Modelling the return on investment of a virtual clinical pharmacy service in rural and remote Australian hospitals

Background The use of medication is the most common intervention in health care, with adverse drug events a leading cause of preventable healthcare harm. Increasingly, virtual pharmacy services have been implemented to support hospitals that lack the access to clinical pharmacy services to support patient safety and best practice medicines management. Aim This research examined the potential return on investment of a virtual clinical pharmacy service (VCPS) conducted in rural and remote hospitals in New South Wales, Australia. Method The original study adopted a stepped wedge randomised controlled trial design implemented in eight facilities. The VCPS involved clinical pharmacists providing virtual clinical pharmacy services consistent with recognised standards of practice for hospital pharmacy via videoconferencing, the electronic medical record and electronic medication management. The cost of clinical pharmacists' time to deliver services was compared with the benefit, expressed as avoided medication‐related hospital admission, of pharmacist identified and physician accepted and actioned medication‐related interventions stratified using the Nesbitt probability method. The return on investment (ROI) analysis modelled variations in parameters using a population of 1000 patients with 1000 simulations. Ethical approval was granted by the Greater Western Human Research Ethics Committee (Reference no: 2019/ETH13355) and the study conforms to Australian National Statement on Ethical Conduct in Human Research . Results The study included 527 participants in the intervention group, with pharmacists identifying 878 medication issues and 73% of interventions accepted and actioned by the physician. The modelled return on investment of the VCPS was estimated at 20.43 (95% confidence interval [CI] 17.57, 23.30), suggesting that for every AUD $1 invested, potential savings of between $17.57 and $23.30 could be generated. Conclusion The integration of virtual clinical pharmacy services into Australian rural and remote hospitals can reduce medication‐related problems encountered in hospitals, leading to cost savings and improvements in patients' quality of life.