Impact of Policy Changes on Utilization of Community Medication Review Services in Ontario among People Living with Diabetes
Bibliographic record
Abstract
Since 2007, the Ontario government has funded pharmacy medication review services (MedsCheck Annual [MCA]) for residents taking 3+ chronic medications. In 2010, MedsCheck was broadened to include patients with diabetes (MCD). In 2016, a policy change added several components to Medscheck services, including diabetes-specific training for pharmacists and diabetes-specific education/goal-setting with patients. The objective of this thesis was to examine the impact of the 2010 and 2016 policy changes on the monthly rate of MedsCheck service delivery among adults living with diabetes. Using interrupted time-series analysis, our study demonstrated that the 2010 policy change slightly increased delivery of MedsCheck services, whereas the 2016 policy change resulted in a dramatic decline in the use of MedsCheck services; with evidence of possible displacement from MCD to MCA. Future research is needed to better understand the impact of the policy changes on access and effectiveness of MedsCheck services, and barriers/facilitators of MedsCheck implementation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.016 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".