From a recent article in The Lancet (The Lancet, Volume 379, Issue 9823, Pages 1310 – 1319, 7 April 2012)
Kind of man versus machine study. Actually, it was more like man plus machine versus machine alone.
“The control group practices therefore used simple feedback; after collection of data at baseline, control practices received computerised feedback for patients identified as at risk from potentially hazardous prescripting and inadequate blood-test monitoring of medicines plus brief written educational materials explaining the importance of each type of error. Practices were asked to introduce changes they considered necessary within 12 weeks after the collection of data at baseline. Intervention practices received simple feedback plus a pharmacist-led information technology complex intervention (PINCER) lasting 12 weeks.”
The bottom line was that the PINCER interventions were more effective than the “simple feedback“. That’s not a surprise to me. The more time you spend selecting and refining a patient’s medication regimen, the better off they’ll be. It’s kind of like going on a diet. It doesn’t really matter what diet you choose as long as you stick to the program. Unless of course you go with the all-donut-all-the-time diet  – I’m skeptical.
Anyway, according to the article “this analysis suggests that PINCER had a 95% probability of being cost effective if the decision-maker’s ceiling willingness to pay reached £75 (~$120 US) per error avoided (at 6 months) or £85 (~140 US) per error avoided (at 12 months). Because the error reduction is sustained at 12 months, this analysis suggests that the intervention could be delivered yearly, rather than every 6 months, and still retain equivalent cost-effectiveness.”
So, if you, your PBM, your healthcare system, etc is willing to pay a little bit up front, they’re likely to prevent at least a few ADEs. Don’t you think that’s worth it?
Note: Bravo to The Lancet for making this article free of charge by simply registering at their website. Awesome.
