Michael S Taglione1, Haroon Ahmad1, Morgan Slater1, Babak Aliarzadeh1, Richard H Glazier1, Andreas Laupacis1, Nav Persaud1. 1. 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.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. INTERPRETATION: 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.
BACKGROUND: 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. METHODS: 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. RESULTS: 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. INTERPRETATION: 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.
Authors: Gordon H Guyatt; Andrew D Oxman; Gunn E Vist; Regina Kunz; Yngve Falck-Ytter; Pablo Alonso-Coello; Holger J Schünemann Journal: BMJ Date: 2008-04-26
Authors: Nav Persaud; Taehoon Lee; Haroon Ahmad; Winny Li; Michael Sergio Taglione; Yathavan Rajakulasingam; Norman Umali; Andrew Boozary; Richard H Glazier; Tara Gomes; Stephen W Hwang; Peter Jüni; Michael Law; Muhammad M Mamdani; Braden Manns; Danielle Martin; Steve Morgan; Paul Oh; Andrew David Pinto; Baiju R Shah; Frank M Sullivan; Kevin E Thorpe; Karen Tu; Andreas Laupacis Journal: BMJ Open Date: 2017-06-12 Impact factor: 2.692
Authors: Karen Bissell; Philippa Ellwood; Eamon Ellwood; Chen-Yuan Chiang; Guy B Marks; Asma El Sony; Innes Asher; Nils Billo; Christophe Perrin Journal: Int J Environ Res Public Health Date: 2019-02-19 Impact factor: 3.390
Authors: Navindra Persaud; Michael Bedard; Andrew S Boozary; Richard H Glazier; Tara Gomes; Stephen W Hwang; Peter Jüni; Michael R Law; Muhammad M Mamdani; Braden J Manns; Danielle Martin; Steven G Morgan; Paul I Oh; Andrew D Pinto; Baiju R Shah; Frank Sullivan; Norman Umali; Kevin E Thorpe; Karen Tu; Andreas Laupacis Journal: JAMA Intern Med Date: 2019-10-07 Impact factor: 21.873