The Effectiveness of Interventions to Evaluate and Reduce Healthcare Costs of Potentially Inappropriate Prescriptions among the Older Adults: A Systematic Review

Sara Mucherino, Manuela Casula, Federica Galimberti, Ilaria Guarino, Elena Olmastroni, Elena Tragni, Valentina Orlando, Enrica Menditto and on behalf of the EDU.RE.DRUG Group
Additional contact information
Sara Mucherino: CIRFF—Center of Pharmacoeconomics and Drug Utilization, Department of Pharmacy, Federico II University of Naples, 80131 Naples, Italy
Manuela Casula: Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, 20133 Milan, Italy
Federica Galimberti: IRCCS MultiMedica Hospital, Sesto S. Giovanni, 20099 Milan, Italy
Ilaria Guarino: CIRFF—Center of Pharmacoeconomics and Drug Utilization, Department of Pharmacy, Federico II University of Naples, 80131 Naples, Italy
Elena Olmastroni: Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, 20133 Milan, Italy
Elena Tragni: Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, 20133 Milan, Italy
Valentina Orlando: CIRFF—Center of Pharmacoeconomics and Drug Utilization, Department of Pharmacy, Federico II University of Naples, 80131 Naples, Italy
Enrica Menditto: CIRFF—Center of Pharmacoeconomics and Drug Utilization, Department of Pharmacy, Federico II University of Naples, 80131 Naples, Italy
on behalf of the EDU.RE.DRUG Group: Collaborators/Membership of the Group/Team Name is provided in the Acknowledgments.

IJERPH, 2022, vol. 19, issue 11, 1-19

Abstract: Potentially inappropriate prescribing (PIP) is associated with an increased risk of adverse drug reactions, recognized as a determinant of adherence and increased healthcare costs. The study’s aim was to explore and compare the results of interventions to reduce PIP and its impact on avoidable healthcare costs. A systematic literature review was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement guidelines. PubMed and Embase were queried until February 2021. Inclusion criteria followed the PICO model: older patients receiving PIP; Interventions aimed at health professionals, structures, and patients; no/any intervention as a comparator; postintervention costs variations as outcomes. The search strategy produced 274 potentially relevant publications, of which 18 articles met inclusion criteria. Two subgroups were analyzed according to the study design: observational studies assessing PIP frequency and related-avoidable costs ( n = 10) and trials, including specific intervention and related outcomes in terms of postintervention effectiveness and avoided costs ( n = 8). PIP prevalence ranged from 21 to 79%. Few educational interventions carried out to reduce PIP prevalence and avoidable costs resulted in a slowly improving prescribing practice but not cost effective. Implementing cost-effective strategies for reducing PIP and clinical and economic implications is fundamental to reducing health systems’ PIP burden.

Keywords: potentially inappropriate prescribing; healthcare costs; educational interventions (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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