Cost-effectiveness and Economic Benefit of Continuous Professional Development for Drug Prescribing: A Systematic Review
| Autor: | David A. Cook, Christopher R. Stephenson, John M. Wilkinson, Stephen Maloney, Jonathan Foo |
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| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | JAMA Network Open |
| ISSN: | 2574-3805 |
| Popis: | Key Points Question What are the comparative costs and benefits of physician continuous professional development (CPD) for drug prescribing? Findings In this systematic review of 38 studies, CPD was associated with reduced health care costs (median drug cost savings of $79 373) compared with no training. More intensive CPD (compared with no training or less intensive interventions) was associated with improved effectiveness (prescribing) outcomes but incurred greater education costs (incremental cost of $3 to $4105 per physician per standardized effectiveness change). Meaning These results suggest that physician CPD for drug prescribing is associated with reduced health care costs and that both effectiveness outcomes and costs should be considered when making education decisions. Importance The economic impact of continuous professional development (CPD) education is incompletely understood. Objective To systematically identify and synthesize published research examining the costs associated with physician CPD for drug prescribing. Evidence Review MEDLINE, Embase, PsycInfo, and the Cochrane Database were searched from inception to April 23, 2020, for comparative studies that evaluated the cost of CPD focused on drug prescribing. Two reviewers independently screened all articles for inclusion and reviewed all included articles to extract data on participants, educational interventions, study designs, and outcomes (costs and effectiveness). Results were synthesized for educational costs, health care costs, and cost-effectiveness. Findings Of 3338 articles screened, 38 were included in this analysis. These studies included at least 15 659 health care professionals and 1 963 197 patients. Twelve studies reported on educational costs, ranging from $281 to $183 554 (median, $15 664). When economic outcomes were evaluated, 31 of 33 studies (94%) comparing CPD with no intervention found that CPD was associated with reduced health care costs (drug costs), ranging from $4731 to $6 912 000 (median, $79 373). Four studies found reduced drug costs for 1-on-1 outreach compared with other CPD approaches. Regarding cost-effectiveness, among 5 studies that compared CPD with no intervention, the incremental cost-effectiveness ratio for a 10% improvement in prescribing ranged from $15 390 to $437 027 to train all program participants. Four comparisons of alternative CPD approaches found that 1-on-1 educational outreach was more effective but more expensive than group education or mailed materials (incremental cost-effectiveness ratio, $18-$4105 per physician trained). Conclusions and Relevance In this systematic review, CPD for drug prescribing was associated with reduced health care (drug) costs. The educational costs and cost-effectiveness of CPD varied widely. Several CPD instructional approaches (including educational outreach) were more effective but more costly than comparators. This systematic review of 38 studies assesses the association between the costs of physician continuous professional development and drug costs related to prescribing. |
| Databáze: | OpenAIRE |
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