Continuous professional development lowers health care costs

Continuous professional development for drug prescribing was associated with reduced health care costs for patients, according to findings published in JAMA Network Open.

Researchers found that more intensive interventions were associated with greater improvements in prescribing outcomes compared with no intervention or less intensive interventions, but they incurred greater education costs for physicians.

“Continuous professional development (CPD) is essential to clinicians’ efforts to maintain competency after completion of training and includes formal educational interventions and unstructured learning activities,” David A. Cook, MD, MHPE, an internist in general internal medicine at the Mayo Clinic, and colleagues wrote.

Cook and colleagues conducted a systematic review of 38 studies that investigated CPD for practicing physicians. They converted all estimated costs of CPD to 2021 U.S. dollars.

The studies included data on more than 15,659 health care professionals and 1,963,197 patients; 68% of the studies enrolled physicians that worked in family, internal or general medicine. Also, most studies focused on the optimal use of specific drugs like antibiotics (39%), analgesics (8%) and antihistamines (5%), among others. Cook and colleagues extracted 12 “cost ingredients” for each study to determine education costs.

Overall, the studies documented improved prescribing outcomes with CPD. However, “the educational costs and cost-effectiveness of CPD varied widely,” Cook and colleagues wrote.

Among the 12 studies that reported costs associated with implementing CPD interventions, the educational costs ranged from $281 to $183,554, with a median of $15,664.

When evaluating economic outcomes, the researchers observed that among 94% of all studies that compared CPD with no intervention, CPD was associated with reduced drug costs, ranging from $4,731 to $6,912,000, with a median of $79,373 in immediate cost savings. Also, compared with other CPD approaches, one-on-one outreach was associated with reduced drug costs, according to data from four studies. However, comparisons of alternative CPD approaches found that this strategy was more expensive for physicians than group education or mailed materials. Data from five studies showed that the incremental cost-effectiveness ratio for a 10% improvement in prescribing ranged from $15,390 to $437,027 to train all program participants with CPD, or $3 to $4,105 per physician, compared with no intervention, Cook and colleagues reported.

Four studies included data that the researchers used to estimate a net benefit of health care cost savings minus educational costs for CPD compared with no education. Three of the studies found a favorable net benefit, according to Cook and colleagues. Yet, the fourth study found that educational costs exceeded health care savings, with a net loss of $879 per physician trained. However, “extrapolation of benefits suggested a break-even point” at about 3.5 years after CPD, the researchers said.