Rheumatologists should consider pharmacists as a resource to help them provide better and more cost-effective care to patients with previously undiagnosed knee osteoarthritis (OA), according to the lead author of a new Canadian study on the topic.
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The study, in Arthritis Care & Research, states that a pharmacist-initiated program involving multiple disciplines resulted in “good value for money from both the societal and the Ministry of Health perspectives.”1
“Pharmacists are well positioned to provide care to patients with chronic diseases due to their accessibility and their frequency of contact,” writes lead author Carlo Marra, BSc, PharmD, PhD, in an e-mail to The Rheumatologist. They “are also uniquely trained among the healthcare team with very specialized medication knowledge across the full scope of diseases.”
Dr. Marra, dean of the School of Pharmacy at Memorial University in Newfoundland, Canada, says he wasn’t surprised the study found that the quality of care improved. “However, the secondary outcomes of improved quality of life and reducing overall healthcare expenditures were a bit surprising,” he writes.
The study reported that the program resulted in incremental cost-effectiveness ratios of $232 (95% confidence interval [CI]—1,530, 2,154) per quality-adjusted-life year (QALY) gained from the Ministry of Health perspective and $14,395 (95% CI—7,826, 23,132) per QALY gained from the societal perspective, versus usual care.
The intervention included the administration of a validated knee OA screening questionnaire, education, pain medication management, physiotherapy-guided exercise and communication with the client’s primary care physician, researchers report. Other findings include improvements in the Arthritis Foundation’s quality indicators of care pass rate (difference of 45.2%; 95% CI—34.5, 55.9) and “significant improvements in pain, function, and quality of life all favoring the multidisciplinary intervention,” study authors write.
Dr. Marra says he hopes the next step will be research into how a pharmacist-initiated, multidisciplinary care approach could affect other chronic conditions, such as inflammatory arthritis. He says he believes the Canadian study could spur similar efforts elsewhere.
“I think the results are exportable to other jurisdictions that have pharmacists participating in the care of patients,” he writes. “However, to have sustainable services that benefit patients, pharmacists would need to be reimbursed for their medication management skills.” (posted 8/22/14)
Richard Quinn is a freelance writer in New Jersey.
1. Marra CA, Grubisic M, Cibere J, et al. Cost-utility analysis of a multidisciplinary
strategy to manage osteoarthritis of the knee: Economic evaluation of a cluster randomized
controlled trial study. Arthritis Care Res (Hoboken). 2014;66(6):810–816.