Ibrahim Nor Haizan, Maruan Khalidah, Mohd Khairy Hasryn Azzuar, Hong Yet Hoi, Dali Ahmad Fauzi, Neoh Chin Fen
Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia.
J Pharm Pharm Sci. 2017;20(1):397-406. doi: 10.18433/J3NW7G.
To systematically review studies on cost-effectiveness of implementing Antimicrobial stewardship programmes (ASP) in the hospital setting.
A systematic literature search was performed using electronic databases, such as EMBASE, PubMed/Medline, CINAHL, NHS and CEA Registry from 2000 until 2017. The quality of each included study was assessed using Joanna Briggs Institute Critical Appraisal Checklist for Economic Evaluations and Consolidated Health Economic Evaluation Reporting Standards Statement checklist.
Of the 313 papers retrieved, five papers were included in this review after assessment for eligibility. The majority of the studies were cost-effectiveness studies, comparing ASP to standard care. Four included economic studies were conducted from the provider (hospital) perspective while the other study was from payer (National Health System) perspective. The cost included for economic analysis were as following: personnel costs, warded cost, medical costs, procedure costs and other costs.
All studies were generally well-conducted with relatively good quality of reporting. Implementing ASP in the hospital setting may be cost-effective. However, comprehensive cost-effectiveness data for ASP remain relatively scant, underlining the need for more prospective clinical and epidemiological studies to incorporate robust economic analyses into clinical decisions. This article is open to POST-PUBLICATION REVIEW. Registered readers (see "For Readers") may comment by clicking on ABSTRACT on the issue's contents page.
系统回顾在医院环境中实施抗菌药物管理计划(ASP)的成本效益研究。
使用电子数据库进行系统文献检索,如EMBASE、PubMed/Medline、CINAHL、NHS和CEA注册库,检索时间为2000年至2017年。使用乔安娜·布里格斯研究所经济评价批判性评价清单和综合卫生经济评价报告标准声明清单对每项纳入研究的质量进行评估。
在检索到的313篇论文中,经过资格评估后,有5篇论文纳入本综述。大多数研究是成本效益研究,将ASP与标准护理进行比较。纳入的四项经济研究是从提供者(医院)角度进行的,而另一项研究是从支付者(国家卫生系统)角度进行的。经济分析中包含的成本如下:人员成本、病房成本、医疗成本、程序成本和其他成本。
所有研究总体上开展良好,报告质量相对较高。在医院环境中实施ASP可能具有成本效益。然而,ASP的综合成本效益数据仍然相对较少,这突出表明需要更多前瞻性临床和流行病学研究,以便将有力的经济分析纳入临床决策。本文接受发表后审查。注册读者(见“读者须知”)可通过点击本期目录页面上的摘要进行评论。