Healthy Skepticism Library item: 11920

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Publication type: report

Health Council of Canada
Safe and Sound: Optimizing Prescribing Behaviours — Summary of Main Themes and Insights (Report on a Policy Symposium).
Toronto: Health Council of Canada 2007 Sep
http://www.healthcouncilcanada.ca/docs/rpts/2007/pharma/HCC_Symp_Sum_EN_FINAL%20web.pdf

Abstract:

Contents

02 EXECUTIVE SUMMARY
04 FOREWORD
05 INTRODUCTION
06 BACKGROUND
08 CENTRAL SYMPOSIUM THEMES
Education and information for prescribers and
patients: supporting safe and sound decisions
Regulation and policy: changing the landscape
The electronic health record: a transformative tool
1 4 CONCLUSION
1 4 WHAT WE HEARD
1 6 REFERENCES
1 7 ABOUT THE HEALTH COUNCIL OF CANADA

Executive summary

This report summarizes the central themes and advice from the Health Council of Canada emerging from a symposium, “Safe and Sound: Optimizing Prescribing Behaviours,” hosted by the Health Council on June 12-13 in Montreal. The purpose of the symposium was to support the continued development of Canada’s National Pharmaceuticals Strategy, in particular to “enhance action to influence the prescribing behaviour of health care professionals so that drugs are used only when needed and the right drug is used for the right problem.”

A number of studies have documented the problems of overuse, underuse, and inappropriate use of
prescription drugs in Canada, problems which result in missed health benefits, harm to individual Canadians, and unnecessary costs to the health care system.

There are two major fronts on which to act in order to optimize prescribing:

1) supporting safe and sound decision-making by physicians and patients, so that the patient is more likely to receive the most appropriate prescription; and

2) changing the policy and regulatory landscape that influences prescribing and medication use in Canada.

Critical to success on both of these fronts is:

3) the electronic health record, an essential transformative tool.

Safe and sound decisions by prescribers and patients require targeted education and easier access to
the right information. Prescribers, pharmacists, patients, and the general public could all benefit from expanded, more coordinated, and more comprehensive use of academic detailing across Canada and education campaigns on appropriate drug use. The costs of running academic detailing programs- one of the few strategies shown to be effective in making prescribing more appropriate – should be weighed against the costs of not running them. The lack of consistent and mandatory training in quality use of medicines in Canada’s medical schools is concerning and points to the urgent
need to correct this problem.

Australia’s National Prescribing Service has shown that academic detailing (in which publicly funded professionals, not pharmaceutical industry representatives, visit health care providers with up-to-date information on appropriate prescribing) can save money for the health care system. Among other strategies, Australia has also recently employed large-scale, targeted consumer-education campaigns to promote the optimal use of drugs. There is much that Canada can learn from
Australia’s leadership.

Changing the landscape requires new regulatory and funding policies to improve access to beneficial
medicines and to monitor and respond to unexpected health effects after medications are on the market. High drug prices, as well as gaps and inequities in insurance coverage for prescription drugs, continue to affect the accessibility of beneficial medicines. Efforts to optimize prescribing practices may be wasted if Canadians cannot access necessary drugs because they cannot afford them.

Public policy affecting the licensing, marketing, and ongoing surveillance of the health outcomes of drugs must also be part of a national strategy to make the use of prescription drugs more effective – for the health of Canadians and the future of our health care system.

The electronic health record has the potential to transform the patient-prescriber relationship by providing information to guide safe and effective prescribing decisions at every health care encounter. This tool also has great potential to support evidence-based public policy on pharmaceuticals and ongoing quality improvement in health care by generating real-world data on drug use and clinical outcomes after medicines are on the market. There is no systematic and ongoing
effort in Canada today to measure how prescription drugs are used and with what effect. The electronic health record is an expensive undertaking but vital to health care renewal, and the Health Council of Canada continues to strongly support the rapid adoption of this transformative tool.