Background: The Cochrane Effective Practice and Organisation of Care group (EPOC) and the Cochrane Consumers and Communication Review Group (CC&CRG) both produce reviews unique to Cochrane. In contrast to reviews that focus on treatments for a specific disease, both groups produce reviews of the effects of interventions to improve health care by changing behaviours of health care professionals and/or consumers, and by changing organizational structures, regulatory policies and financial systems. For example, reviews from EPOC or the CC&CRG could address whether providing reminders to physicians or consumers or establishing prevention clinics can effectively increase the uptake of influenza vaccines. This type of evidence can be difficult for decision makers to find, read and use.
Objectives: Work with the Canadian Agency for Drugs and Technologies in Health (CADTH) to summarise evidence for prescribing and drug use, to make this evidence available in an easy to use database, and to promote its use by decision makers.
Methods: Given the mandate to develop resources for health care decision makers to use evidence, CADTH approached EPOC, and subsequently the CC&CRG, to create a database of evidence for prescribing and drug use. Evidence from reviews (Cochrane and non-Cochrane reviews) that had already synthesised and filtered high quality studies of interventions for prescribing and drug use were searched for and analysed. Collaboration and communication with CADTH and their Advisory Committee of representatives from the Health Ministries and other health organizations provided feedback into the content, presentation and format of the database. Strategies for promotion and dissemination of the database have been developed by CADTH and EPOC.
Results: The Interventions: Database houses approximately 70 summaries of reviews (1/2 are from Cochrane reviews) relevant to evidence based prescribing and drug use (available at http://www.cadth.ca/index.php/en/compus/optimal-ther-resources/interventions). The reviews combine high-quality evidence on interventions to change both professional practice and consumer behaviour, which is unique. The presentation of the evidence has also been tailored specifically to meet the needs of decision makers. Evidence is organised by categories intuitive to the user; summaries of the reviews provide bottom line statements of the effectiveness of the interventions via standardised evidence statements; statistics are presented in user-friendly numbers and in tables; and links to the included studies are provided for users who wish to obtain more detailed information.
Conclusions: Working with an agency that has strong links with health care decision makers and an interest in incorporating relevant evidence into decision making provides an excellent opportunity to promote the evidence in Cochrane Reviews. Working in this way has also offered a unique opportunity to refine and improve the accessibility of evidence in systematic reviews, and to produce consistent and standardised summaries of evidence relating to providers and consumers. Despite any challenges that arose from our differences in goals and contexts - CADTH working within political and funding constraints to make recommendations and the Cochrane groups working from an academic perspective to provide accurate and transparent information - a relevant and tailored source of evidence for decision makers in relation to prescribing and drug use was created.