Élisabeth Martin

Public/private partnerships for prescription drug coverage: policy formulation and outcomes in Quebec's universal drug insurance program, with comparisons to the Medicare prescription drug program in the United States.

In January 1997, the government of Quebec, Canada, implemented a public/private prescription drug program that covered the entire population of the province. Under this program, the public sector collaborates with private insurers to protect all Quebecers from the high cost of drugs. This article outlines the principal features and history of the Quebec plan and draws parallels between the factors that led to its emergence and those that led to the passage of the Medicare Prescription Drug, Improvement and Modernization Act (MMA) in the United States. It also discusses the challenges and similarities of both programs and analyzes Quebecs ten years of experience to identify adjustments that may help U.S. policymakers optimize the MMA.

Costs of moderate to severe chronic pain in primary care patients – a study of the ACCORD Program

Background The economic burden of chronic noncancer pain (CNCP) remains insufficiently documented in primary care. Purpose To evaluate the annual direct health care costs and productivity costs associated with moderate to severe CNCP in primary care patients taking into account their pain disability. Materials and methods Patients reporting noncancer pain for at least 6 months, at a pain intensity of 4 or more on a 0 (no pain) to 10 (worst possible pain) intensity scale, and at a frequency of at least 2 days a week, were recruited from community pharmacies. Patients’ characteristics, health care utilization, and productivity losses (absenteeism and presenteeism) were documented using administrative databases, pharmacies’ renewal charts, telephone, and self-administered questionnaires. Patients were stratified by tertile of pain disability measured by the Brief Pain Inventory questionnaire. Results Patients (number =483) were, on average, 59 years old, mainly women (67.5%), and suffered from CNCP for a mean of 12 years at an average pain intensity of 6.5±1.9. The annual direct health care costs and productivity costs averaged CAD

The willingness of community pharmacists to participate in a practice-based research network

9,565 (±

Knowledge, Attitudes and Beliefs about Chronic Noncancer Pain in Primary Care: a Canadian Survey of Physicians and Pharmacists

13,993) and CAD

Pharmacotherapeutic management of chronic noncancer pain in primary care: lessons for pharmacists

7,072 (±

Priorities for action to improve cardiovascular preventive care of patients with multimorbid conditions in primary care--a participatory action research project.

11,716), respectively. The use of complementary health care services accounted for almost 50% of the direct health care costs. The mean adjusted total direct health care costs (considering pain-related hospitalizations only) and productivity costs increased with more pain disability: low disability, CAD

Priority interventions to improve the management of chronic non-cancer pain in primary care: a participatory research of the accORD program

12,118; moderate, CAD

Identifying heavy health care users among primary care patients with chronic non-cancer pain

18,278; and severe, CAD

Anticoagulation management services in community pharmacy: Feasibility of implementing a quality improvement programme through a practice-based research network

19,216; P=0.001. Conclusion The economic burden of CNCP is substantial and increases with the level of pain disability, which suggests the need for and potential benefits of improving CNCP management through specific and adapted treatment plans targeting the impact of pain on daily functioning.

Community Pharmacist Training-and-Communication Network and Drug-Related Problems in Patients With CKD: A Multicenter, Cluster-Randomized, Controlled Trial

Background: Practice-based research networks (PBRNs) are groups of practitioners and researchers with an interest in designing, evaluating and disseminating solutions to the real-world problems of clinical practices. Objective: To evaluate the level of interest of community pharmacists in participating in a PBRN and to document the services such a network should offer. Method: In a survey of community pharmacists in Montreal, Quebec, and surrounding areas, a questionnaire was mailed to a random sample of 1250 pharmacists. Two of the 28 questions were related to PBRNs: one assessed the pharmacists’ interest in participating in a PBRN; the other sought their views on which services and activities this network should offer. Results: In total, 571 (45.7%) pharmacists completed the questionnaire, but 6 did not answer the questions about the PBRN. Of the respondents, 58.9% indicated they were “very interested” or “interested” in joining a PBRN, while 41.1% reported little or no interest. The most popular potential services identified were access to clinical tools developed in research projects (77.0%), access to continuing education training programs developed in research projects (75.9%), information about conferences on pharmacy practice research (64.1%) and participation in the development of new pharmaceutical practices (56.1%). Conclusion: This study suggests that the level of interest that community pharmacists have in PBRNs is sufficient to further evaluate how such networks may optimize and facilitate pharmacy practice research. Can Pharm J 2013;146:47-54.