Cost-consequence analysis of self-administration of medication during hospitalization: a pragmatic randomized controlled trial in a Danish hospital setting

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Standard

Cost-consequence analysis of self-administration of medication during hospitalization : a pragmatic randomized controlled trial in a Danish hospital setting. / Sørensen, Charlotte Arp; de Thurah, Annette; Lisby, Marianne; Olesen, Charlotte; Sørensen, Signe Bredsgaard; Enemark, Ulrika.

In: Therapeutic Advances in Drug Safety, Vol. 11, No. January-December, 01.2020, p. 1-16.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Harvard

APA

CBE

MLA

Vancouver

Author

Bibtex

@article{0ab3a2d6d2744969848b7b0cc515415a,
title = "Cost-consequence analysis of self-administration of medication during hospitalization: a pragmatic randomized controlled trial in a Danish hospital setting",
abstract = "Objectives: The objective of this study was to evaluate the costs and consequences of introducing {"}self-administration of medication{"} (SAM) during hospitalization as compared with nurse-led dispensing and administration of medication.Methods: This pragmatic randomized controlled trial was performed in a Danish Cardiology Unit. Patients ⩾18 years old capable of self-administering medication were eligible. In the intervention group, patients self-administered their medication. In the control group, medication was dispensed and administered by nurses. The implementation of SAM was used to evaluate the cost–consequences. The micro-costing analysis used the hospital perspective and a short-term incremental costing approach. The costs for medication, materials, and nursing time were included. Consequences included the dispensing error proportion, patients{\textquoteright} perceptions regarding medication, satisfaction, and deviations in the medication list at followup. In addition, the number of readmissions and general practitioner (GP) contacts within 30 days after discharge was included.Results: The total cost (TC) per patient in the intervention group was 49.9€ (95% CI: 46.6–53.2) compared with 52.6€ (95% CI: 46.6–58.6) in the control group. The difference between the groups was not statistically significant (p = 0.09). Sensitivity analysis consistently showed TCs favoring the intervention. The dispensing error proportion was 9.7% (95% CI: 7.9–11.6) in the intervention group compared with 12.8% (95% CI: 10.9–15.6) in the control group. The difference was statistically significant (p = 0.02). The analysis also found changes in the perceptions regarding medication (indicating higher medication adherence), increased satisfaction, and fewer patients with deviations in the medication list at follow-up. No statistically significant differences between the groups in relation to readmissions and GP contacts within 30 days were observed.Conclusions: SAM seems to cost less although the cost difference was small and not statistically significant. As SAM had positive effects on patient outcomes, the results indicate that SAM may be cost-effective.",
keywords = "health economic evaluation, cost analysis, cost–consequence, self-administration, self-management, dispensing error, beliefs about medicines, satisfaction",
author = "S{\o}rensen, {Charlotte Arp} and {de Thurah}, Annette and Marianne Lisby and Charlotte Olesen and S{\o}rensen, {Signe Bredsgaard} and Ulrika Enemark",
year = "2020",
month = jan,
doi = "10.1177/2042098620929921",
language = "English",
volume = "11",
pages = "1--16",
journal = "Therapeutic Advances in Drug Safety",
issn = "2042-0986",
publisher = "SAGE",
number = "January-December",

}

RIS

TY - JOUR

T1 - Cost-consequence analysis of self-administration of medication during hospitalization

T2 - a pragmatic randomized controlled trial in a Danish hospital setting

AU - Sørensen, Charlotte Arp

AU - de Thurah, Annette

AU - Lisby, Marianne

AU - Olesen, Charlotte

AU - Sørensen, Signe Bredsgaard

AU - Enemark, Ulrika

PY - 2020/1

Y1 - 2020/1

N2 - Objectives: The objective of this study was to evaluate the costs and consequences of introducing "self-administration of medication" (SAM) during hospitalization as compared with nurse-led dispensing and administration of medication.Methods: This pragmatic randomized controlled trial was performed in a Danish Cardiology Unit. Patients ⩾18 years old capable of self-administering medication were eligible. In the intervention group, patients self-administered their medication. In the control group, medication was dispensed and administered by nurses. The implementation of SAM was used to evaluate the cost–consequences. The micro-costing analysis used the hospital perspective and a short-term incremental costing approach. The costs for medication, materials, and nursing time were included. Consequences included the dispensing error proportion, patients’ perceptions regarding medication, satisfaction, and deviations in the medication list at followup. In addition, the number of readmissions and general practitioner (GP) contacts within 30 days after discharge was included.Results: The total cost (TC) per patient in the intervention group was 49.9€ (95% CI: 46.6–53.2) compared with 52.6€ (95% CI: 46.6–58.6) in the control group. The difference between the groups was not statistically significant (p = 0.09). Sensitivity analysis consistently showed TCs favoring the intervention. The dispensing error proportion was 9.7% (95% CI: 7.9–11.6) in the intervention group compared with 12.8% (95% CI: 10.9–15.6) in the control group. The difference was statistically significant (p = 0.02). The analysis also found changes in the perceptions regarding medication (indicating higher medication adherence), increased satisfaction, and fewer patients with deviations in the medication list at follow-up. No statistically significant differences between the groups in relation to readmissions and GP contacts within 30 days were observed.Conclusions: SAM seems to cost less although the cost difference was small and not statistically significant. As SAM had positive effects on patient outcomes, the results indicate that SAM may be cost-effective.

AB - Objectives: The objective of this study was to evaluate the costs and consequences of introducing "self-administration of medication" (SAM) during hospitalization as compared with nurse-led dispensing and administration of medication.Methods: This pragmatic randomized controlled trial was performed in a Danish Cardiology Unit. Patients ⩾18 years old capable of self-administering medication were eligible. In the intervention group, patients self-administered their medication. In the control group, medication was dispensed and administered by nurses. The implementation of SAM was used to evaluate the cost–consequences. The micro-costing analysis used the hospital perspective and a short-term incremental costing approach. The costs for medication, materials, and nursing time were included. Consequences included the dispensing error proportion, patients’ perceptions regarding medication, satisfaction, and deviations in the medication list at followup. In addition, the number of readmissions and general practitioner (GP) contacts within 30 days after discharge was included.Results: The total cost (TC) per patient in the intervention group was 49.9€ (95% CI: 46.6–53.2) compared with 52.6€ (95% CI: 46.6–58.6) in the control group. The difference between the groups was not statistically significant (p = 0.09). Sensitivity analysis consistently showed TCs favoring the intervention. The dispensing error proportion was 9.7% (95% CI: 7.9–11.6) in the intervention group compared with 12.8% (95% CI: 10.9–15.6) in the control group. The difference was statistically significant (p = 0.02). The analysis also found changes in the perceptions regarding medication (indicating higher medication adherence), increased satisfaction, and fewer patients with deviations in the medication list at follow-up. No statistically significant differences between the groups in relation to readmissions and GP contacts within 30 days were observed.Conclusions: SAM seems to cost less although the cost difference was small and not statistically significant. As SAM had positive effects on patient outcomes, the results indicate that SAM may be cost-effective.

KW - health economic evaluation

KW - cost analysis

KW - cost–consequence

KW - self-administration

KW - self-management

KW - dispensing error

KW - beliefs about medicines

KW - satisfaction

U2 - 10.1177/2042098620929921

DO - 10.1177/2042098620929921

M3 - Journal article

C2 - 32922722

VL - 11

SP - 1

EP - 16

JO - Therapeutic Advances in Drug Safety

JF - Therapeutic Advances in Drug Safety

SN - 2042-0986

IS - January-December

ER -