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Evaluating Australia‘s National Strategy for Quality Use of Medicines
Results of indicator measurements
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Quality Use of Medicines
National Strategy for Quality Use of Medicines established 1992
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The Vision Partnership Awareness Enabling Maintaining Government
Policy development Health professionals Government Industry Consumers Partnership Maintaining Facilitation and co-ordination Objective information and ethical promotion Healthy Consumers Education & training Services and interventions Routine data collection
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The Original Vision for QUM (1992)
National Facilitation & Co-ordination Objective Information Education & Training Consumer Services Provider Services Campaigns Australian National Formulary National Therapeutic Guidelines Australian Prescriber Consumer Medicines Information Consumer education for self-reliance School kits & adult learning Core curricula for providers Ethical promotion Undergraduate, postgraduate & continuing ed’n Multidisciplinary team approach Awareness Motivation Confidence Medication records Compliance aids Disposal of unwanted medicines Stimulate teamwork Academic detailing Models of practice Audit & feedback Critical appraisal of promotion General awareness Elderly Asthma Analgesics Out-of-date medication Targeted Grants for Further Development Medication review
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Evaluation Indicators were developed in1993
to mirror the national strategy framework address all key strategies, all partners, all stages of learning monitor process, impact and outcome (implementation and effect)
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Are there nationally recognised therapeutic guidelines?
Process Indicator: Are there nationally recognised therapeutic guidelines? Therapeutic guidelines now cover ten therapeutic areas 60% general practitioners report using antibiotic guidelines
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Process Indicator: Is there Consumer Medicines Information?
Consumer medicines information developed for over 1900 products 60% of consumers report receiving consumer medicines information with their last new medicine
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Process Indicator: Are medication review services available?
1998: services for aged care facilities 127,000 (85%) residents in Australia provided with the service in 2002 2001: funding for community services 1294 (~10%) pharmacists accredited, 3272 (~65%) pharmacies registered to provide the service 22,000 home visits in 2003
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Guidelines for medication management in aged care facilities
Process Indicator: Are there guidelines for medication management in aged-care facilities? Guidelines for medication management in aged care facilities 3rd edition 2003 ~40,000 distributed
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Process Indicator: Is there a medication disposal service?
Return Unwanted Medicines, established 1998 250 tonnes of medication collected in 2003
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Process Indicator: Is there Quality Use of Medicines education for health professionals?
National Prescribing Service Newsletters & prescribing feedback over 20,000 GPs Locally based-facilitators Academic detailing, Clinical audits, Case studies, over 50% of GPs participating
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Impact indicators: Percent of consumers asking questions of their doctor when prescribed a new medicine
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Impact indicator: changes in medication use
Ratio of inhaled corticosteroids to short acting bronchodilators for asthma
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Outcome indicators: changes in hospitalisation rates
Hospitalisation rates for asthma
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Where are we up to?
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Partnership Awareness Enabling Maintaining Healthy Consumers
National Health Policy National Medicines Policy Federal, State & Territory QUM Policies Integrated & consistent Awareness Enabling Maintaining Medication Review funds Co-ordination, facilitation mechanism Funding & evaluation process Dialogue & collaboration All involved & endorsed Therapeutic Guidelines National Therapeutics Bulletin National Formulary CMI Codes of Conduct Healthy Consumers National Prescribing Service Partnership QUM Curricula ( all groups) Complementary Health Care Information technology Other health policies Media Private health industry ADR reporting (HP’s & consumers) Medication management aids (funded) Discharge planning standards Medication review services Medication disposal services Drug utilisation feed back Campaigns National Media Liaison Strategy Drug use audits National Data set
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Lessons learned Useful for identifying successes and gaps in implementation & informing strategic action plans Articulation of essential activities in the policy document & in manual of indicators has led to prioritisation Continuous feedback through a number of different channels and in a number of different formats has been essential
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