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The Effectiveness of Interventions to Evaluate and Reduce Healthcare Costs of Potentially Inappropriate Prescriptions among the Older Adults: A Systematic Review

Author

Listed:
  • Sara Mucherino

    (CIRFF—Center of Pharmacoeconomics and Drug Utilization, Department of Pharmacy, Federico II University of Naples, 80131 Naples, Italy)

  • Manuela Casula

    (Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, 20133 Milan, Italy
    IRCCS MultiMedica Hospital, Sesto S. Giovanni, 20099 Milan, Italy)

  • Federica Galimberti

    (IRCCS MultiMedica Hospital, Sesto S. Giovanni, 20099 Milan, Italy)

  • Ilaria Guarino

    (CIRFF—Center of Pharmacoeconomics and Drug Utilization, Department of Pharmacy, Federico II University of Naples, 80131 Naples, Italy)

  • Elena Olmastroni

    (Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, 20133 Milan, Italy)

  • Elena Tragni

    (Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, 20133 Milan, Italy)

  • Valentina Orlando

    (CIRFF—Center of Pharmacoeconomics and Drug Utilization, Department of Pharmacy, Federico II University of Naples, 80131 Naples, Italy)

  • Enrica Menditto

    (CIRFF—Center of Pharmacoeconomics and Drug Utilization, Department of Pharmacy, Federico II University of Naples, 80131 Naples, Italy)

  • on behalf of the EDU.RE.DRUG Group

    (Collaborators/Membership of the Group/Team Name is provided in the Acknowledgments.)

Abstract

Potentially inappropriate prescribing (PIP) is associated with an increased risk of adverse drug reactions, recognized as a determinant of adherence and increased healthcare costs. The study’s aim was to explore and compare the results of interventions to reduce PIP and its impact on avoidable healthcare costs. A systematic literature review was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement guidelines. PubMed and Embase were queried until February 2021. Inclusion criteria followed the PICO model: older patients receiving PIP; Interventions aimed at health professionals, structures, and patients; no/any intervention as a comparator; postintervention costs variations as outcomes. The search strategy produced 274 potentially relevant publications, of which 18 articles met inclusion criteria. Two subgroups were analyzed according to the study design: observational studies assessing PIP frequency and related-avoidable costs ( n = 10) and trials, including specific intervention and related outcomes in terms of postintervention effectiveness and avoided costs ( n = 8). PIP prevalence ranged from 21 to 79%. Few educational interventions carried out to reduce PIP prevalence and avoidable costs resulted in a slowly improving prescribing practice but not cost effective. Implementing cost-effective strategies for reducing PIP and clinical and economic implications is fundamental to reducing health systems’ PIP burden.

Suggested Citation

  • Sara Mucherino & Manuela Casula & Federica Galimberti & Ilaria Guarino & Elena Olmastroni & Elena Tragni & Valentina Orlando & Enrica Menditto & on behalf of the EDU.RE.DRUG Group, 2022. "The Effectiveness of Interventions to Evaluate and Reduce Healthcare Costs of Potentially Inappropriate Prescriptions among the Older Adults: A Systematic Review," IJERPH, MDPI, vol. 19(11), pages 1-19, May.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:11:p:6724-:d:829235
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    References listed on IDEAS

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    1. Buetow, Stephen A. & Sibbald, Bonnie & Cantrill, Judith A. & Halliwell, Shirley, 1997. "Appropriateness in health care: Application to prescribing," Social Science & Medicine, Elsevier, vol. 45(2), pages 261-271, July.
    2. Katharina Elisabeth Fischer & Taika Koch & Karel Kostev & Tom Stargardt, 2018. "The impact of physician-level drug budgets on prescribing behavior," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(2), pages 213-222, March.
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