Cost-Effectiveness Analysis: Personal Systems Approach in Improving Medication Adherence in Adult Kidney Transplant Patients.
Cost-Effectiveness Analysis: Personal Systems Approach in Improving Medication Adherence in Adult Kidney Transplant Patients.
复制标题
成本效益分析：个人系统方法在提高成人肾移植患者的药物依从性。
DOI：
10.1097/jhq.0000000000000327
复制
发表时间：
2022-07-01
影响因子：
1.3
通讯作者：
Russell, Cynthia
中科院分区：
文献类型：
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作者：
Whittington, Melanie;Goggin, Kathy;Noel-MacDonnell, Janelle;Hathaway, Donna;Remy, Laura;Aholt, Dana;Clark, Debra;Miller, Courtney;Ashbaugh, Catherine;Wakefield, Mark;Ellis, Rebecca B.;Russell, Cynthia
改善移植中药物依从性的干预措施最近从关注动机和意图转向关注个人层面的质量改善策略。这些策略将坚持与既定的日常生活、环境提示和支持的人联系起来。本评估的目的是估计实施的成本和成本效益的个人层面的干预显示增加药物依从性。为了估计干预成本，在与项目发起人进行关键信息提供者访谈并审查实施支出之后，采用了直接计量微观成本计算方法。成本效益是通过比较增量实施成本和与不遵守增量百分比相关的医疗保健成本来计算的，增量百分比定义为每次两两比较服用大于或等于其药物剂量85%的患者的百分比。该干预措施的实施资源较少，每位患者的实施成本约为520美元，并且与药物依从性的显着改善有关。与依从性改善相关的预期医疗保健节省远远超过了这些实施成本。这种个人层面的干预是一种低成本、有效的干预，在成人肾移植受者的药物依从性方面具有显著的统计学和临床改善。
Interventions to improve medication non-adherence in transplantation have recently moved from a focus on motivation and intention, to a focus on person-level quality improvement strategies. These strategies link adherence to established daily routines, environmental cues and supportive people. The objective of this evaluation was to estimate the cost of implementation and the cost-effectiveness of a person-level intervention shown to increase medication adherence. To estimate the intervention costs, a direct measure micro-costing approach was used following key informant interviews with project champions and a review of implementation expenditures. Cost-effectiveness was calculated by comparing the incremental implementation costs and healthcare costs associated with non-adherence to the incremental percent adherent, defined as the percent of patients who took greater or equal to 85% of their medication doses, for each pairwise comparison. The intervention was low-resource to implement, costing approximately $520 to implement per patient, and was associated with significant improvements in medication adherence. These implementation costs were more than outweighed by the expected healthcare savings associated with improvements in adherence. This person-level intervention is a low cost, efficacious intervention associated with significant statistical and clinical improvements in medication adherence in adult kidney transplant recipients.
影响因子：
2.1
作者：
Russell CL;Ashbaugh C;Peace L;Cetingok M;Hamburger KQ;Owens S;Coffey D;Webb AW;Hathaway D;Winsett RP;Madsen R;Wakefield MR
通讯作者：
Wakefield MR