Evaluation of a national quality use of medicines service in Australia: an evolving model

• Published in: Journal of evaluation in clinical practice 2006-04, Vol.12 (2), p.202-217
• Main Authors: Beilby, Justin, Wutzke, Sonia E., Bowman, Jenny, Mackson, Judith M, Weekes, Lynn M.
• Format: Article
• Language: English
• Subjects: Australia; Communication; Data Collection; Drug Prescriptions - standards; Drug Utilization - trends; general practitioners; Humans; Motivation; pharmacists; Politics; prescribing; Program Evaluation - methods; quality use of medicines; Regional Medical Programs - standards
• ISSN: 1356-1294; 1365-2753
• DOI: 10.1111/j.1365-2753.2006.00620.x

Rationale  To describe the first phase of a global evaluation framework for the National Prescribing Service (NPS), with a focus on services for health professionals, and in particular highlight the lessons learnt from evaluation around the establishment and implementation of this national pragram. Methods  The agreed evaluation framework used mixed methods focused around a series of evaluation questions, aimed at measuring the overall effect of this new organization as well as the individual pragrams within it. The evaluation questions were determined a priori and were based on the objectives established by the organization in its first year of operation. A detailed analyses has been completed of: the process, scope and reach of pragram delivery using both quantitative and qualitative measures; changes in attitudes and knowledge measured through key informant interviews and surveys of professional groups and consumers; and changes in prescribing behaviour and savings to the Pharmaceutical Benefits Scheme (PBS) through analysis of prescription data. The evaluation period for this report was mid‐1998 to mid‐2004. Results  The NPS has successfully implemented a complex, multi‐facted pragram across Australia. From 1998 to 2004, in addition to print material provided to all general practitioners (GPs) and pharmacists, 90% of all GPs have been actively involved in one or more educational activity; 116 of 120 divisions of general practice have coordinated local NPS pragrams; and 9% of pharmacists have actively participated in at least one educational activity. Sixty per cent of GPs and pharmacists rated the printed educational materials as good or very good. In the last three years, the NPS activities have generated savings in the range of $121–163 million to the PBS, owing to changes in prescribing practices. Conclusion  The national evaluation framework has informed pragram delivery and ongoing design and development. Continued refinement of existing evaluation methods and further exploration of new techniques will remain a priority for the organization.