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A cluster randomised control trial to evaluate the effectiveness and cost-effectiveness of the Italian medicines use review (I-MUR) for asthma patients

Manfrin, Andrea, Tinelli, Michela, Thomas, Trudy, Krska, Janet (2017) A cluster randomised control trial to evaluate the effectiveness and cost-effectiveness of the Italian medicines use review (I-MUR) for asthma patients. BMC Health Services Research, 17 . E-ISSN 1472-6963. (doi:10.1186/s12913-017-2245-9)

Abstract

Background: The economic burden of asthma, which relates to the degree of control, is €5 billion annually in Italy. Pharmacists could help improve asthma control, reducing this burden. This study aimed to evaluate the effectiveness and cost-effectiveness of Medicines Use Reviews provided by community pharmacists in asthma.

Results: Numbers of pharmacists and patients enrolled were 283 (A = 136; B = 147) and 1263 (A = 600; B = 663), numbers completing were 201 (A = 97; B = 104) and 816 (A = 400; B = 416), respectively. Patients were similar in age and gender and 56.13% (458/816) had poor/partial asthma control. Pharmacists identified 1256 PCIs (mean 1.54/patient), mostly need for education, monitoring and potentially ineffective therapy. Median ACT score at baseline differed between groups (A = 19, B = 18; p < 0.01). Odds ratio for improved asthma control was 1.76 (95% CI 1.33–2.33) and number needed to treat 10 (95% CI 6–28). Number of active ingredients reduced by 7.9% post-intervention (p < 0.01). Adherence improved by 35.4% 3 months post-intervention and 40.0% at 6 months (p < 0.01). The probability of the intervention being more cost-effective than usual care was 100% at 9 months.

Conclusions: This community pharmacist-based intervention demonstrated both effectiveness and costeffectiveness. It has since been implemented as the first community pharmacy cognitive service in Italy.

Item Type: Article
DOI/Identification number: 10.1186/s12913-017-2245-9
Uncontrolled keywords: Asthma control, Medicines use review, Community pharmacy, Effectiveness, Cost-effectiveness, Medway School of Pharmacy
Subjects: R Medicine > RS Pharmacy and materia medica
Divisions: Faculties > Sciences > Medway School of Pharmacy
Depositing User: Trudy Thomas
Date Deposited: 23 Nov 2017 18:11 UTC
Last Modified: 26 Feb 2020 13:39 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/64642 (The current URI for this page, for reference purposes)
Manfrin, Andrea: https://orcid.org/0000-0003-3457-9981
Thomas, Trudy: https://orcid.org/0000-0002-4817-8065
Krska, Janet: https://orcid.org/0000-0002-4148-5652
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