An economic analysis of a randomized, controlled, multicenter study of clinical pharmacist interventions for high-risk veterans: the IMPROVE study. Impact of Managed Pharmaceutical Care Resource Utilization and Outcomes in Veterans Affairs Medical Centers

Pharmacotherapy. 2000 Oct;20(10):1149-58. doi: 10.1592/phco.20.15.1149.34590.


Study objective: To determine if clinical pharmacists could affect economic resource use and humanistic outcomes in an ambulatory, high-risk population.

Design: Prospective, randomized, controlled study.

Setting: Nine Veterans Affairs medical centers.

Patients: Patients who were at high risk for medication-related problems.

Intervention: Patients were randomized to usual medical care with input from a clinical pharmacist (intervention group) or just usual medical care (control group).

Measurements and main results: Of 1,054 patients enrolled, 523 were randomized to the intervention group and 531 to the control group. The number of clinic visits increased in the intervention group (p=0.003), but there was no difference in clinic costs. Mean increases in total health care costs were $1,020 for the intervention group and $1,313 for the control group (p=0.06).

Conclusion: Including the cost of pharmacist interventions, overall health care expenditures were similar for patients randomized to see a clinical pharmacist versus usual medical care.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Ambulatory Care / economics
  • Chronic Disease
  • Confounding Factors, Epidemiologic
  • Drug Monitoring / methods*
  • Female
  • Hospitals, Veterans / economics*
  • Humans
  • Male
  • Middle Aged
  • Patient Care Team*
  • Patient Satisfaction
  • Pharmacists
  • Pharmacy Service, Hospital / economics*
  • Prospective Studies
  • Quality-Adjusted Life Years
  • Risk Factors
  • Treatment Refusal
  • United States