Factors influencing the effects of policies and interventions to promote the appropriate use of medicines in high-income countries: A rapid realist review.

Autor: Charbonneau M; Canadian Medication Appropriateness and Deprescribing Network, Montreal, Université de Montréal, QC, Canada. Electronic address: mathieu.charbonneau@carleton.ca., Morgan SG; School of Population and Public Health, University of British Columbia, Vancouver BC, Canada., Gagnon C; Canadian Medication Appropriateness and Deprescribing Network, Université de Montréal, Montreal, QC, Canada., Sadowski CA; Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, AB, Canada., Silvius JL; Alberta Health Services, Edmonton, AB, Canada; Cumming School of Medicine, University of Calgary, Calgary, AB, Canada., Tannenbaum C; Faculties of Pharmacy and Medicine, Université de Montréal, Montreal, QC, Canada; Michel Saucier Endowed Chair in Pharmacy, Health & Aging, Université de Montréal, Montreal, QC, Canada., Turner JP; Faculté de Pharmacie, Université de Montréal, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada; Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia.
Jazyk: angličtina
Zdroj: Health policy (Amsterdam, Netherlands) [Health Policy] 2024 Apr; Vol. 142, pp. 105027. Date of Electronic Publication: 2024 Feb 24.
DOI: 10.1016/j.healthpol.2024.105027
Abstrakt: Background: The appropriate use of medicines has long been recognized as a fundamental component of medicine policies. We aimed to extract lessons from published research on how policy contexts and mechanisms can affect the outcomes of national- or health-system level interventions to promote appropriate medicine use (defined as an increase in underutilized medications or decrease in inappropriate medication use).
Methods: We conducted a rapid realist review of published evidence concerning system-level policies to promote the appropriate use of medicines in high-income countries with universal prescription drug coverage. We searched MEDLINE and Embase to identify relevant publications. We used a realist evaluation framework to identify contexts, mechanisms, and outcomes for each intervention and to hypothesize which policy contexts and mechanisms supported successful outcomes in terms of relative changes in the prevalence of use of the specific medication classes targeted.
Results: From 1,318 identified studies, 18 met our inclusion criteria. 13 distinct policies were identified. Three main policy-related factors underpinned successful interventions: involving providers and patients through program interventions; central coordination through national agencies dedicated to medicine policies; and the establishment of an explicit and integrated national medicine policy strategy.
Conclusion: Policymakers can improve coordination of national pharmaceutical policies to reduce harms from inappropriate medicines use, thus improving health outcomes through cost-effective programs.
Competing Interests: Declaration of competing interest MC has no real or perceived conflicts of interest; SM has no real or perceived conflicts of interest; CG has no real or perceived conflicts of interest; CAS discloses funding from Pfizer Canada (project: A Quality Improvement Project to Address lower urinary tract symptoms by pharmacists in the community, $109,000.00); JLS has no real or perceived conflicts of interest; CT has no real or perceived conflicts of interest; JPT has no real or perceived conflicts of interest.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: