Centre for Big Data Research in Health, Faculty of Medicine and Health, UNSW Sydney, Sydney 2052, Australia.
Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide 5000, Australia.
Int J Environ Res Public Health. 2021 Dec 18;18(24):13345. doi: 10.3390/ijerph182413345.
Australia spends more than $20 billion annually on medicines, delivering significant health benefits for the population. However, inappropriate prescribing and medicine use also result in harm to individuals and populations, and waste of precious health resources. Medication data linked with other routine collections enable evidence generation in pharmacoepidemiology; the science of quantifying the use, effectiveness and safety of medicines in real-world clinical practice. This review details the history of medicines policy and data access in Australia, the strengths of existing data sources, and the infrastructure and governance enabling and impeding evidence generation in the field. Currently, substantial gaps persist with respect to cohesive, contemporary linked data sources supporting quality use of medicines, effectiveness and safety research; exemplified by Australia's limited capacity to contribute to the global effort in real-world studies of vaccine and disease-modifying treatments for COVID-19. We propose a roadmap to bolster the discipline, and population health more broadly, underpinned by a distinct capability governing and streamlining access to linked data assets for accredited researchers. Robust real-world evidence generation requires current data roadblocks to be remedied as a matter of urgency to deliver efficient and equitable health care and improve the health and well-being of all Australians.
澳大利亚每年在药品上的花费超过 200 亿澳元，这为民众带来了显著的健康效益。然而，不适当的处方和用药也会给个人和人群带来伤害，并浪费宝贵的卫生资源。将药物数据与其他常规收集的数据相关联，能够在药物流行病学领域产生证据；药物流行病学是一门量化药物在真实临床实践中的使用、效果和安全性的科学。本综述详细介绍了澳大利亚药品政策和数据获取的历史、现有数据源的优势，以及为该领域产生证据提供支持和阻碍的基础设施和治理情况。目前，在支持药物合理使用、效果和安全性研究的连贯、现代的综合数据源方面仍存在很大差距；这突出表明澳大利亚在为全球努力提供关于 COVID-19 疫苗和疾病修正治疗的真实世界研究方面能力有限。我们提出了一个路线图，以加强这一学科，并更广泛地促进人口健康，其基础是一个明确的管理和简化获取经认可的研究人员的相关联数据资产的能力。为了提供高效和公平的医疗保健，改善所有澳大利亚人的健康和福祉，迫切需要解决当前的数据障碍，以产生强有力的真实世界证据。
