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非癌症环境下远程药学服务的经济评价:系统评价。

Economic evaluations of telepharmacy services in non-cancer settings: A systematic review.

机构信息

Centre for Online Health, The University of Queensland, Brisbane, Australia; Centre for Health Services Research, The University of Queensland, Brisbane, Australia; School of Pharmacy, The University of Queensland, Brisbane, Australia; Pharmacy Department, Princess Alexandra Hospital, Brisbane, Australia.

Centre for Online Health, The University of Queensland, Brisbane, Australia; Centre for Health Services Research, The University of Queensland, Brisbane, Australia.

出版信息

Res Social Adm Pharm. 2024 Mar;20(3):246-254. doi: 10.1016/j.sapharm.2024.01.002. Epub 2024 Jan 5.

Abstract

BACKGROUND

Telepharmacy is the provision of pharmacy services from a distance to a patient using telecommunications and other technologies. There has been limited research investigating the cost-effectiveness of telepharmacy services.

OBJECTIVE

To provide a comprehensive review and narrative synthesis of the available economic evidence on telepharmacy services in non-cancer settings.

METHOD

A systematic literature search of four databases including PubMed, Embase, CINAHL, and EconLit was undertaken to identify economic evaluations comparing telepharmacy services to standard pharmacy care. Abstracts and full texts were screened by two independent reviewers for inclusion against the eligibility criteria. Key economic findings were extracted from included articles to determine the cost-effectiveness of the reported telepharmacy services.

RESULTS

The review included six studies; two were cost-minimisation analyses, three were cost effectiveness analyses (CEA) and one study conducted both a CEA and cost-utility analysis. Telepharmacy services predominantly relied upon telephone modes of communication, with three that used remote patient monitoring. These services managed a variety of clinical situations which included newly initiated antibiotics, antiretroviral therapy management, and medications for chronic conditions, as well as hypertension management. Articles were of relatively high reporting quality, scoring an average of 83% on the Consolidated Health Economics Reporting Standards checklist. Four of the six studies reported that telepharmacy was less costly than usual care, with two that reported telepharmacy as cost-effective to the healthcare system according to a specified cost-effectiveness threshold.

CONCLUSIONS

Overall, this review demonstrates that there is emerging evidence that telepharmacy services can be cost-effective compared with standard care in non-cancer settings. Further research is needed to complement these findings, particularly reflecting the increased uptake of telehealth and telepharmacy services since the onset of the Coronavirus disease pandemic.

摘要

背景

远程药学是指通过电信和其他技术为患者提供药学服务。目前,关于远程药学服务的成本效益的研究有限。

目的

对非癌症环境中远程药学服务的现有经济证据进行全面回顾和叙述性综合分析。

方法

对包括 PubMed、Embase、CINAHL 和 EconLit 在内的四个数据库进行系统文献检索,以确定将远程药学服务与标准药学护理进行比较的经济评估。两名独立评审员对摘要和全文进行筛选,以确定是否符合纳入标准。从纳入的文章中提取关键经济发现,以确定报告的远程药学服务的成本效益。

结果

该综述纳入了六项研究;其中两项是成本最小化分析,三项是成本效益分析(CEA),一项研究同时进行了 CEA 和成本效用分析。远程药学服务主要依赖于电话沟通模式,其中三项使用远程患者监测。这些服务管理各种临床情况,包括新开始的抗生素、抗逆转录病毒疗法管理以及慢性病药物治疗,以及高血压管理。这些文章的报告质量相对较高,在综合健康经济学报告标准清单上平均得分为 83%。六项研究中有四项报告称远程药学服务的成本低于常规护理,其中两项报告称远程药学服务根据特定的成本效益阈值对医疗保健系统具有成本效益。

结论

总体而言,本综述表明,有新的证据表明,在非癌症环境中,与标准护理相比,远程药学服务具有成本效益。需要进一步的研究来补充这些发现,特别是反映自冠状病毒病大流行开始以来远程医疗和远程药学服务的使用率增加。

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