Medication non-adherence is associated with almost 200,000 deaths annually and €80–125 billion in the European Union. Novel technological advances (smart pill bottles, digital inhalers and spacers, electronic pill blisters, e-injection pens, e-Health applications, big data) could help managing non-adherence. Healthcare professionals seem however inadequately informed about non-adherence, availability of technological solutions in daily practice is limited, and collaborative efforts to push forward their implementation are scarce. The European Network to Advance Best practices and technoLogy on medication adherencE (ENABLE, COST Action 19132) aims to 1) raise awareness of adherence enhancing solutions, 2) foster knowledge on medication adherence, 3) accelerate clinical application of novel technologies and 4) work collaboratively towards economically viable policy, and implementation of adherence enhancing technology across healthcare systems.
Background Several new antidiabetic medicines (GLP-1 receptor agonists, DPP-4 inhibitors, and SGLT-2 inhibitors) have been approved by the European Medicines Agency since 2006. The aim of this study was to evaluate the uptake of new antidiabetic medicines in European countries over a 10-year period. Methods The study used IQVIA quarterly value and volume sales data January 2006–December 2016. The market uptake of new antidiabetic medicines together with intensity of prescribing policy for all antidiabetic medicines were estimated for Austria, Croatia, France, Germany, Hungary, Italy, Poland, Slovenia, Spain, Sweden, and the United Kingdom. The following measures were determined: number of available new active substances, median time to first continuous use, volume market share, and annual therapy cost. Results All countries had at least one new antidiabetic medicine in continuous use and an increase in intensity of prescribing policy for all antidiabetic medicines was observed. A tenfold difference in median time to first continuous use (3–30 months) was found. The annual therapy cost in 2016 of new antidiabetic medicines ranged from EUR 363 to EUR 769. Among new antidiabetic medicines, the market share of DPP-4 inhibitors was the highest. Countries with a higher volume market share of incretin-based medicines (Spain, France, Austria, and Germany) in 2011 had a lower increase in intensity of prescribing policy. This kind of correlation was not found in the case of SGLT-2 inhibitors. Conclusions This study found important differences and variability in the uptake of new antidiabetic medicines in the included countries.
Background In December 2014 Slovene Chamber of Pharmacies defined procedures for Medicines Use Review (MUR) in Slovenia, together with an educational program and certification to ensure pharmacists' competency to perform MUR. The first 15 pharmacists were certified in June 2015 and implemented the service in their practices. Objective This study aimed to understand the implementation of MUR from the perspectives of the first community pharmacists providing the service in practice. Methods A focus group with first MUR providers took place in February 2016, 6 months after the first pharmacists were certified to provide MUR service. Based on regional and institutional criteria ten pharmacists from the first certified group were chosen and invited to participate in guided discussion, where the development and assurance of competencies, the provision of the service in practice and the future of the service were addressed. The discussion was voice recorded with written consent obtained from all participants. Analysis was performed in NVivo 11 software with the use of inductive qualitative content analysis approach. Main outcome measure Views, challenges and opportunities for the Medicines Use Review service in Slovenia. Results Seven pharmacists attended the focus group, 5 from public pharmaceutical institution and 2 from concessionary pharmacies. Three main thematical categories were identified: quality assurance of MUR, different stakeholders' perceptions of MUR and MURs' management. Pharmacists' broad knowledge in pharmacotherapy was emphasized as the basis of quality provision and main advantage in performing MUR in comparison with other healthcare professions. Recognisability of MUR among different stakeholders should be improved with comprehensive approach in marketing of the service. Positive patient feedback was reported, however persuading them to attend MUR presented a challenge. Better management of the service, especially in terms of work organization, would facilitate MUR provision. Conclusion Overall, positive experiences with implementation and provision were reported. To ensure MUR sustainability, the service needs to become more widely known and opportunities must be provided for continuing professional development of providing pharmacists.
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