Abstract:
BACKGROUND:In 2011, Manitoba implemented a province-wide program of physician detailing and free sampling for generic atorvastatin to increase use of this generic statin. We examined the impact of this unique combined program of detailing and sampling for generic atorvastatin on the use and cost of statin medicines, market share of generic atorvastatin, the choice of starting statin for new users, and switching from a branded statin to generic atorvastatin. METHODS:We conducted a retrospective study of Manitoba insurance claims data for all continuously enrolled patients who filled one or more prescriptions for a statin between 2008 and 2013. Data were linked to physician-level data on the number of detailing visits and sample provision. We used interrupted time series analyses to assess policy-related changes in the use and cost of statin medicines, market share of generic atorvastatin, the choice of starting statin for new users, and switching from a branded statin to generic atorvastatin. RESULTS:The detailing program reached 31% (651/2103) of physicians who prescribed a statin during the study period. Collectively, these physicians prescribed 61% of statins dispensed in the province. Free sample cards were provided to 61% (394/651) of the detailed physicians. The program did not change the level or trend in the overall statin use rate and the total cost of statins or increase the number of patients switching from another branded statin to generic atorvastatin. We found the program had a small impact on atorvastatin's market share of new prescriptions, with a level increase of 2.6%. CONCLUSIONS:Though physician detailers were skilled at targeting high-prescribing physicians, a combined program of detailing visits and sample provision for generic atorvastatin did not lower overall statin costs or lead to switching from branded statins to the generic. The preceding introduction of generic atorvastatin appeared sufficient to modify prescribing patterns and decrease costs.
journal_name
Implement Scijournal_title
Implementation science : ISauthors
Worthington HC,Cheng L,Majumdar SR,Morgan SG,Raymond CB,Soumerai SB,Law MRdoi
10.1186/s13012-017-0671-zsubject
Has Abstractpub_date
2017-11-25 00:00:00pages
141issue
1issn
1748-5908pii
10.1186/s13012-017-0671-zjournal_volume
12pub_type
杂志文章abstract:BACKGROUND:Clinical practice guidelines have the potential to facilitate the implementation of evidence into practice, support clinical decision making, specify beneficial therapeutic approaches, and influence public policy. However, these potential benefits have not been consistently achieved. The limited impact of gu...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-6-69
更新日期:2011-07-06 00:00:00
abstract:BACKGROUND:Implementation of multifaceted interventions typically involves many diverse elements working together in interrelated ways, including intervention components, implementation strategies, and features of local context. Given this real-world complexity, implementation researchers may be interested in a new mat...
journal_title:Implementation science : IS
pub_type: 杂志文章
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更新日期:2020-12-11 00:00:00
abstract:BACKGROUND:Organizational factors are considered to be an important influence on health workers' uptake of interventions that improve their practices. These are additionally influenced by factors operating at individual and broader health system levels. We sought to explore contextual influences on worker motivation, a...
journal_title:Implementation science : IS
pub_type: 杂志文章
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abstract:BACKGROUND:There is a need to unpack the empirical, practical, and personal challenges within participatory approaches advocated to optimize implementation. The unpredictable, chaotic nature of participatory approaches complicates application of implementation theories, methods, and strategies which do not address rese...
journal_title:Implementation science : IS
pub_type: 杂志文章
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更新日期:2020-09-03 00:00:00
abstract:BACKGROUND:While it is recommended that childcare services implement policies and practices to support obesity prevention, there remains limited evidence to inform policy and practice. The aim of this study is to examine the effectiveness of performance review and facilitated feedback in increasing the implementation o...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s13012-019-0865-7
更新日期:2019-02-18 00:00:00
abstract:BACKGROUND:In the UK, NHS hospitals receive large amounts of evidence-based recommendations for care delivery from the National Institute for Health and Care Excellence (NICE) and other organisations. Little is known about how NHS organisations implement such guidance and best practice for doing so. This study was ther...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-015-0283-4
更新日期:2015-06-30 00:00:00
abstract:BACKGROUND:Cardiovascular risk management is largely provided in primary healthcare, but not all patients with established cardiovascular diseases receive preventive treatment as recommended. Accreditation of healthcare organizations has been introduced across the world with a range of aims, including the improvement o...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-7-94
更新日期:2012-10-04 00:00:00
abstract:BACKGROUND:There is substantial evidence about the effectiveness of audit with feedback, but none that we know have been conducted in home care settings. The primary purpose of the Data for Improvement and Clinical Excellence - Home Care (DICE-HC) project was to evaluate the effects of an audit and feedback delivered t...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0600-1
更新日期:2017-05-18 00:00:00
abstract:BACKGROUND:With the current funding climate and need for advancements in implementation science, there is a growing demand for grantsmanship workshops to increase the quality and rigor of proposals. A group-based implementation science-focused grantsmanship workshop, the Implementation Development Workshop (IDW), is on...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-016-0429-z
更新日期:2016-05-06 00:00:00
abstract:BACKGROUND:Large-scale implementation of evidence-based psychotherapies (EBPs) such as cognitive processing therapy (CPT) for posttraumatic stress disorder can have a tremendous impact on mental and physical health, healthcare utilization, and quality of life. While many mental health systems (MHS) have invested heavil...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
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更新日期:2017-03-06 00:00:00
abstract:BACKGROUND:A large proportion of the annual 3.3 million neonatal deaths could be averted if there was a high uptake of basic evidence-based practices. In order to overcome this 'know-do' gap, there is an urgent need for in-depth understanding of knowledge translation (KT). A major factor to consider in the successful t...
journal_title:Implementation science : IS
pub_type: 杂志文章
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更新日期:2012-12-03 00:00:00
abstract:BACKGROUND:In the 21st century, government and industry are supplementing hierarchical, bureaucratic forms of organization with network forms, compatible with principles of devolved governance and decentralization of services. Clinical networks are employed as a key health policy approach to engage clinicians in improv...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-7-108
更新日期:2012-11-02 00:00:00
abstract:BACKGROUND:Though the knowledge base on implementation strategies is growing, much remains unknown about how to most effectively operationalize these strategies in diverse contexts. For example, while evidence shows that champions can effectively support implementation efforts in some circumstances, little has been rep...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01048-1
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:The Portuguese National Health Directorate has issued clinical practice guidelines on prescription of anti-inflammatory drugs, acid suppressive therapy, and antiplatelets. However, their effectiveness in changing actual practice is unknown. METHODS:The study will compare the effectiveness of educational out...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
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更新日期:2014-01-15 00:00:00
abstract:BACKGROUND:In 2014, nursing home administration and government officials were facing increasing public and media scrutiny around the variation of antipsychotic medication (APM) prescribing across Ontario nursing homes. In response, policy makers partnered to test an academic detailing (AD) intervention to address appro...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0602-z
更新日期:2017-05-26 00:00:00
abstract:BACKGROUND:Evidence-based practice (EBP) implementation represents a strategic change in organizations that requires effective leadership and alignment of leadership and organizational support across organizational levels. As such, there is a need for combining leadership development with organizational strategies to s...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
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更新日期:2017-03-03 00:00:00
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journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-018-0795-9
更新日期:2018-08-06 00:00:00
abstract:BACKGROUND:There is growing interest in the use of cognitive, behavioural, and organisational theories in implementation research. However, the extent of use of theory in implementation research is uncertain. METHODS:We conducted a systematic review of use of theory in 235 rigorous evaluations of guideline disseminati...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-5-14
更新日期:2010-02-09 00:00:00
abstract:BACKGROUND:Two of the current methodological barriers to implementation science efforts are the lack of agreement regarding constructs hypothesized to affect implementation success and identifiable measures of these constructs. In order to address these gaps, the main goals of this paper were to identify a multi-level ...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/1748-5908-8-22
更新日期:2013-02-17 00:00:00
abstract:BACKGROUND:Over the past years, implementation science has gained more and more importance in German-speaking countries. Reliable and valid questionnaires are needed for evaluating the implementation of evidence-based practices. On an international level, several initiatives focused on the identification of questionnai...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-018-0837-3
更新日期:2018-12-12 00:00:00
abstract:BACKGROUND:The use of opinion leaders is a strategy used to speed the process of translating research into practice. Much is still unknown about opinion leader attributes and activities and the context in which they are most effective. Agent-based modeling is a methodological tool that enables demonstration of the inte...
journal_title:Implementation science : IS
pub_type: 杂志文章
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更新日期:2014-09-27 00:00:00
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journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2018-12-05 00:00:00
abstract:BACKGROUND:The use of guidelines in general practice is not optimal. Although evidence-based methods to improve guideline adherence are available, variation in physician adherence to general practice guidelines remains relatively high. The objective for this study is to transfer a quality improvement strategy based on ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-4-6
更新日期:2009-02-17 00:00:00
abstract:BACKGROUND:Planning a public health initiative is both a science and an art. Public health practitioners work in a complex, often time-constrained environment, where formal research literature can be unavailable or uncertain. Consequently, public health practitioners often draw upon other forms of knowledge. METHODS:T...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-7-20
更新日期:2012-03-20 00:00:00
abstract:BACKGROUND:Considerable racial and socio-economic disparities exist in breast cancer. In spite of the existence of numerous evidence-based interventions (EBIs) aimed at reducing breast cancer screening barriers among the underserved, there is a lack of uptake or sub-optimal uptake of EBIs in community and clinical sett...
journal_title:Implementation science : IS
pub_type: 临床试验,杂志文章
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更新日期:2015-10-14 00:00:00
abstract:BACKGROUND:To better understand the efficacy of various implementation strategies, improved methods for describing and classifying the nature of these strategies are urgently required. The aim of this study was to develop and pilot the feasibility of a taxonomy to classify the nature and content of implementation strat...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-8-32
更新日期:2013-03-15 00:00:00
abstract:BACKGROUND:The Graded Repetitive Arm Supplementary Program (GRASP) is a hand and arm exercise programme designed to increase the intensity of exercise achieved in inpatient stroke rehabilitation. GRASP was shown to be effective in a randomised controlled trial in 2009 and has since experienced unusually rapid uptake in...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-014-0090-3
更新日期:2014-08-12 00:00:00
abstract:BACKGROUND:More than a fifth of Australian children arrive at school developmentally vulnerable. To counteract this, the Healthy Kids Check (HKC), a one-off health assessment aimed at preschool children, was introduced in 2008 into Australian general practice. Delivery of services has, however, remained low. The Theore...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-9-60
更新日期:2014-05-23 00:00:00
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journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-016-0539-7
更新日期:2017-02-10 00:00:00
abstract:BACKGROUND:Scientific knowledge is in constant change. The flow of new information requires a frequent re-evaluation of the available research results. Clinical practice guidelines (CPGs) are not exempted from this phenomenon and need to be kept updated to maintain the validity of their recommendations. The objective o...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/1748-5908-7-109
更新日期:2012-11-19 00:00:00