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Evaluating Australia‘s National Strategy for Quality Use of Medicines

Evaluating Australia‘s National Strategy for Quality Use of Medicines. Results of indicator measurements 1992-2003. Quality Use of Medicines. National Strategy for Quality Use of Medicines established 1992. http://www.health.gov.au/nmp/quality.htm. Awareness . Enabling. Maintaining.

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Evaluating Australia‘s National Strategy for Quality Use of Medicines

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  1. Evaluating Australia‘s National Strategy for Quality Use of Medicines Results of indicator measurements 1992-2003

  2. Quality Use of Medicines • National Strategy for Quality Use of Medicines established 1992 http://www.health.gov.au/nmp/quality.htm

  3. Awareness Enabling Maintaining Government Health professionals Partnership Industry Consumers The Vision Policy development Facilitation and co-ordination Objective information and ethical promotion HealthyConsumers Education & training Services and interventions Routine data collection

  4. The Original Vision for QUM (1992) National Facilitation & Co-ordination Australian National Formulary Consumer education for self-reliance Awareness Motivation Confidence Stimulate teamwork General awareness Objective Information Education & Training Consumer Services Provider Services Campaigns School kits & adult learning Academic detailing National Therapeutic Guidelines Medication records Elderly Core curricula for providers Models of practice Asthma Medication review Australian Prescriber Analgesics Undergraduate, postgraduate & continuing ed’n Audit & feedback Compliance aids Consumer Medicines Information Out-of-date medication Disposal of unwanted medicines Critical appraisal of promotion Multidisciplinary team approach Ethical promotion Targeted Grants for Further Development

  5. 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) http://www.health.gov.au/nmp/publications/pharm.htm

  6. Process Indicator: Are there nationally recognised therapeutic guidelines? • Therapeutic guidelinesnow cover ten therapeutic areas • 60% general practitionersreport using antibiotic guidelines http://www.tg.com.au/home/index.html

  7. 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 • http://www.health.gov.au/nmp/pdf/cmi.pdf

  8. 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 • http://www.hic.gov.au/providers/incentives_allowances/pharmacy_agreement/about_hmr.htm

  9. 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 • http://www.health.gov.au/nmp/pdf/resguide.pdf

  10. Process Indicator: Is there a medication disposal service? • Return Unwanted Medicines, established 1998 • 250 tonnes of medication collected in 2003 http://www.returnmed.com.au

  11. 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 • http://www.nps.org.au/

  12. Impact indicators: Percent of consumers asking questions of their doctor when prescribed a new medicine

  13. Impact indicator: changes in medication use Ratio of inhaled corticosteroids to short acting bronchodilators for asthma

  14. Outcome indicators: changes in hospitalisation rates Hospitalisation rates for asthma

  15. Where are we up to?

  16. Information technology Complementary Health Care Private health industry Other health policies Media • 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 HealthyConsumers National Prescribing Service Partnership • QUM Curricula ( all groups) • 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

  17. 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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