A case study of polypharmacy management in nine European countries: Implications for change management and implementation
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , , , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10316/101131 https://doi.org/10.1371/journal.pone.0195232 |
Resumo: | Background Multimorbidity and its associated polypharmacy contribute to an increase in adverse drug events, hospitalizations, and healthcare spending. This study aimed to address: what exists regarding polypharmacy management in the European Union (EU); why programs were, or were not, developed; and, how identified initiatives were developed, implemented, and sustained. Methods Change management principles (Kotter) and normalization process theory (NPT) informed data collection and analysis. Nine case studies were conducted in eight EU countries: Germany (Lower Saxony), Greece, Italy (Campania), Poland, Portugal, Spain (Catalonia), Sweden (Uppsala), and the United Kingdom (Northern Ireland and Scotland). The workflow included a review of country/region specific polypharmacy policies, key informant interviews with stakeholders involved in policy development and implementation and, focus groups of clinicians and managers. Data were analyzed using thematic analysis of individual cases and framework analysis across cases. Results Polypharmacy initiatives were identified in five regions (Catalonia, Lower Saxony, Northern Ireland, Scotland, and Uppsala) and included all care settings. There was agreement, even in cases without initiatives, that polypharmacy is a significant issue to address. Common themes regarding the development and implementation of polypharmacy management initiatives were: locally adapted solutions, organizational culture supporting innovation and teamwork, adequate workforce training, multidisciplinary teams, changes in workflow, redefinition of roles and responsibilities of professionals, policies and legislation supporting the initiative, and data management and information and communication systems to assist development and implementation. Depending on the setting, these were considered either facilitators or barriers to implementation. Conclusion Within the studied EU countries, polypharmacy management was not widely addressed. These results highlight the importance of change management and theory-based implementation strategies, and provide examples of polypharmacy management initiatives that can assist managers and policymakers in developing new programs or scaling up existing ones, particularly in places currently lacking such initiatives. |
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A case study of polypharmacy management in nine European countries: Implications for change management and implementationBackground Multimorbidity and its associated polypharmacy contribute to an increase in adverse drug events, hospitalizations, and healthcare spending. This study aimed to address: what exists regarding polypharmacy management in the European Union (EU); why programs were, or were not, developed; and, how identified initiatives were developed, implemented, and sustained. Methods Change management principles (Kotter) and normalization process theory (NPT) informed data collection and analysis. Nine case studies were conducted in eight EU countries: Germany (Lower Saxony), Greece, Italy (Campania), Poland, Portugal, Spain (Catalonia), Sweden (Uppsala), and the United Kingdom (Northern Ireland and Scotland). The workflow included a review of country/region specific polypharmacy policies, key informant interviews with stakeholders involved in policy development and implementation and, focus groups of clinicians and managers. Data were analyzed using thematic analysis of individual cases and framework analysis across cases. Results Polypharmacy initiatives were identified in five regions (Catalonia, Lower Saxony, Northern Ireland, Scotland, and Uppsala) and included all care settings. There was agreement, even in cases without initiatives, that polypharmacy is a significant issue to address. Common themes regarding the development and implementation of polypharmacy management initiatives were: locally adapted solutions, organizational culture supporting innovation and teamwork, adequate workforce training, multidisciplinary teams, changes in workflow, redefinition of roles and responsibilities of professionals, policies and legislation supporting the initiative, and data management and information and communication systems to assist development and implementation. Depending on the setting, these were considered either facilitators or barriers to implementation. Conclusion Within the studied EU countries, polypharmacy management was not widely addressed. These results highlight the importance of change management and theory-based implementation strategies, and provide examples of polypharmacy management initiatives that can assist managers and policymakers in developing new programs or scaling up existing ones, particularly in places currently lacking such initiatives.3910-3178-31BA | MARIA MARGARIDA COUTINHO DE SEABRA CASTEL-BRANCO CAETANOinfo:eu-repo/semantics/publishedVersionPlos2018info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://hdl.handle.net/10316/101131http://hdl.handle.net/10316/101131https://doi.org/10.1371/journal.pone.0195232engcv-prod-144181McIntosh, JenniferAlonso, AlbertMacLure, KatieStewart, DerekKempen, ThomasMair, AlpanaCastel-Branco, MargaridaCodina, CharlesFernandez-Llimos, FernandoFleming, GlendaGennimata, DimitraGillespie, UlrikaHarrison, CathyIllario, MaddalenaJunius-Walker, UlrikeKampolis, Christos F.Kardas, PrzemyslawLewekMalva, JoãoMenditto, EnricaScullin, ClaireWiese, Birgittinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-08-19T14:25:10Zoai:estudogeral.uc.pt:10316/101131Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T21:18:22.389467Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
A case study of polypharmacy management in nine European countries: Implications for change management and implementation |
title |
A case study of polypharmacy management in nine European countries: Implications for change management and implementation |
spellingShingle |
A case study of polypharmacy management in nine European countries: Implications for change management and implementation McIntosh, Jennifer |
title_short |
A case study of polypharmacy management in nine European countries: Implications for change management and implementation |
title_full |
A case study of polypharmacy management in nine European countries: Implications for change management and implementation |
title_fullStr |
A case study of polypharmacy management in nine European countries: Implications for change management and implementation |
title_full_unstemmed |
A case study of polypharmacy management in nine European countries: Implications for change management and implementation |
title_sort |
A case study of polypharmacy management in nine European countries: Implications for change management and implementation |
author |
McIntosh, Jennifer |
author_facet |
McIntosh, Jennifer Alonso, Albert MacLure, Katie Stewart, Derek Kempen, Thomas Mair, Alpana Castel-Branco, Margarida Codina, Charles Fernandez-Llimos, Fernando Fleming, Glenda Gennimata, Dimitra Gillespie, Ulrika Harrison, Cathy Illario, Maddalena Junius-Walker, Ulrike Kampolis, Christos F. Kardas, Przemyslaw Lewek Malva, João Menditto, Enrica Scullin, Claire Wiese, Birgitt |
author_role |
author |
author2 |
Alonso, Albert MacLure, Katie Stewart, Derek Kempen, Thomas Mair, Alpana Castel-Branco, Margarida Codina, Charles Fernandez-Llimos, Fernando Fleming, Glenda Gennimata, Dimitra Gillespie, Ulrika Harrison, Cathy Illario, Maddalena Junius-Walker, Ulrike Kampolis, Christos F. Kardas, Przemyslaw Lewek Malva, João Menditto, Enrica Scullin, Claire Wiese, Birgitt |
author2_role |
author author author author author author author author author author author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
McIntosh, Jennifer Alonso, Albert MacLure, Katie Stewart, Derek Kempen, Thomas Mair, Alpana Castel-Branco, Margarida Codina, Charles Fernandez-Llimos, Fernando Fleming, Glenda Gennimata, Dimitra Gillespie, Ulrika Harrison, Cathy Illario, Maddalena Junius-Walker, Ulrike Kampolis, Christos F. Kardas, Przemyslaw Lewek Malva, João Menditto, Enrica Scullin, Claire Wiese, Birgitt |
description |
Background Multimorbidity and its associated polypharmacy contribute to an increase in adverse drug events, hospitalizations, and healthcare spending. This study aimed to address: what exists regarding polypharmacy management in the European Union (EU); why programs were, or were not, developed; and, how identified initiatives were developed, implemented, and sustained. Methods Change management principles (Kotter) and normalization process theory (NPT) informed data collection and analysis. Nine case studies were conducted in eight EU countries: Germany (Lower Saxony), Greece, Italy (Campania), Poland, Portugal, Spain (Catalonia), Sweden (Uppsala), and the United Kingdom (Northern Ireland and Scotland). The workflow included a review of country/region specific polypharmacy policies, key informant interviews with stakeholders involved in policy development and implementation and, focus groups of clinicians and managers. Data were analyzed using thematic analysis of individual cases and framework analysis across cases. Results Polypharmacy initiatives were identified in five regions (Catalonia, Lower Saxony, Northern Ireland, Scotland, and Uppsala) and included all care settings. There was agreement, even in cases without initiatives, that polypharmacy is a significant issue to address. Common themes regarding the development and implementation of polypharmacy management initiatives were: locally adapted solutions, organizational culture supporting innovation and teamwork, adequate workforce training, multidisciplinary teams, changes in workflow, redefinition of roles and responsibilities of professionals, policies and legislation supporting the initiative, and data management and information and communication systems to assist development and implementation. Depending on the setting, these were considered either facilitators or barriers to implementation. Conclusion Within the studied EU countries, polypharmacy management was not widely addressed. These results highlight the importance of change management and theory-based implementation strategies, and provide examples of polypharmacy management initiatives that can assist managers and policymakers in developing new programs or scaling up existing ones, particularly in places currently lacking such initiatives. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10316/101131 http://hdl.handle.net/10316/101131 https://doi.org/10.1371/journal.pone.0195232 |
url |
http://hdl.handle.net/10316/101131 https://doi.org/10.1371/journal.pone.0195232 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
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cv-prod-144181 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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Plos |
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Plos |
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