Article type
Abstract
"Background
The health technology assessment (HTA) centre and the drug information centre (DIC) in Region Västra Götaland, Sweden, provide evidence-based replies to pharmacotherapeutic queries.
Objectives
To explore replies provided by HTA and DIC, focusing on the cited literature and recipients’ interpretation of key messages.
Methods
Two drug-related queries were first investigated using the HTA approach, and subsequently evaluated by two DIC teams blinded for the HTA results: (I) ticagrelor versus clopidogrel after acute coronary syndrome in older patients; (II) pharmacological treatment (cyclooxygenase inhibitors, corticosteroids, antibiotics, immunoglobulin) in children with symptoms described as paediatric acute-onset neuropsychiatric syndrome. Physicians attending two pharmacotherapy courses (n=28) were asked to interpret the key message of HTA/DIC replies, i.e., whether the scientific literature favoured one alternative or the other on a 5-point scale (query I: 1=favours ticagrelor, 5=favours clopidogrel; query II: 1=pharmacological treatment not favoured, 5=pharmacological treatment favoured), or the option “Not assessable from the scientific literature”.
Results
The replies to query I from HTA/DIC teams 1/2 cited 1/4/4 guidelines, none overlapping; 13/3/2 systematic reviews, one of which included in both DIC replies not included in the HTA; and out of 4 original studies identified in the HTA to match the question at issue, 4/2 were included in the DIC replies. The corresponding numbers for query II were 5/5/3 guidelines, all overlapping; 1/3/3 systematic reviews, all overlapping, and out of 7 original studies identified in the HTA to match the question at issue, none were included in the DIC replies. For query I, the key message of the HTA, compared to the DIC replies, was interpreted to favour clopidogrel to a greater extent, median (interquartile range): 4.5 (4‒5) versus 3 (2‒4), P=0.014. For query II, the interpretation of the key message of the HTA was closer to “treatment not favoured”: 2 (2‒3) for each of the four pharmacological alternatives; DIC: 4 (3‒4) for cyclooxygenase inhibitors and corticosteroids (P=0.007), 4 (3‒4.75) for antibiotics (P=0.004), and 3 (2‒4) for immunoglobulins (P=0.026).
Conclusions
HTA and DIC replies to drug-related queries vary regarding the cited literature and recipients’ interpretation of key messages, aspects that deserve further attention."
The health technology assessment (HTA) centre and the drug information centre (DIC) in Region Västra Götaland, Sweden, provide evidence-based replies to pharmacotherapeutic queries.
Objectives
To explore replies provided by HTA and DIC, focusing on the cited literature and recipients’ interpretation of key messages.
Methods
Two drug-related queries were first investigated using the HTA approach, and subsequently evaluated by two DIC teams blinded for the HTA results: (I) ticagrelor versus clopidogrel after acute coronary syndrome in older patients; (II) pharmacological treatment (cyclooxygenase inhibitors, corticosteroids, antibiotics, immunoglobulin) in children with symptoms described as paediatric acute-onset neuropsychiatric syndrome. Physicians attending two pharmacotherapy courses (n=28) were asked to interpret the key message of HTA/DIC replies, i.e., whether the scientific literature favoured one alternative or the other on a 5-point scale (query I: 1=favours ticagrelor, 5=favours clopidogrel; query II: 1=pharmacological treatment not favoured, 5=pharmacological treatment favoured), or the option “Not assessable from the scientific literature”.
Results
The replies to query I from HTA/DIC teams 1/2 cited 1/4/4 guidelines, none overlapping; 13/3/2 systematic reviews, one of which included in both DIC replies not included in the HTA; and out of 4 original studies identified in the HTA to match the question at issue, 4/2 were included in the DIC replies. The corresponding numbers for query II were 5/5/3 guidelines, all overlapping; 1/3/3 systematic reviews, all overlapping, and out of 7 original studies identified in the HTA to match the question at issue, none were included in the DIC replies. For query I, the key message of the HTA, compared to the DIC replies, was interpreted to favour clopidogrel to a greater extent, median (interquartile range): 4.5 (4‒5) versus 3 (2‒4), P=0.014. For query II, the interpretation of the key message of the HTA was closer to “treatment not favoured”: 2 (2‒3) for each of the four pharmacological alternatives; DIC: 4 (3‒4) for cyclooxygenase inhibitors and corticosteroids (P=0.007), 4 (3‒4.75) for antibiotics (P=0.004), and 3 (2‒4) for immunoglobulins (P=0.026).
Conclusions
HTA and DIC replies to drug-related queries vary regarding the cited literature and recipients’ interpretation of key messages, aspects that deserve further attention."