Taglione Michael S, Ahmad Haroon, Slater Morgan, Aliarzadeh Babak, Glazier Richard H, Laupacis Andreas, Persaud Nav
Faculty of Medicine (Taglione), University of Toronto; Li Ka Shing Knowledge Institute (Taglione, Ahmad, Glazier, Laupacis, Persaud); Department of Family and Community Medicine (Slater, Glazier, Persaud), St. Michael's Hospital; Department of Family and Community Medicine (Aliarzadeh, Glazier, Laupacis, Persaud), University of Toronto; University of Toronto Practice Based Research Network (Aliarzadeh); Institute for Clinical Evaluative Sciences (Glazier), Toronto, Ont.
CMAJ Open. 2017 Feb 16;5(1):E137-E143. doi: 10.9778/cmajo.20160122. eCollection 2017 Jan-Mar.
Some evidence supports the use of a short list of essential medicines to improve prescribing. We aimed to create a preliminary essential medicines list for use in Canada.
The 2013 World Health Organization Model List of Essential Medicines was initially adapted by the research team. Fourteen Canadian clinicians gave suggestions for changes to the list. Literature relevant to each unique suggestion was gathered and presented to 3 clinician-scientists who used a modified nominal group technique to make recommendations on the suggested changes. Audits of prescriptions of 2 Toronto-based family health teams (an inner city clinic and a suburban site) between Aug. 1, 2013, and July 30, 2014, were performed to identify common prescriptions that were not on the draft list. Literature relevant to these additional medications was gathered and shared with the clinician-scientist review panel to determine whether each should be added to the list, and a list was developed. The audits were repeated based on the final list to provide a preliminary assessment of the coverage of the list.
The multistep process produced a list of 125 medications. The medications included on this list covered 90.8% and 92.6% of prescriptions at the inner city clinic and the suburban site, respectively. In total, 93% of the patients seen at the inner city clinic and 96% of the patients seen at the suburban clinic had all or all but 1 of their medications covered by the list.
A preliminary list of essential medicines was developed that covered most, but not all, prescriptions at 2 primary care sites. The list should be further refined based on wider input.
一些证据支持使用简短的基本药物清单来改善处方开具情况。我们旨在创建一份供加拿大使用的初步基本药物清单。
研究团队最初对2013年世界卫生组织基本药物示范清单进行了改编。14名加拿大临床医生对清单的修改提出了建议。收集了与每个独特建议相关的文献，并提交给3名临床医生科学家，他们使用改良的名义群体技术对建议的修改提出建议。对2013年8月1日至2014年7月30日期间多伦多两个家庭健康团队（一个市中心诊所和一个郊区诊所）的处方进行审核，以确定草案清单上未列出的常见处方。收集了与这些额外药物相关的文献，并与临床医生科学家评审小组分享，以确定每种药物是否应添加到清单中，并制定了一份清单。根据最终清单重复审核，以对清单的覆盖范围进行初步评估。
多步骤过程产生了一份包含125种药物的清单。该清单上的药物分别覆盖了市中心诊所和郊区诊所90.8%和92.6%的处方。总体而言，市中心诊所93%的患者和郊区诊所96%的患者所服用的药物全部或几乎全部在清单范围内。
制定了一份初步基本药物清单，该清单涵盖了两个初级保健地点的大部分但并非全部处方。应根据更广泛的意见进一步完善该清单。
