EVALUATING THE OUTCOMES AND COST-EFFECTIVENESS OF AMBULATORY CARE PHARMACY SERVICES IN SINGAPORE

Abstract

In the first part of this thesis, we reviewed the literature and found that pharmacist-provided medication review did not significantly improve clinical, economic and humanistic outcomes. We also found substantial variations in the quality of the evaluation methodology. The second part of the thesis focused on evaluating the outcomes of ambulatory care pharmacy services in Singapore. A collaborative care model with pharmacist-provided medication review for hemodialysis patients resulted in a 27% reduction in unplanned hospital admissions compared with usual. Another study evaluating the outcomes of a home-based medication review service for elderly at high risk of readmissions demonstrated a 26% and 20% reduction in readmissions and emergency department visits respectively compared with usual care. The last part of the thesis evaluated the cost-effectiveness of ambulatory care pharmacy services. We found that the services were cost-effective compared with usual care from both the patient’s and healthcare provider’s perspectives.