Primary care physicians report high trust in and usefulness of the Stockholm drug and therapeutic committee’s list of recommended essential medicines (the ‘Wise List’)

Abstract

PurposeInappropriate use of medicines causes increased morbidity, mortality, adverse drug reactions, therapeutic failures and drug resistance as well as wastes valuable resources. Evidence-based cost-effective treatment recommendations of essential medicines are a way of avoiding these. We assessed primary care prescribers’ knowledge about and perceptions of an essential medicines formulary, as well as the reasons for adhering to the recommendations.MethodsWe conducted a web based questionnaire survey targeting all physicians working in the primary healthcare of the Stockholm healthcare region (2.3 million inhabitants), regarding the knowledge of, attitudes to and usefulness of the essential medicines formulary of the Stockholm Drug and Therapeutics Committee, the so-called Wise List.ResultsOf the 1862 physicians reached by our e-mail invitations, 526 (28%) participated in the survey. All but one respondent knew of the formulary, and 72% used it at least once a week when prescribing. The main reason for using the formulary was evidence-based prescribing; 97% trusted the guidelines, and almost all (98%) found the content easy to understand. At the same time, many prescribers thought that the annual changes of some recommendations were too frequent, and some felt that a national formulary would increase its trustworthiness.ConclusionsWe found that the essential medicines formulary was widely used and trusted by the prescribers. The high uptake of the treatment recommendations could be due to the Stockholm Drug and Therapeutics Committee’s transparent process for developing recommendations involving respected experts and clinicians using strict criteria for handling potential conflicts of interest, feedback to prescribers, continuous medical education and minor financial incentives.Electronic supplementary materialThe online version of this article (10.1007/s00228-017-2354-8) contains supplementary material, which is available to authorized users.

Implementation and monitoring of decisions by pharmacy and therapeutics committees in South African public sector hospitals

“…This was much lower than the study conducted in Denmark with a 100% response rate, however, only nine hospitals were targeted [33]. Our response rate was similar to that of a survey among physicians in Malaysia (34.8%) [34], and higher though than seen among physicians taking part in web based survey in Sweden (28%) [31] and a Canadian study where the response rate was only 24% [20]. This may be a reflection of the large number of targeted hospitals in our survey.…”

“…An online electronic survey was regarded the most appropriate method to distribute the questionnaire and collect the data, considering i) the size of the country; ii) the study being conducted in all nine provinces; and iii) lack of available manpower and finances to travel and administer the questionnaire using face-to-face interviews. Advantages of web-based questionnaires are that they can speed-up the process, reach as many potential interviewees as possible as well as remove some of the bottlenecks associated with more traditional approaches [30,31], however, recognizing that response rates may not be as high as with paper-based surveys [32].…”

Mapping of Current Obstacles for Rationalizing Use of Medicines (CORUM) in Europe: Current Situation and Potential Solutions

“…We do know that if physicians trust key personnel involved in the development of prescribing guidance, there is a comprehensive dissemination strategy and prescribing is regularly monitored, there is high adherence to any prescribing guidance produced. This is illustrated by high adherence rates to recommended treatment guidance in Stockholm County Council in Sweden with their "Wise List" of medicines and guidelines (Gustafsson et al, 2011;Bjorkhem-Bergman et al, 2013;Eriksen et al, 2017;Eriksen et al, 2018). There are concerns though that DTCs recorded the lowest percentage of being key for promoting RUM (Figure 1).…”

Drug and therapeutics committees in Nigeria: evaluation of scope and functionality

“…Studies in high income countries have highlighted the importance of DTCs in the promotion of RUM, and the cost-effective use of medicines, through learning with adherence to recommendations regarding prescribing enhanced through trust in those compiling the formulary (12)(13)(14)(15). A few studies have described DTCs among lower and middle income countries (LMICs), but their functionality and mode of operation are poorly reported (16-18).…”