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Spackman E, Clement F, Allan GM, Bell CM, Bjerre LM, Blackburn DF, Blais R, Hazlewood G, Klarenbach S, Nicolle LE, Persaud N, Alessi-Severini S, Tierney M, Wijeysundera HC, Manns B. Developing key performance indicators for prescription medication systems. PLoS One 2019; 14:e0210794. [PMID: 30645647 PMCID: PMC6333341 DOI: 10.1371/journal.pone.0210794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 01/02/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To develop key performance indicators that evaluate the effectiveness of a prescription medication system. METHODS A modified RAND/UCLA appropriateness method was used to develop key performance indicators (KPIs) for a prescription medication system. A broad list of potential KPIs was compiled. A multidisciplinary group composed of 21 experts rated the potential KPIs. A face-to-face meeting was held following the first rating exercise to discuss each potential KPI individually. The expert panel undertook a final rating of KPIs. The final set of KPIs were those indicators where at least 80 percent of experts rated the indicator highly i.e. rating of ≥ 7 on a scale from 1 to 9. RESULTS 292 KPIs were identified from the published literature. After removing duplicates and combining similar indicators 71 KPIs were included. The final ranking resulted in six indicators being ranked 7 or higher by 80% of the respondents and an additional seven indicators being ranked 7 or higher by ≥70 but ≤80% of respondents. The six selected indicators include four specific disease areas, measure structural and process aspects of health service delivery, and assessed three of the domains of healthcare quality: efficiency, effectiveness, and safety. CONCLUSIONS These indicators are recommended as a starting point to assess the current performance of prescription medication systems. Consideration should be given to developing indicators in additional disease areas as well as indicators that measure the domains of timeliness and patient-centeredness. Future work should focus on the feasibility of measuring these indicators.
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Affiliation(s)
- Eldon Spackman
- Department of Community Health Sciences and O’Brien Institute of Public Health, Calgary, Alberta, Canada
| | - Fiona Clement
- Department of Community Health Sciences and O’Brien Institute of Public Health, Calgary, Alberta, Canada
| | - G. Michael Allan
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Chaim M. Bell
- Department of Medicine, Sinai Health System and University of Toronto, Toronto, Ontario, Canada
| | - Lise M. Bjerre
- Department of Family Medicine, Bruyère Research Institute, and School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Dave F. Blackburn
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Régis Blais
- School of Public Health, Université de Montréal, Montreal, Quebec, Canada
| | - Glen Hazlewood
- Department of Community Health Sciences and O’Brien Institute of Public Health, Calgary, Alberta, Canada
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Scott Klarenbach
- Department of Medicine University of Alberta, Edmonton, Alberta, Canada
| | - Lindsay E. Nicolle
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Nav Persaud
- St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Silvia Alessi-Severini
- College of Pharmacy and Manitoba Centre for Health Policy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mike Tierney
- Independent Researcher, Ottawa, Onttario, Canada
| | - Harindra C. Wijeysundera
- Canadian Agency for Drugs and Technology in Health (CADTH), Ottawa, Ontario, Canada
- Schulich Heart Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Canada
| | - Braden Manns
- Department of Community Health Sciences and O’Brien Institute of Public Health, Calgary, Alberta, Canada
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
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Smith AD, Olson C, Lyons B, Tran D, Blackburn DF. Adherence to abiraterone among the first 86 recipients after release in Saskatchewan. ACTA ACUST UNITED AC 2015; 22:64-7. [PMID: 25684990 DOI: 10.3747/co.22.2219] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Metastatic castration-resistant prostate cancer is now commonly treated with abiraterone, an orally administered chronic medication. Although abiraterone has certain advantages over docetaxel-based therapy, patients are now responsible for ensuring optimal adherence to their medication. To our knowledge, adherence to abiraterone in a real-world setting has never been described. The objective of the present study was to measure adherence to abiraterone among the first patients to receive the drug in Saskatchewan. Electronic pharmacy claims were obtained from the Saskatchewan Cancer Agency after removal of patient names and identifiers. All patients with at least 1 dispensation for abiraterone between August 2011 and October 2013 were eligible. The primary endpoint was the percentage of patients achieving optimal adherence at 6 months, defined as a medication possession ratio (mpr) of 80% or better. During the study period, 141 patients received abiraterone, among whom 86 could be followed for at least 6 months. Optimal adherence was achieved in 82.6% of patients (71 of 86) at 6 months, with 79.1% achieving a mpr of at least 90%. Of patients with available follow-up to 1 year, 81.6% (31 of 38) maintained optimal adherence during the entire period.
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Affiliation(s)
- A D Smith
- The Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON
| | - C Olson
- Saskatoon Cancer Centre, Saskatoon, SK
| | - B Lyons
- Saskatoon Cancer Centre, Saskatoon, SK
| | - D Tran
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK
| | - D F Blackburn
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK
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