An essential medicines list in Ireland: A qualitative interview study of interest-holders
Notice bibliographique
Résumé
Abstract Background The World Health Organization recommends each country develop a national essential medicines list (NEML), prioritising a core medicines set aligned with national health needs. Policy in Ireland partly focusses on prescribing costs and quality, which creates opportunities for NEML development. We aimed to explore interest-holders’ perspectives on an Irish NEML. Methods We applied a descriptive qualitative methodology. Using purposive and snowball sampling, we recruited interest-holders from Irish bodies/groups with roles in shaping Ireland’s medicines policy/use with potential for involvement in a NEML. Semi-structured interviews were conducted and analysis involved Braun and Clarke’s six-stage approach to thematic analysis. Results Thirteen participants were interviewed and three themes were generated: 1) the NEML’s purpose, 2) NEML barriers and facilitators and 3) development and implementation processes. For participants, an NEML’s purpose is meeting the population’s priority needs. Participants also outlined roles in ensuring adequate supplies and as a national formulary. Views differed on whether an NEML should involve reduced costs to patients for access. Participants proposed that the national government health department, the state body who run the health service (HSE), and/or the medicines regulator (HPRA) should be responsible for an NEML. Conclusions Participants perceived an NEML in Ireland as beneficial and aligning with the WHO’s vision: medicines that effectively and safely treat the priority healthcare needs of the population. Future work should explore the patients’ and the public’s perspectives on an NEML. Other countries’ NEMLs offer exemplars to inform Ireland’s approach. Research in Context What is already known about the topic? According to The World Health Organization, "each country has the direct responsibility of evaluating and adopting a list of essential drugs, according to its own [health] policy." These national essential medicines lists (NEMLs) can be used to standardising medications used across healthcare institutions. This can have benefits for procurement costs, patient safety and preventing shortages. What does this study add to the literature? We interviewed 13 medicines policy interest-holders about an Irish NEML. Participants envisioned an NEML as meeting the population’s priority needs. They also outlined roles for an NEML in ensuring supplies and as a national formulary. Barriers (e.g. achieving consensus) and facilitators (e.g. buy-in) to developing and implementing an NEML were outlined. Participants said transparent development processes, the use of financial incentives and a communications strategy, could help overcome barriers. Participants proposed that the national government health department, the state body who run the health service (HSE), and/or the medicines regulator (HPRA) should be responsible for an NEML. What are the policy implications? An NEML could fit into Ireland’s ongoing health reform policy: Sláintecare. Participants’ suggested strategies for overcome NEML barriers are backed-up by findings in other high-income countries (e.g. Sweden and Canada) where transparency, financial incentives and a communications strategy contributed to NEML success.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,034 | 0,039 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,003 | 0,003 |
| Études des sciences et des technologies | 0,013 | 0,012 |
| Communication savante | 0,007 | 0,008 |
| Science ouverte | 0,004 | 0,011 |
| Intégrité de la recherche | 0,003 | 0,007 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».