Article type
Year
Abstract
Background: The Canadian Optimal Medication Prescribing and Utilization Service (COMPUS) aims to identify and promote best practices in drug prescribing and use by health care professionals and consumers. The Cochrane Effective Practice and Organisation of Care (EPOC) and the Consumers and Communication Review (CC&CRG) Groups have expertise to synthesise and summarise this evidence.
Objectives: To identify, assess and summarise synthesised evidence of the effects of interventions directed to consumers to change prescribing and drug use. To develop ways to summarise and present this evidence to facilitate its use by decision makers.
Methods: EPOC and CC&CRG handsearched systematic reviews in the Cochrane and DARE databases for reviews of relevance. Methods to summarise the evidence into useful summaries with statistics, and to standardise statements of the effectiveness of interventions were developed in collaboration with CADTH and their Advisory Committee.
Results: Over 96 potentially relevant reviews were found. Twenty-one relevant, high quality and up-to-date reviews were summarised (11 were Cochrane reviews). The summaries highlight key information from the review, such as what evidence was found in each review. The overall effects of the interventions were summarised qualitatively, using standard statements of effectiveness based on meta-analyses or vote counting. Effects were also provided quantitatively in tables using absolute and relative numbers when possible. While a body of research on evidence based prescribing and drug use for consumers exists, it had not been systematically analysed or organized previously. Based on a search of published and grey literature (including policy documents, organisation policies), a taxonomy to organise interventions for evidence based prescribing and drug use for consumers was developed. This taxonomy can be used to inform policy makers about which interventions exist, which interventions work and which do not, and where evidence is lacking. Outcomes in this body of research were also not organised systematically. The reviews focused almost exclusively on interventions to improve adherence to medications. A taxonomy of outcomes was also developed. It indicates that research to evaluate a range of outcomes relevant to evidence-based prescribing and drug use by consumers is needed. Overall, practical medication management strategies, self-monitoring, reminders and simplified dosing regimens appear generally effective to improve adherence to drug use, although successful elements of these interventions are not well understood. Mixed results were found for interventions such as mass mailings, packaging changes and patient support. No evidence on consumer participation was found.
Conclusions: Through this project, EPOC and CC&CRG groups had the opportunity to develop tools to organise and present review-level research for interventions on evidence based prescribing and drug use directed to consumers. Before summarising the evidence it was necessary to organise the literature in a taxonomy and to consult with users to determine the best presentation of results. Both activities ensured a relevant and useful resource of systematic review-level evidence for decision makers.
Objectives: To identify, assess and summarise synthesised evidence of the effects of interventions directed to consumers to change prescribing and drug use. To develop ways to summarise and present this evidence to facilitate its use by decision makers.
Methods: EPOC and CC&CRG handsearched systematic reviews in the Cochrane and DARE databases for reviews of relevance. Methods to summarise the evidence into useful summaries with statistics, and to standardise statements of the effectiveness of interventions were developed in collaboration with CADTH and their Advisory Committee.
Results: Over 96 potentially relevant reviews were found. Twenty-one relevant, high quality and up-to-date reviews were summarised (11 were Cochrane reviews). The summaries highlight key information from the review, such as what evidence was found in each review. The overall effects of the interventions were summarised qualitatively, using standard statements of effectiveness based on meta-analyses or vote counting. Effects were also provided quantitatively in tables using absolute and relative numbers when possible. While a body of research on evidence based prescribing and drug use for consumers exists, it had not been systematically analysed or organized previously. Based on a search of published and grey literature (including policy documents, organisation policies), a taxonomy to organise interventions for evidence based prescribing and drug use for consumers was developed. This taxonomy can be used to inform policy makers about which interventions exist, which interventions work and which do not, and where evidence is lacking. Outcomes in this body of research were also not organised systematically. The reviews focused almost exclusively on interventions to improve adherence to medications. A taxonomy of outcomes was also developed. It indicates that research to evaluate a range of outcomes relevant to evidence-based prescribing and drug use by consumers is needed. Overall, practical medication management strategies, self-monitoring, reminders and simplified dosing regimens appear generally effective to improve adherence to drug use, although successful elements of these interventions are not well understood. Mixed results were found for interventions such as mass mailings, packaging changes and patient support. No evidence on consumer participation was found.
Conclusions: Through this project, EPOC and CC&CRG groups had the opportunity to develop tools to organise and present review-level research for interventions on evidence based prescribing and drug use directed to consumers. Before summarising the evidence it was necessary to organise the literature in a taxonomy and to consult with users to determine the best presentation of results. Both activities ensured a relevant and useful resource of systematic review-level evidence for decision makers.