Jornal de Prática Geral

The Potential Cost-Effectiveness of Pharmacist Delivered Brief Intervention for Alcohol Misuse

Abstract

Héctor José Navarro, Anthony Shakeshaft, Christopher M Doran and Dennis J Petrie

The provision of brief intervention (BI) for alcohol misuse in community pharmacies appears to be feasible, although little has been done in determining its impact. This research aims to model pharmacists’ delivered screening, BI and costs per additional risky drinker reducing alcohol consumption relative to current practice in rural Australia. A decision model was developed to assess costs and changes in outcomes from pharmacist-delivered screening and BI on alcohol consumption in 10 rural communities in New South Wales, Australia. Nine different scenarios were utilised to test the robustness of results to variations in key parameters. Based on evidence from current practice, approximately 22% of all risky drinkers in a defined community would reduce alcohol consumption annually, of which about 0.02% would do so because of pharmacist-delivered screening and BI and 1% would do so because of pharmacist screening only. Realistic increments of 10% and 20% in pharmacist-delivered screening and BI would reduce the proportion of risky drinkers by 0.5% and 1.6% at a cost of AUD$50 and AUD$40 respectively, per additional risky drinker reducing alcohol consumption. These findings suggest that increments in pharmacistdelivered screening and BI rates may result in potential cost-effective reductions in alcohol consumption, although its widespread adoption is unlikely to occur because almost all risky drinking pharmacy customers would need to be screened to achieve a reasonable effect size.