topic Block-randomised
Incremental cost-effectiveness ratio
Indicated prevention
Health education
SF36
url http://hdl.handle.net/20.500.11937/31443