Costs and Cost-Effectiveness of User-Testing of Health Professionals' Guidelines to Reduce the Frequency of Intravenous Medicines Administration Errors by Nurses in the United Kingdom: A Probabilistic Model Based on Voriconazole Administration.
Costs and Cost-Effectiveness of User-Testing of Health Professionals' Guidelines to Reduce the Frequency of Intravenous Medicines Administration Errors by Nurses in the United Kingdom: A Probabilistic Model Based on Voriconazole Administration.
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DOI：
10.1007/s40258-021-00675-z
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发表时间：
2022-01
影响因子：
3.6
通讯作者：
Kandiyali R
中科院分区：
文献类型：
--
作者：
Jones MD;Franklin BD;Raynor DK;Thom H;Watson MC;Kandiyali R
在英国，注射药物通常由护士按照注射药物指南（IMG）制备和管理。我们早期的研究证实，与标准IMG指南相比，用户测试的正确给药频率更高。当前的研究旨在模拟用户测试的成本效益。通过修改现有的概率决策分析模型，探讨了用户测试的成本和成本效益。调整后的模型考虑由护士给住院病人静脉注射伏立康唑。它包括11种错误类型，它们被发现的概率和危害程度。模型输入（包括成本）来源于我们之前的研究和其他已发表的数据。从使用IMG的121个NHS信托机构和卫生委员会的角度，以5年为期限，使用20 000个样本（足以收敛）进行蒙特卡洛模拟。对用药错误和其他不确定因素的风险进行敏感性分析。2万英镑/质量调整生命年的净货币效益为3190,064英镑（95%可信区间（CrI）： - 346,709至8,480,665），有利于用户测试，成本效益的可能性为96%。增量成本节省为240,943英镑（95% CrI 43,527-491,576），同样支持用户测试指南，有99%的机会节省成本。用户测试的总成本为6317英镑（95% CrI 6012-6627）。这些发现对一系列输入参数的假设是稳健的，但更大的不确定性与更低的用药错误风险有关。注射药物指南用户检测是一种低成本干预措施，极有可能具有成本效益，特别是对高风险药物而言。在线版本包含补充材料，可在10.1007/s40258-021-00675-z获得。
In the UK, injectable medicines are often prepared and administered by nurses following the Injectable Medicines Guide (IMG). Our earlier study confirmed a higher frequency of correct administration with user-tested versus standard IMG guidelines. This current study aimed to model the cost-effectiveness of user-testing. The costs and cost-effectiveness of user-testing were explored by modifying an existing probabilistic decision-analytic model. The adapted model considered administration of intravenous voriconazole to hospital inpatients by nurses. It included 11 error types, their probability of detection and level of harm. Model inputs (including costs) were derived from our previous study and other published data. Monte Carlo simulation using 20,000 samples (sufficient for convergence) was performed with a 5-year time horizon from the perspective of the 121 NHS trusts and health boards that use the IMG. Sensitivity analyses were undertaken for the risk of a medication error and other sources of uncertainty. The net monetary benefit at £20,000/quality-adjusted life year was £3,190,064 (95% credible interval (CrI): −346,709 to 8,480,665), favouring user-testing with a 96% chance of cost-effectiveness. Incremental cost-savings were £240,943 (95% CrI 43,527–491,576), also favouring user-tested guidelines with a 99% chance of cost-saving. The total user testing cost was £6317 (95% CrI 6012–6627). These findings were robust to assumptions about a range of input parameters, but greater uncertainty was seen with a lower medication error risk. User-testing of injectable medicines guidelines is a low-cost intervention that is highly likely to be cost-effective, especially for high-risk medicines. The online version contains supplementary material available at 10.1007/s40258-021-00675-z.
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影响因子：
2.4
作者：
Karnon, Jonathan;McIntosh, Aileen;Tappenden, Paul
通讯作者：
Tappenden, Paul
影响因子：
2.6
作者：
Chang, A;Schyve, PM;Loeb, JM
通讯作者：
Loeb, JM
DOI：
10.1111/j.1365-2753.2008.01000.x
发表时间：
2009-04-01
影响因子：
2.4
作者：
Karnon, Jonathan;Campbell, Fiona;Czoski-Murray, Carolyn
通讯作者：
Czoski-Murray, Carolyn
DOI：
10.1093/ajhp/48.12.2611
发表时间：
1991-12-01
期刊：
AMERICAN JOURNAL OF HOSPITAL PHARMACY
影响因子：
--
作者：
HARTWIG, SC;DENGER, SD;SCHNEIDER, PJ
通讯作者：
SCHNEIDER, PJ
影响因子：
6.2
作者：
Douglass, Amy M.;Elder, Joshua;Coil, Clinton J.
通讯作者：
Coil, Clinton J.