Initiatives and reforms across Scotland in recent years to improve prescribing; fndings and global implications of drug prescriptions.

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dc.contributor.authorMacBride-Stewart, Sean
dc.contributor.authorMcTaggart, Stuart
dc.contributor.authorKurdi, Amanj Baker
dc.contributor.authorSneddon, Jacqueline
dc.contributor.authorMcBurney, Stephen
dc.contributor.authorNascimento, Renata Cristina Rezende Macedo do
dc.contributor.authorMueller, Tanja
dc.contributor.authorKwon, Hye-Young
dc.contributor.authorMorton, Alec
dc.contributor.authorSeaton, Ronald Andrew
dc.contributor.authorTimoney, Angela
dc.contributor.authorBennie, Marion
dc.contributor.authorSefah, Israel Abebrese
dc.contributor.authorPisana, Alice
dc.contributor.authorMeyer, Johanna Catherine
dc.contributor.authorGodman, Brian
dc.date.accessioned2022-11-04T19:35:57Z
dc.date.available2022-11-04T19:35:57Z
dc.date.issued2021pt_BR
dc.description.abstractObjective: Global expenditure on medicines is increasingly driven by a number of factors. These include the launch of new premium-priced medicines for complex diseases including oncology, a rise in non-communicable diseases especially with ageing populations and changes in clinical practice. There are also concerns with the rise in antimicrobial resistance due to inappropriate prescribing of antimicrobials as well as concerns with polyphar- macy. Both situations increase morbidity, mortality and costs. We are aware of ongoing activities across Scotland to improve the managed entry of new medicines, including new oncology medicines, improve the prescribing of antimicrobials as well as enhance the prescribing of low-cost multiple sourced medicines and biosimilars without compromising care. In addition, we are seeking to address concerns with polypharmacy. Consequently, we wanted to document these multiple measures and their outcomes to provide an overview to inform all key stakeholders in Scotland as well as the global community as resource pressures grow. Methods: A narrative review of the literature documenting examples of ongoing national and regional initiatives across Scotland to infuence future prescribing and their impact where known across multiple disease areas. Signifcant fndings: The coordinated approach to improve the prescribing of new medicines limited the prescribing of dabigatran when frst launched with recent research providing guidance on the effectiveness and safety of different direct oral anticoagulants as more are launched. The patient reported outcome measures project and other ongoing research activities, including linking datasets, is progressing under the Cancer Medicines Outcomes Programme in Scotland to improve future care with typical differences in the effectiveness of new cancer medicines in routine care versus clinical trials. The Scottish Antimicrobial Prescribing Group is also active in Scotland instigating multiple measures to improve antimicrobial prescribing. This includes improving the dosing of gentamicin and vancomycin as well as reducing the prescribing of antibiotics for women with urinary tract infections. Multiple activities have also resulted in high International Non- proprietary Name (INN) prescribing in Scotland at between 91.4% and 100% across a range of medicines. In addition, increased prescribing of low-cost multiple sourced medicines versus patented medicines in a class or related class, as well as biosimilars, leading to considerable savings without compromising care. There have also been initiatives to address concerns with the rising costs of combination inhalers for patients with respiratory diseases as well as areas of polypharmacy with varying success. Conclusion: Multiple and coordinated approaches have improved the quality and effciency of prescribing pharmaceuticals in Scotland. Additional measures are still needed and we will continue to monitor this situation.pt_BR
dc.identifier.citationMACBRIDE-STEWART, S. et al. Initiatives and reforms across Scotland in recent years to improve prescribing; fndings and global implications of drug prescriptions. International Journal of Clinical and Experimental Medicine, v. 14, p. 2563-2664, 2021. Disponível em: <https://strathprints.strath.ac.uk/78512/>. Acesso em: 11 out. 2022.pt_BR
dc.identifier.issn1940-5901
dc.identifier.urihttp://www.repositorio.ufop.br/jspui/handle/123456789/15767
dc.language.isoen_USpt_BR
dc.rightsabertopt_BR
dc.rights.licenseThis is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Fonte: International Journal of Clinical and Experimental Medicine <https://strathprints.strath.ac.uk/78512/>. Acesso em: 23 maio 2022.pt_BR
dc.subjectAntimicrobialspt_BR
dc.subjectBiosimilarspt_BR
dc.subjectGenericspt_BR
dc.subjectHealthcare reformspt_BR
dc.titleInitiatives and reforms across Scotland in recent years to improve prescribing; fndings and global implications of drug prescriptions.pt_BR
dc.typeArtigo publicado em periodicopt_BR
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