DSEN Abstract
A content analysis of organizations and programs that implement approaches to address appropriate prescribing and use (AU) of medications

*This research was funded by the Drug Safety and Effectiveness Network (DSEN) and conducted by the following investigators: Alia Januwalla, Keelia Quinn de Launay, Richelle Baddeliyanage, Shusmita Rashid, Sharon E. Straus. The statements made herein are those of the stated authors, who are independent researchers.

What is the issue?

  • Each year millions of Canadians are not receiving drugs that can optimize longevity and quality of life; and, thousands of Canadians die from, and millions more experience, adverse drug reactions
  • Canada does not currently have a national strategy to address appropriate use (AU) of medications, however, there are several initiatives across the country and worldwide aimed at improving appropriate prescribing of medications.

Summary and Implications

  • A scoping review completed for DSEN synthesized information on national and international approaches to appropriate use (AU). This review highlighted a need to better understand the strategies being used to implement AU initiatives. DSEN MAGIC was engaged to conduct a content analysis to explore the implementation strategies used by organizations and programs with expertise in AU. The objective of this query was to inform Health Canada’s efforts in supporting a conversation to develop a national AU framework.
  • The study data identified common principles underpinning a national framework of best practices for the implementation of AU approaches:
    • Active and respectful collaborations & partnerships
    • Coordination with existing AU initiatives
    • Explicit consideration of regional and localized delivery
    • Continuous clinical education and training
    • Continuous assessment of evidence
    • Clearly defined formulary manual
    • Multi-faceted, systems-based strategy

For more information, please contact Alia Januwalla: januwallaa@smh.ca

What was the aim of the study?

  • The purpose of this project was to describe the various organizations that are conducting work in AU to understand the types of strategies used to implement AU initiatives. This report will help inform Health Canada’s efforts to support a national conversation on the merits of a national strategy on appropriate prescribing and use of drugs.

How was the study conducted?

  • Qualitative interviews and a document review were used to identify how organizations implement AU approaches, and the key barriers and facilitators associated with these processes. 

What did the study find?

  • Development and dissemination of guidelines and evidence summaries were the most commonly used AU approaches across national, regional, and locally-operating organizations and programs. Regulatory action was commonly used in regionallyoperating groups.
  • Use of educational materials was the predominant implementation strategy used by groups implementing AU approaches.
  • The majority of implementation approaches primarily targeted healthcare professionals (primary care physicians, nurses, and pharmacists) followed by organizations. 
  • Barriers and facilitators impacting the implementation of AU approaches had commonalities that were categorized into 10 factors influencing implementation success.
  • The factors informed the development of 23 recommendations for implementing AU approaches, based on actor and intervention types.

Link to publication: Morgan et al, 2016.

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