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.

Highlights

  • Inappropriate use of medicines causes increased morbidity, mortality, adverse drug reactions, therapeutic failures and drug resistance as well as being a waste of resourcesEur J Clin Pharmacol (2018) 74:131–138[1,2,3,4,5,6]

  • We found that the essential medicines formulary was widely used and trusted by the prescribers

  • The web survey response rate was 28% (n = 526), i.e. more than one fourth of all physicians working in primary healthcare facilities (PHCs) in the Stockholm healthcare region

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Summary

Introduction

Inappropriate use of medicines causes increased morbidity, mortality, adverse drug reactions, therapeutic failures and drug resistance as well as being a waste of resourcesEur J Clin Pharmacol (2018) 74:131–138[1,2,3,4,5,6]. Guidelines that promote evidence-based use of cost-effective medicines could contribute to improved use of medicines. It is well-known that adherence to treatment recommendations is hard to achieve and has been shown to vary markedly among prescribers and between institutions [7,8,9,10]. It is especially demanding for general practitioners (GPs) to be up to date with the development within the wide range of therapeutic areas represented among their patients. If guidelines are not fully adopted, their potential will not be realised [11]

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