The ‘Wise List’– A Comprehensive Concept to Select, Communicate and Achieve Adherence to Recommendations of Essential Drugs in Ambulatory Care in Stockholm

Abstract

Abstract:The aim was to present and evaluate the impact of a comprehensive strategy over 10 years to select, communicate and achieve adherence to essential drug recommendations (EDR) in ambulatory care in a metropolitan healthcare region. EDRs were issued and launched as a 'Wise List' by the regional Drug and Therapeutics Committee in Stockholm. This study presents the concept by: (i) documenting the process for selecting, communicating and monitoring the impact of the 'Wise List'; (ii) analysing the variation in the number of drug substances recommended between 2000 and 2010; (iii) assessing the attitudes to the 'Wise List' among prescribers and the public; (iv) evaluating the adherence to recommendations between 2003 and 2009. The 'Wise List' consistently contained 200 drug substances for treating common diseases. The drugs were selected based on their efficacy, safety, suitability and cost-effectiveness. The 'Wise List' was known among one-third of a surveyed sample of the public in 2002 after initial marketing campaigns. All surveyed prescribers knew about the concept and 81% found the recommendations trustworthy in 2005. Adherence to recommendations increased from 69% in 1999 to 77% in 2009. In primary care, adherence increased from 83% to 87% from 2003 to 2009. The coefficient of variation (CV%) decreased from 6.1% to 3.8% for 156 healthcare centres between these years. The acceptance of the 'Wise List' in terms of trust among physicians and among the public and increased adherence may be explained by clear criteria for drug recommendations, a comprehensive communication strategy, electronic access to recommendations, continuous medical education and involvement of professional networks and patients.

How do regional sickness funds encourage more rational use of medicines, including the increase of generic uptake? A case study from Austria

“…Sickness fund staff believed that these training courses contributed to increased adherence to prescribing rules. This mirrors similar experience in other countries where educational activities have enhanced the relationship between payers and prescribers, and improved prescribing quality, for example, the provision of more information and prescribing activities to increase adherence to the Wise List, a list of recommended treatments in Stockholm County in Sweden [44].…”

“…joint reimbursement lists and joint DTC for outpatient and hospital care as demonstrated in Sweden [44] and Scotland [61]. This would, however, require a fundamental change in the organization and funding of the Austrian healthcare and pharmaceutical sector, which is beyond the mandate of the sickness funds.…”

The medicine selection process in four large university hospitals in Brazil: Does the DTC have a role?

“…The critical, independent, comparative and transparent evaluation of the available options must precede decision-making. The process reaches its goal with the selection of efficient, safe technologies for the profile of the population under care (Gustafsson et al, 2011). However, meeting these criteria demands the structuring of DTCs that are aware of and committed to this crucial activity.…”

Concepto de adherencia preventiva en el ámbito de las adicciones

“…Basándonos en las apreciaciones de Jiménez (2014), si aumentamos la motivación y centramos los programas en la modificación de comportamientos de riesgo, mejora del estilo de vida y satisfacción de necesidades incentivando la participación activa de la población diana, tendremos más probabilidad de conseguir una conducta adherente a la prevención. Además, en otras investigaciones se ha señalado que la adherencia a la actividad física aumenta cuando la población intervenida presenta tasas mayores de autoeficacia y autocontrol (Robinson, Newton, Jones y Dawson, 2014), la credibilidad de la información suministrada aumenta la tasa de adherencia (Gustafsson, Wettermark, Godman, Andersén-Karlsson, Bergman, Hasselstrçm, Hensjç et al, 2011), o que cuando aumenta el optimismo disposicional se da una menor tasa de adherencia en adictos a la heroína (Zaidi, 2014).…”