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

Lars L. Gustafsson*, Björn Wettermark, Brian Godman, Eva Andersén-Karlsson, Ulf Bergman, Jan Hasselström, Lars Olof Hensjö, Paul Hjemdahl, Ingrid Jägre, Margaretha Julander, Bo Ringertz, Daniel Schmidt, Susan Sjöberg, Folke Sjöqvist, Carl Olav Stiller, Elisabeth Törnqvist, Rolf Tryselius, Sigurd Vitols, Christer Von Bahr

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

150 Citations (Scopus)

Abstract

The aim was to present and evaluate the impact of a comprehensive strategy over 10years 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.

Original languageEnglish
Pages (from-to)224-233
Number of pages10
JournalBasic and Clinical Pharmacology and Toxicology
Volume108
Issue number4
DOIs
Publication statusPublished - Apr 2011
Externally publishedYes

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