加拿大儿童临时基本药物清单的制定：共识达成过程
Development of a provisional essential medicines list for children in Canada: consensus process.
作者信息
Woods Hannah, Oronsaye Efosa, Bali Anjli, Rajakulasingam Yathavan, Lee Taehoon, Umali Norman, Cohen Eyal, Finkelstein Yaron, Offringa Martin, Persaud Nav
机构信息
Affiliations: Centre for Urban Health Solutions (Woods, Oronsaye, Bali, Rajakulasingam, Lee, Umali, Persaud), Li Ka Shing Knowledge Institute, St. Michael's Hospital; Department of Family and Community Medicine (Persaud), University of Toronto; The Hospital for Sick Children (Cohen, Finkelstein, Offringa); University of Toronto (Cohen, Finkelstein, Offringa); Institute of Health Policy, Management and Evaluation (Cohen, Persaud), Toronto, Ont.
出版信息
CMAJ Open. 2018 Mar 26;6(1):E146-E150. doi: 10.9778/cmajo.20170129.
BACKGROUND
Worldwide, many countries have developed a list of essential medicines for children to improve prescribing. We aimed to create an essential medicines list for children in Canada.
METHODS
We adapted the previously created preliminary list of essential medicines for adults in Canada and the WHO Model List of Essential Medicines for Children to create a provisional list of essential medicines for children in Canada. Canadian clinicians made suggestions for changes. Literature relevant to each suggestion was presented to clinician-scientists, who used a modified nominal group technique to make recommendations on the suggestions. Ontario Public Drug Programs prescription data were reviewed to identify commonly prescribed medications missing from the list. Literature relevant to these medications was shared with a clinician-scientist review panel to determine which should be added, and a revised list was developed.
RESULTS
A total of 76 items were removed from the list of essential medicines for adults in Canada because they were not indicated for use in children or were not relevant in the Canadian health care context; 7 medications were added to the child list based on Ontario Public Drugs Programs prescribing data and clinician-scientist review. Suggestions to add, remove or substitute medications were made by peer-reviewers and resulted in removal of 1 medication and replacement of 1 medication. The process produced a provisional list of 67 essential medications for children.
INTERPRETATION
A provisional list of 67 essential medicines for children was created through a peer-reviewed, multistep process based on current clinical evidence, Canadian clinical practice guidelines and historical prescribing data. It is publicly posted at http://cleanmeds.ca/. The list should be further developed based on wider input and should be continuously revised based on emerging evidence of the safety and effectiveness of these medicines in all pediatric age groups.
背景
在全球范围内，许多国家都制定了儿童基本药物清单以改善处方开具情况。我们旨在制定加拿大儿童基本药物清单。
方法
我们改编了之前制定的加拿大成人基本药物初步清单以及世界卫生组织儿童基本药物示范清单，以创建加拿大儿童基本药物临时清单。加拿大临床医生提出了修改建议。将与每条建议相关的文献呈递给临床医生科学家，他们使用改良的名义群体技术对这些建议提出建议。对安大略省公共药物项目的处方数据进行审查，以确定清单中遗漏的常用处方药。与临床医生科学家审查小组分享与这些药物相关的文献，以确定应添加哪些药物，并制定了修订清单。
结果
加拿大成人基本药物清单中总共删除了76种药物，因为它们未被指明可用于儿童或在加拿大医疗保健环境中不相关；根据安大略省公共药物项目的处方数据和临床医生科学家审查，在儿童清单中添加了7种药物。同行评审员提出了添加、删除或替代药物的建议，结果删除了1种药物并替换了1种药物。该过程产生了一份包含67种儿童基本药物的临时清单。
解读
通过基于当前临床证据、加拿大临床实践指南和历史处方数据的同行评审多步骤过程，创建了一份包含67种儿童基本药物的临时清单。该清单已在http://cleanmeds.ca/上公开发布。应根据更广泛的意见进一步完善该清单，并应根据这些药物在所有儿科年龄组中的安全性和有效性的新证据不断修订。
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