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Pharmacy World and Science

, Volume 27, Issue 3, pp 236–242 | Cite as

Health Professionals: How Do They Assess New Medicines?

  • Rebecca Cheng
  • Kirsty Cook
  • Sarah Dowman
  • Rebecca Lawn
  • Jemma Leary
  • Taryn Quinn
  • Kim Schroder
  • Nicola Smith
  • June TordoffEmail author
Article

Abstract

Objective: To identify the types of information used by health professionals when assessing a new medicine, and to discover whether measures of clinical effectiveness and cost-effectiveness are understood and used.

Method: A cross-sectional survey of 56 health professionals was undertaken in a tertiary hospital in New Zealand. Respondents were consultants, registrars, house-surgeons, pharmacists, and specialist nurses

Main outcome measures: Health professionals’ opinions on clinical and cost information required for assessing a new medicine; their ability to calculate measures of risk; and their ability to define clinical effectiveness, cost-effectiveness and types of economic analysis.

Results: Thirty-four percent of respondents considered journals and research to be the most accurate sources of information when assessing a new medicine. Efficacy, safety, contraindications and side-effects were the most important information sought. In total, 93% gave an acceptable definition of clinical effectiveness, and 38% of cost-effectiveness. The majority of each profession (except specialist nurses) could calculate relative risk reduction (RRR) and absolute risk reduction (ARR) but fewer could calculate numbers needed to treat (NNT). Eighty-four percent of respondents felt that cost affected their assessment of a new medicine. Less than a quarter of respondents could define each type of economic analysis. Consultants and pharmacists appeared to have the best knowledge of economic analysis.

Conclusion: Efficacy, safety, contraindications and side-effects were the most important information sought when assessing a new medicine. Health professionals’ knowledge of clinical effectiveness was greater than their knowledge of cost-effectiveness. Consultants and pharmacists appeared to have the best knowledge of economic analysis.

Keywords

Decision making Drug New Zealand Nurse Pharmacist Pharmacoeconomics Physician Safety 

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References

  1. Segal, R, Pathak, S. 1988Formulary decision making: identifying factors that influence P&T Committee drug evaluationsHosp Formul231748PubMedGoogle Scholar
  2. Weekes, LM, Brooks, C. 1996Drug and therapeutics committees in Australia: expected and actual performanceBr J Clin Pharmacol425517PubMedGoogle Scholar
  3. *Medicines Pharmacy and Industry Group and Nursing and Midwifery Policy Branch. (2003). Supplementary prescribing by nurses and pharmacists within the NHS in England. Department of Health: London, 1–67Google Scholar
  4. Gentry, S. 2001Nurse Prescribing Regulations take effect. Media ReleaseMinistry of HealthWellingtonGoogle Scholar
  5. Anon,  1998Prescribing new drugs in general practiceMeRec Bull9214Google Scholar
  6. McGettigan, P.,  et al. 2001Prescribers prefer people. The sources of information used by doctors for prescribing suggest that the medium is more important than the messageBr J Clin Pharmacol511849CrossRefPubMedGoogle Scholar
  7. Jones, MI, Greensfield, SM, Bradley, CP. 2000Prescribing new drugs: qualitative study of influences on consultants and general practitionersBMJ3233782CrossRefGoogle Scholar
  8. Prosser, H, Solomon, A, Walley, T. 2003Influences on GP’s decision to prescribe new drugs – the importance of who says whatFam Pract20618CrossRefPubMedGoogle Scholar
  9. Peay, MY, Peay, ER. 1984Differences among practitioners in patterns of preference for information sources in the adoption of new drugsSoc Sci Med18101925CrossRefPubMedGoogle Scholar
  10. Hall, J, Cantrill, J, Noyce, P. 2003The information sources used by community nurse prescribersBr J Nurs128108PubMedGoogle Scholar
  11. Glanville, J, Haines, M, Auston, I. 1998Finding information on clinical effectivenessBMJ3172003PubMedGoogle Scholar
  12. Rosenberg, W, Donald, A. 1995Evidence based medicine: an approach to clinical problem-solvingBMJ31011226PubMedGoogle Scholar
  13. Laupacis, A, Sackett, D, Roberts, R. 1996An assessment of clinically useful measures of the consequences of treatmentN Engl J Med318172833Google Scholar
  14. McCormack, JP, Levine, M. 1993Meaningful interpretation of risk reduction from clinical drug trialsAnn Pharmacother2712727PubMedGoogle Scholar
  15. Fahey T, Newton J. (1995). Conveying the benefits and risks of treatment. Br J Gen Pract (45): 339–41Google Scholar
  16. Cook, RJ, Sackett, DL. 1995The number needed to treat: a clinically useful measure of treatment effectBMJ3104524PubMedGoogle Scholar
  17. Cranney, M, Walley, T. 1996Same information, different decisions: The influence of evidence on the management of hypertension in the elderlyBr J Gen Pract466613PubMedGoogle Scholar
  18. Naylor, DC, Chen, E, Strauss, B. 1992Measured enthusiasm. Does the method of reporting trial results alter perceptions of therapeutics effectiveness?Ann Int Med11791621PubMedGoogle Scholar
  19. Bucher, HC, Weinbacher, M, Gyr, K. 1994Influence of method of reporting study results on decision of physicians to prescribe drugs to lower cholesterol concentrationBMJ3097615PubMedGoogle Scholar
  20. Bobbio, MDB, Giustetto, G. 1994Completeness of reporting trial results: effect on physicians willingness to prescribeLancet343120911CrossRefPubMedGoogle Scholar
  21. Forrow, L, Taylor, WC, Arnold, RM. 1992Absolutely relative: how research results are summarised can affect treatment decisionsAm J Med921214CrossRefPubMedGoogle Scholar
  22. Walzak, D, Swindells, S, Bhardwaj, A. 1994Primary Care physicians and the cost of drugs: a study of prescribing practices based on recognition of information sourcesJ Clin Pharmacol34115963PubMedGoogle Scholar
  23. Reichert, S, Simon, T, Halm, EA. 2000Physicians’ attitudes about prescribing and knowledge of the costs of common medicationsArch Intern Med1602799803CrossRefPubMedGoogle Scholar
  24. Drummond, M, Cooke, J, Walley, T. 1997Economic evaluation under managed competition: evidence from the UKSoc Sci Med4558395CrossRefPubMedGoogle Scholar
  25. Hoffmann, C,  et al. 2002Do health-care decision makers find economic evaluations useful? The findings of focus group research in UK health authoritiesValue Health5718CrossRefPubMedGoogle Scholar
  26. Odedina, FT,  et al. 2002Use of pharmacoeconomic data in making hospital formulary decisionsAm J Health Syst Pharm5914414PubMedGoogle Scholar
  27. Tordoff J et al. Processes for the assessment of new medicines in New Zealand hospitals. Annual Scientific Meeting, 2003. Sydney: Australasian Society of Clinical and Experimental Pharmacologists and ToxicologistsGoogle Scholar
  28. Kobelt, G. 2002Health economics: An introduction to economic evaluation2Office of Health EconomicsLondonGoogle Scholar
  29. Drummond, MF,  et al. 1996Methods for the economic evaluation of health programmes2Oxford University PressOxfordGoogle Scholar
  30. Pharmaceutical Management Agency. Prescription for pharmacoeconomic analysis. 1999. Available at http://www. pharmac.govt.nz/pdf (accessed on 5.12.03)Google Scholar
  31. Australian Department of Health Housing and Community Services. Guidelines for the pharmaceutical industry on preparation of submissions to the Pharmaceutical Benefits Advisory Committee. Australian Government Publishing Service: Canberra, Australia, 1922Google Scholar
  32. Elliott, R, Payne, K, Silcock, J. 1996Health economics – do or be done byPharm J257832Google Scholar
  33. Barber, NA. 1986Pharmacists’ guide to statisticsBr J Pharm Pract83547Google Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Rebecca Cheng
    • 2
  • Kirsty Cook
    • 2
  • Sarah Dowman
    • 2
  • Rebecca Lawn
    • 2
  • Jemma Leary
    • 2
  • Taryn Quinn
    • 2
  • Kim Schroder
    • 2
  • Nicola Smith
    • 2
  • June Tordoff
    • 1
    Email author
  1. 1.Lecturer, School of PharmacyUniversity of OtagoNew Zealand
  2. 2.Undergraduate Pharmacy students (4th year)University of OtagoNew Zealand

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