All Wales Therapeutics and Toxicology Centre, Wales, United Kingdom.
Cardiff University School of Medicine, Wales, United Kingdom.
Br J Clin Pharmacol. 2021 Oct;87(10):3961-3970. doi: 10.1111/bcp.14817. Epub 2021 Apr 8.
To review the medicines optimisation activities of the All Wales Medicines Strategy Group (AWMSG), a committee established in 2002 to advise the Welsh Government on "all matters related to prescribing". Although AWMSG conducts other activities (e.g., health technology appraisal for medicines), we focus here on its role in advising on medicines optimisation.
Prescribing indicators have been used in Wales to measure change, together with data on volumes and costs of medicines dispensed. A range of improvement strategies have been categorised under the "four Es", namely educational initiatives, economic incentives, "engineering" and "enforcement".
AWMSG has helped health professionals in NHS Wales to reduce harm and waste, and to reduce inappropriate local or regional duplication and variation. Specific initiatives include the achievement of major cost savings by supporting increased generic prescribing and an "invest to save" approach related to prescribing of hypnotics and tranquillisers, non-steroidal anti-inflammatory drugs (NSAIDs) and proton pump inhibitors. AWMSG also successfully commissioned the introduction of a single national in-patient medication chart for Wales in 2004. Ongoing priorities include a focus on reducing prescribing of certain medicines deemed "low value for prescribing" and on optimising the use of biosimilar medicines.
Since 2002, AWMSG has acted as a national medicines optimisation committee in Wales. From the outset, pharmacists and clinical pharmacologists have collaborated closely and shared their complementary expertise to make a much greater contribution to the safe, effective and cost-effective use of medicines than either group could have achieved by working separately.
回顾全威尔士药品战略小组（AWMSG）的药品优化活动，该小组于 2002 年成立，旨在就“与处方相关的所有事项”向威尔士政府提供建议。尽管 AWMSG 开展了其他活动（例如药品的卫生技术评估），但我们这里重点关注其在药品优化方面的建议作用。
威尔士采用处方指标来衡量变化，同时还记录了药品配给量和成本数据。一系列改进策略被归类为“四个 E”，即教育举措、经济激励、“工程”和“执法”。
AWMSG 帮助 NHS 威尔士的卫生专业人员减少了伤害和浪费，并减少了不适当的当地或区域重复和差异。具体举措包括通过支持增加通用处方和与催眠药和镇静剂、非甾体抗炎药（NSAIDs）和质子泵抑制剂的处方相关的“投资以节省”方法，实现了重大成本节约。AWMSG 还成功委托在 2004 年为威尔士引入了单一的全国住院病人用药图表。持续的重点包括减少某些被认为“处方价值低”的药物的处方数量，并优化生物类似药物的使用。
自 2002 年以来，AWMSG 一直担任威尔士的国家药品优化委员会。从一开始，药剂师和临床药理学家就密切合作，分享他们互补的专业知识，为安全、有效和经济有效地使用药物做出了比任何一个单独工作的团队都更大的贡献。
