Choose a date below for programme information

WEDNESDAY 15 NOVEMBER

09.00 – 10.30

EDUCATIONAL SESSION E1W

Cross-National Comparison of Drug Utilization

Background

Most articles reporting cross-national comparison (CNC) of drug utilization (DU) data focus on reporting of outcomes. Method sections generally contain little information about data sources, data management, bias control, etc.,. Furthermore, discussion sections rarely contain in depth considerations of limitations of data sources. We must be aware that studies attempting CNC of DU data are particularly prone to systematic biases which could seriously jeopardize the validity of the comparison.  In a collaborative effort of EuroDURG, WHO Collaborating Centre of Utrecht University and a grant from ISPE, we developed a methodology to assess the validity of CNC studies. This work resulted in a Good Practice Guideline for designing, conducting, reporting and reviewing CNC studies.

Aims

  • To demonstrate the problems encountered while comparing DU data of different countries
  • To give a global overview of the CNC guideline
  • To focus on sources of bias in designing a CNC study
  • To focus on sources of bias in conducting a CNC study

Description

In a general introduction, using a large range of published CNC studies, methodological pitfalls that have jeopardized the comparison will be demonstrated. It will be shown that all problems encountered are mapped and discussed while developing a CNC methodology. The results of this common effort, the CNC guidelines will be globally presented. Then we will focus first on the sources of bias in designing a CNC study and second on the sources of bias in conducting a CNC study. Different published examples will be presented and the published information will be used to evaluate possible biases using a CNC checklist, developed for this purpose.

 Chairpersons: Monique Elseviers, Belgium
Aukje Mantel-Teeuwisse, The Netherlands
 Speaker: Monique Elseviers, Belgium
Introduction: Pitfalls of cross-national comparison (CNC) studies
 Speaker: Yared Santa Ana-Tellez, Spain/ Mexico
Development and lay-out of the CNC guideline
 Speaker: Carlos Duran, Belgium/ Ecuador
Sources of bias in conducting a CNC study
 Speaker: Yared Santa Ana-Tellez, Spain/ Mexico
Sources of bias in designing a CNC study

 

09.00 – 10.30

EDUCATIONAL SESSION E2W

Time Series Analysis

Background

Empirical research in drug utilization often describes and analyses change on various levels: health status of individual patients; populations exposed to changing health challenges and therapeutical options; introduction of expensive new treatments; health care systems being changed by regulatory and political decisions. For understanding such processes, the analysis of longitudinal data is essential. For this, time series analysis methods have been developed which can be employed in drug utilization research.

Aims

Focusing on the use of large, usually secondary, data sets, the session will present an introduction to the field as well as methods to address the particular problems encountered in longitudinal research, such as the impact of (possibly multiple) interventions and auto-correlations in the observations.

Description

The session will start with an introduction to the field, assuming no previous knowledge of time-series analyses, but presupposing some familiarity with methods of descriptive and confirmatory statistics. The subsequent speakers will present methods for analysing data with auto-correlations and seasonal influences appropriately, and for describing interrupted time series in order to describe the effects of interventions and/or external events in the field.

Chairpersons: Gisbert W. Selke, Germany
Peter Mol, The Netherlands 
 Speaker: Gisbert W. Selke, Germany
Introduction to time series analysis
 Speaker: Peter Mol, The Netherlands
Interrupted time series analyses applied to study impact of safety communication about medicine
 Speaker: Joris Komen, The Netherlands
Dealing with auto-correlation and seasonality in time series

 

09.00 – 10.30

EDUCATIONAL SESSION E3W

Data Sources – Validation Research

Background

Assessing how drugs are used in clinical practice and their possible relation to clinical outcomes is one of the cornerstones of pharmacoepidemiologic research. However, due to variety in type of data sources,  registration practices and methods used to collect drug use data this can be complicated.  As a consequence, many different methods have been developed making comparability of results difficult.

Aims

To give insights into methods that are applied to different data sources to assess drug exposure, how these relate to actual patient drug use and how exposure assessment definition influences outcome estimates.

Description

This session will include three different presentations of 20 minutes followed by 10 minutes for discussion.

Chairpersons: Helga Gardarsdottir, The Netherlands
Tatiana Borges Luz
 Speaker: Helga Gardarsdottir, The Netherlands
Comparisons of methods used to assess drug exposures in observational data
 Speaker: Antti Tanskanen, Finland
Validation of exposure assessment using mathematical modelling and expert review: The PRE2DUP method
 Speaker: Luisa Ibáñez, Spain
Validation of clinical outcomes in observational studies

 

11.00 – 12.30

EDUCATIONAL SESSION E4W

Adherence Research Using Databases

Background

Adherence describes the extent to which an individual behavior regarding a medical treatment regimen corresponds with the recommendations of the health care provider. In order for a prescribed medication to have the desired effect on the patient, the patient has to take the intended dose, and continue to take the medication for as long as it is deemed necessary. And thus, medication non-adherence has been associated with adverse clinical outcomes and increased health care costs. Although the concept seems to be quite straight forward, assessing medication adherence accurately using electronic databases remains a challenge.

Aims

The aims are to introduce participants to medication adherence concepts and methodologies used to assess drug exposure using electronic databases, and to give insights into the assumptions and challenges faced when describing patterns of medication consumption.

Description

The session will start with an introduction to the field, assuming no previous knowledge of medication adherence and methodology for its assessment using electronic databases, but presupposing some familiarity with drug utilization research concepts. The most relevant measures, assumption to be taken while measuring adherence and definitions of exposure using electronic databases will be presented. New methodologies to describe adherence patterns more precisely and challenges associated will also be described.

Chairpersons: Anna Birna Almarsdottir, Denmark
Gabriel Sanfélix-Gimeno, Spain
 Speaker: Anna Birna Almarsdottir & Gabriel Sanfélix-Gimeno
Introduction to adherence: definition, concepts and importance
 Speaker: Rob Heerdink, The Netherlands
Assessing adherence using electronic databases: measures, assumptions, and exposure definition
 Speaker: Emma Aarnio, Finland
Trajectory modeling and its challenges when measuring adherence with databases

 

11.00 – 12.30

EDUCATIONAL SESSION E5W

Quality of Quality Indicators

Background

Quality indicators (QIs) are increasingly used as a tool by health authorities across countries to achieve safe, cost-effective and quality care, for professional learning and accreditation as well as financial incentives. QIs can include outcome indicators such as BP, lipid and HbA1c targets, prescribing ratios such as % of fluorquinolones versus all antibiotics prescribed for patients with respiratory infections or a maximum % of injectable vs. oral medicines, adherence to prescribing guidelines, as well as prescribing targets. To be successful and achieve desired objectives, when developing, applying and evaluating robust QIs, the developers need to consider key aspects such as the dimensions of quality being evaluated, potential data sources to ensure reliability, their ease of use, their validity in achieving the desired objective, and the budget impact of data collection. These can be considered as key aspects of the quality of QIs.

Aims

Discuss the development of QIs within healthcare systems and potential ways to assess their rationale and the ability to achieve the desired outcome

Description

The session will start with an overview of the topic of QI and how they can be used to measure quality of care/drug utilization. This will be followed by two examples of using QI from a global and a regional perspective, covering different therapeutic areas. We will conclude the session with a workshop and discussion.

Chairpersons: Brian Godman, UK,
Jane Robertson, UK
 Speaker: Stephen Campbell, UK
Outline of QIs, their development and key considerations for measuring their quality
 Speaker: Jane Robertson, (UK)
Potential indicators to assess the quality of antibiotic use across Europe
 Speaker: Seán Macbride-Stewart, UK
Quality Prescribing Indicators – Scotland’s experience

 

11.00 – 12.30

EDUCATIONAL SESSION E6W

Using Field Studies in Drug Utilization Research

Background

The use of large databases is common in drug utilization research. Whilst we have large databases available in many countries, there is a scarcity of such datasources in many low- and middle-income countries. Furthermore, in some cases, we need to collect information which is not contained in databases. Hence we use other data collection methods including questionnaires and observation of practice to answer our research questions.

Description

This educational session provides basic theory and practical tips in conducting drug utilization studies when required information is not captured in databases or when large databases are not available. Common study designs used to collect data through observation, medical records or questionnaires will be presented and the strengths and limitations of working without large databases discussed. Course participants learn about different study designs and data collection methods and discuss how to answer relevant questions about safety and utilization of medicines in primary and secondary care settings using field studies.

Aims

  • To analyze common study designs of pharmacoepidemiologic studies without large databases
  • To discuss strengths and limitations of different study designs and data collection methods
  • To identify strategies to improve quality and reliability of pharmacoepidemiological studies conducted without large databases
Chairpersons: Katja Taxis, The Netherlands
Veronika Wirtz, USA 
 Speaker: Katja Taxis, The Netherlands
Data collection through questionnaires and observation
 Speaker: Lisa Pont, Australia
Examples of studies done without large databases
 Speaker: Annie Fourrier-Réglat, France
Introduction and overview of study designs

 

Scientific Programme Part I

13.30 – 15.00

WELCOME CEREMONY

Chairpersons: Marion Bennie, UK
Katja Taxis, The Netherlands
 Speaker: Dean from Strathclyde University

 

KEYNOTE LECTURES

In this opening session, Thomas Balkizas, from IBM Watson will provide a view from the industry of the future capability of digital technology to both support interrogation of current clinical/health data. This will include progressing of non structured text and  machine learning to generate new knowledge and how such approaches support the delivery of new digital health solutions, both at a patient level  and at a systems level . He will take the audience from the here and now to a new digital paradigm supporting health care delivery and intelligence on the health impact for the public and payers.  He will illustrate his talk by giving key exemplars in the context of health. The second speaker, Bjorn Wettermark will talk about the challenges of digitalization for DUR. Giving us a glimpse of the opportunities and challenges of digital health holds for research in the field of medicine use.

 

14.00    

K1W:                   Thomas Balkizas, UK:  Digital Health: The future is here

 

14.30

K2W:                   Björn Wettermark, Sweden: Digitalizing and DUR: Challenges and opportunities

 

16.00 – 17.30

PARALLEL SESSION P1W

Antimicrobial Use and Resistance

Background             

Antibiotic resistance is a global threat. The Global Action Plan on antimicrobial resistance requests all countries to report on patterns of resistance and consumption of antibacterials. These are important in establishing the extent of the problems in country and provide the basis for developing interventions to change practices. While there is an established history of reporting antibacterial consumption in  developed countries, other countries are now just starting routine reporting  on antimicrobial use.

Aims

To give an update on existing ambulatory antimicrobial surveillance systems (international, national aspect). To show effective interventions which results in more prudent antibiotic use in ambulatory care.

Chairpersons: Ria Benko, Hungary
Jane Robertson, UK
 Speaker: Carl Llor, Spain
 Abstract 123: Ria Benko, University Of Szeged, Hungary
The pattern of antibiotic use among Hungarian, Norwegian and Portuguese children
 Abstract 92: Mike Fleming, Information Services Division, NHS National Services Scotland, UK
Characterisation of risk factors associated with antibiotic resistance in urinary isolates in the community: an exemplar of NHS Scotland’s Infection Intelligence Platform
Abstract 89: William Malcolm, Health Protection Scotland, NHS National Services Scotland, Glasgow, UK
Measuring potential adverse consequences of restricting antibiotic treatment of respiratory tract infections in primary care: a population data linkage study using NHS Scotland’s Infection Intelligence Platform
Abstract 151: Verica Ivanovska, Faculty of Medical Sciences, Stip, Macedonia, 2Utrecht University Netherlands, Utrecht, The Netherlands
Impact of the national intervention programme on parental knowledge, attitudes and practice of antibiotic use for respiratory infections

   

16.00 – 17.30

PARALLEL SESSION P2W

ePrescribing and eDispensing Systems

Background

Medicines prescriptions represent the most frequent healthcare treatment but to date, a large amount of medicine prescription, administration and management and information sharing and transfer has remained handled using paper-based prescriptions, charts and records.

Safe and effective prescription and administration of medicines remains challenging, with medication errors, hospital admissions due to medicine-related adverse events and discrepancy in medication relating to changes in care settings remaining all too frequent. In recent years, there have been concerted effort to replace traditional paper-based prescription and medicine management systems with electronic solutions (i.e. Computerized Physician Order Entry, CPOE and electronic Prescribing and Medicines Administration, ePMA).

The term ‘ePharmacy’ is used to describe fully integrated electronic Prescribing and Medicines Administration systems. ePharmacy is considered key to delivering integrated Patient Electronic Health Records (EHR) systems as an enabler of continuity and integrated care. The anticipated benefits of ePharmacy implementations include safer medicine prescriptions, a reduction in data duplication and entry errors, medicine reconciliation, medicine information transfer and sharing, lower cost for health systems and improved care for patients.

However, ePharmacy are large scale and complex implementations, incorporating a number of core components: community pharmacy, Acute Medication Service, Chronic Medication Service, Hospital Electronic Prescribing and Medicines Administration systems, emergency care records, data and information governance etc. Consequently, uptake remains low and large-scale implementations are often slow to progress.

Aims

This session will include presentations from leading experts in the field of ePrescribing / eDispensing implementation and evaluation which will provide fundamental information for all of those interested in adopting and deploying these solutions in future.

Chairpersons: Matt-Mouley Bouamrane, UK
Robert Vander Stichele, Belgium
 Speaker: Aziz Sheikh, UK
ePrescribing Toolkit for NHS Hospitals
 Speaker: Alison Strath, UK
Scotland ePharmacy programme
 Speaker: Robert Vander Stichele, Belgium
Short intro into the terminology and the interoperativity of systems
 Abstract 90: Marion Bennie, University of Strathclyde, UK
Analysis of risk factors for bacteraemia and subsequent mortality in Scotland: a national data linkage matched case-control study using NHS Scotland’s Infection Intelligence Platform


 

16.00 – 17.30

PARALLEL SESSION P3W

Adherence

Background

Medication adherence is the process by which patients take their medications as prescribed. It is a dynamic process, comprising three elements: initiation of therapy, implementation of the dosing regimen and persistence with treatment. Medication adherence can be measured using different methods, including pill counts, self‐report, therapeutic drug monitoring, automatic/electronic compilation of dosing history data and electronic prescription/refi ll databases. In recent years, adherence research based on existing administrative databases gained more interest. Strengths and limitations has to be taken into account however while measuring the three elements of adherence using big data.

Aims

  • To stress the importance of the three while speaking about adherence
  • To present different methods to measure adherence focusing on current electronic developments and the availability of big data
  • To evaluate the added value and the limitations of database research in the field of adherence research

Description

During his presentation, Bernard Vrijens will present the different elements of adherence, present different methods to measure adherence with the unique place of database research and will handle strengths and limitations of the latter method. The lecture will be followed by the oral presentation of four selected abstracts in the field of adherence research.

Chairpersons:  Monique Elseviers, Belgium
Bernard Vrijens, Belgium
 Speaker: Bernard Vrijens, Belgium
Adherence research & big data: strengths and limitations
 Abstract 165: Enrica Menditto, CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, Naples, Italy
A snapshot of medication adherence across three European countries: application of common methodology.
 Abstract 118: Daniel Bejarano-Quisoboni, Center for Public Health Research (CSISP-FISABIO), Valencia, Spain
Adherence Trajectories to Essential Medications and Clinical Outcomes after Acute Coronary Syndrome. A Population-Based Cohort Study
Abstract 137: Alexandra Leila Dima, Health Services and Performance Research (HESPER), Université Claude Bernard Lyon 1, France
Introducing Adhere R: an R package for visualization of medication histories and calculation of adherence to medications using electronic healthcare data
 Abstract 43: Johanna Meyer, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria, South Africa
Adherence to antiretroviral treatment amongst patients in Botswana: A multi-measure approach to guide future practice

 

 

THURSDAY 16 NOVEMBER

Scientific Programme Part II

08.30 – 10.00

PARALLEL SESSION P4T

Prescribing and de-Prescribing in Old Age

Background

During the last decade explicit criteria are more and more used to evaluate the appropriateness of prescribing in old age. Moreover, evidence is growing that appropriate prescribing is associated with better health outcomes (hospitalization, mortality).  In recent years, also de-prescribing gained attention to tackle the problem of polypharmacy in old age. Extended medication lists  candidate for de-prescribing as well as guidelines on how to communicate de-prescribing with patients are lacking as yet.

Aims

  • To highlight the specific position of de-prescribing as an additional tool to tackle polypharmacy and associated negative outcome in old age
  • To handle the current evidence of medications, candidate for de-prescribing
  • To offer guidance in the practice of communicating de-prescribing with de patient and his caregivers/family

Description

The guest speaker will give a state-of the art lecture about deprescribing as supplementary to appropriate prescribing in the pharmaco-therapeutic in old age handling the evidence of candidate medication for de-prescribing as well as the specific problems related to the communication with patients and family about de-prescribing . The lecture will be followed by the oral presentation of four selected abstracts in the field of polypharmacy, appropriate prescribing and de-prescribing in old age.

 Chairpersons: Monique Elseviers, Belgium
Lisa Pont, Australia
 Speaker: Bruce Guthrie, UK
Reducing high-risk prescribing and optimising prescribing in people with polypharmacy
 Abstract 174: Christina Raae-Hansen, Pharmaceutical Care Research Group, School of Pharmacy, University College Cork (UCC), Cork, Ireland
Trends of potentially inappropriate prescribing in early old aged people over a 5-year period
 Abstract 192: Edwin Tan, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden, 2Centre for Medicine Use and Safety, Monash University, Parkville, Australia
Antihypertensive medication regimen intensity and incident dementia in an older population
Abstract 71:  Marie-laure Laroche, Centre of Pharmacovigilance and Pharmacoepidemiology, Limoges, France
Prescription of futile and essential drugs in the last three months of life of older patients receiving palliative care
Abstract 210: Hans Wouters, Dept. Of Pharmacotherapy, -Epidemiology & -Economics, University Of Groningen, Groningen, The Netherlands, 2dept. Of General Practice And Elderly Care Medicine, University Medical Center Groningen, Groningen, The Netherlands
Discontinuing Inappropriate Medication In Nursing Home Residents (DIM-NHR STUDY): A Cluster Randomized Controlled Trial

 

08.30 – 10.00

PARALLEL SESSION P5T

Gender Difference and Safety in DU

Background

Men and women are alike in many ways. However, the two genders have important biological and behavioral differences, which may affect manifestation of diseases, the treatment approaches, efficacy and safety of medicines. Distinct drug utilisation in men and women have been demonstrated in drug utilization studies. Some gender related differences might be attributed to biological differences or different incidence and prevalence of disease. However, other cannot be explained on medical grounds, and may indicate unequal treatment or behavioral peculiarities.

Aims

To present an overview of gender related differences in drug utilization and drug safety; to explore the potential opportunities and challenges studying the reasons and consequences of these differences.

Chairpersons: Jolanta Gulbonovic, Lithuania
Janet Krska, UK
 Speaker: Ylva Böttiger, Sweden
Differences in prescribing to women and men: sex or gender?
 Speaker: Petra Denig, The Netherlands      
Differences in side effects between women and men: sex or gender?
 Abstract 199: Andréia Turmina Fontanella, Graduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
Psychotropic drug use and the differences between men and women: results from a household survey
 Abstract 188: Gisbert W. Selke, Wissenschaftliches Institut der AOK, Berlin, Germany
Concerns regarding the safety of combined hormonal contraceptives: influence of an EU risk assessment process on prescription patterns. An analysis of German claims data 2011–2015

 

08.30 – 10.00

PARALLEL SESSION P6T

Decisions Support to Improve Drug Use

Background

Evidence Based Medicine has produced new methods to synthesize scientific knowledge for support of clinical practice and new international databases for point-of-care information provision. Clinicians have become more sophisticated in searching for relevant information and high-tech decision support is available to interact with interoperable electronic health care records.

Aims

To provide an overview of the characteristics of point-of-care knowledge databases,  the available evidence of impact

Chairpersons: Robert Vander Stichele, Belgium
Catherine Sermet, France
 Speaker: Stijn Van De Velde, Norway
Guidelines for implementation of decision support systems
 Abstract 207: Rianne Weersink, University of Groningen, Groningen, the Netherlands, 2Health Base Foundation, Houten, The Netherlands
Developing advices for safe drug use in patients with liver cirrhosis
 Abstract 201: Helene van der Meer, University Of Groningen, Groningen, The Netherlands
Latent class analysis of anticholinergic and sedative medication use:  a national population study
 Abstract 1: Heshu Abdullah-koolmees, UMC Utrecht, Utrecht, The Netherlands, 2Utrecht University, Utrecht, The Netherlands
Predicting rehospitalization in patients treated with antipsychotics: a prospective observational study
Abstract 58: Janet Krska, Medway School of Pharmacy, Universities of Greenwich and Kent, Chatham Maritime, UK
Development and testing of the Side Effects Patient Assessment Tool (SE-PAST)

 

10.30 – 12.00

PARALLEL SESSION P7T

Globalization of DUR

Background

DUR is a global discipline. While a lot of the sessions focus on European DUR. In this session, we want to have a look at the situation in three other continents/regions of the world: South America, Africa and Asia.

Aim

To give a global perspective of DUR by discussing state of DUR and challenges outside Europe.

Description

The topic of this session is a global perspective of DUR. The speakers origin from three different continents. They will speak about the current situation of DUR, giving examples of their own and others’ research. They will discuss the specific challenges they face in their region. Similarities and differences will emerge. Speakers will cover South America, Africa and Asia.

Chairpersons: Robert Vander Stichele, Belgium
Aukje Mantel-Teeuwisse, The Netherlands
 Speaker: Claudia Garcia Serpa Osorio-de-Castro, Brazil
Exploring federal data on medicines procurement in Brazil
 Speaker: Fatima Suleman, South Africa
Global drug utilization review: what’s happening in Africa
 Speaker:  TBA

 

10.30 – 12.00

PARALLEL SESSION P8T

Drug Use in Pregnancy and Pediatrics           

Background

Evaluation of appropriateness in drug use is a common topic of interest for DU studies in pregnancy and pediatrics. Main reasons are represented by a risk-benefit profile of medicines different from standard patient, by formal off-label use  and by difficulties in evaluating  time and intensity of exposure (trimesters for pregnancy, doses adjusted for age and weight for children, …).

Aims

  • To describe updates in methods of DU studies focusing on pediatric population and pregnancy.
  • To map sources of data and their limitations in this field.
  • To highlight future challenges in DU studies for these populations.

Description

The first lecture will be devoted to DU in pediatrics and the second one to DU in pregnancy, possibly with speakers involved in international networks collecting specific data in these 2 populations. Two further oral communications will be identified from abstracts, by preferring those with focus on developing strategies for DU research to address  clinical/regulatory questions.

Chairpersons: Elisabetta Poluzzi, Italy
Hedvig Nordeng, Norway
 Speaker: Hedvig Nordeng, Norway
Drug Utilisation in Pregnancy – a multinational perspective
 Speaker:   Pauline De Bruyne, Belgium
 Abstract 84: Pierre-Olivier Blotiere, Department of Studies in Public Health, French National Health Insurance (CNAMTS), France
Risks of specific major congenital malformations associated with prenatal exposure to antiepileptic drugs: a nationwide cohort study based on the French healthcare databases
Abstract 100: Elin Dahlén, Department of Healthcare Development, The Health and Medical Care Administration, Stockholm County Council, Sweden
Health care utilization and dispensed medicines among children in Stockholm, Sweden

 

10.30 – 12.00

PARALLEL SESSION P9T

Evolving Methods in DUR

Description

Presentation of submitted abstracts on methodological questions of DUR covering different countries, therapeutic areas and methodological challenges.

Chairpersons:  Björn Wettermark, Sweden
Marion Bennie, UK
 Abstract 167: Clifford Nangle, University Of Dundee, Dundee, UK, 2NHS National Services Scotland, Edinburgh, UK
Modelling free-text prescription dose instructions to support daily dosage calculation
 Abstract 200: Job FM Van Boven, Department of Clinical Pharmacy & Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
Dynamics of discontinuation in new metformin users in the first year of treatment
 Abstract 15: Catherine Sermet, Irdes, Paris, France
Measuring polypharmacy in the elderly on a French national health database: impact of calculation method on prevalence and therapeutic classes
 Abstract 146: Mikael Hoffmann, The Nepi Foundation, Linköping, Sweden
National monthly standard-reports of incidence-rates of drugs in Sweden – development process, validation and results
Abstract 46: Chris Johnson, Pharmacy & Prescribing Support Unit, Nhs Greater Glasgow & Clyde, Glasgow, UK                            
Doing the right thing’: Factors influencing GP prescribing of antidepressants and prescribed doses
Abstract 161: Sandy Maumus-Robert, Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Team Pharmacoepidemiology, UMR 1219, Bordeaux, France
Off-label use of oral morphine sulfate for opioid maintenance purpose in France: results from the 2009-2015 UTOPIA study


Scientific Programme Part III

13.00 – 14.30

WORKSHOP W1T

DUR on the Life Cycle of Drugs

Background

Drug utilization studies are useful tools for healthcare professionals, regulators, payers and the pharmaceutical industry during all different stages of the life cycle of medicines. Studies prior to the introduction of new medicines may focus on the burden-of-illness, unmet need and the potential budget impact of new medicines. After introduction there is a need for studies, e.g, on physicians prescribing behavior and characteristics of patients initiated on the drugs as well as pharmaco-epidemiological studies on the effectiveness and safety. Later along the life cycle studies, questions such as rational introduction of generics and how to stop prescribing may be of relevance.

Statins are among the most commonly used drugs in the population. Numerous drug utilization studies have added fuel to a lively debate on the benefit risk balance of statins across different populations. Most statins have now lost their patents and generics are available. Recently, PCSK9 inhibitors were introduced as a new drug of class to treat patients with familial hyper-cholesterolemia. These medicines are very effective at lowering LDL-c but there are questions around the benefit-risk and the potential budget impact. Consequently, there is a need to design good drug utilization studies to monitor the introduction of these new drugs.

Aims

To explore how drug utilization studies can contribute to improve lifecycle management of new medicines, using the new lipid lowering drugs as an example.

Description

The workshop will begin with an overview on different types of drug utilization studies conducted on statins and how they contributed to our knowledge about the benefit/risk and place in therapy of the drugs. This is followed by an introduction to the new biologic lipid lowering drugs.  The rest of the workshop will be dedicated to interactive group discussions on drug utilization studies that could be conducted as part of the lifecycle management of these new drugs. Each group is given the assignment to identify the key drug utilization studies to conduct during different phases in the introduction of the new drugs.

 Chairpersons: Björn Wettermark, Sweden
Debra Rowett, Australia
 Speaker:  Björn Wettermark, Sweden
What can we learn from drug utilization studies on statins – Overview of studies on prescribing patterns, rational use and patient adherence to statin therapy in different populations
 Speaker: Peter Mol, The Netherlands
Introduction to the PCSK9 inhibitors. Challenges from a regulatory and a payer perspective

 

13.00 – 14.30

SYMPOSIUM S2T

Data Visualization

Background

Visualization of research data is necessary both for exploratory analysis, trying to uncover structures within the observations, and for presenting results in such a way that the audience can quickly grasp the essence of the results of analysis. In both cases, a wide choice of representations is available, and in choosing, the researcher has to take into account the psychology of perception, a grasp of the subject matter, available statistical methods and technical possibilities.

Aims

To be able to design meaningful diagrams for different contexts and varying audiences, and to become familiar with methods for visualising large data sets and high-dimensional data, both statically and interactively.

Description

In this symposium different ways for data visualization ranging from simple to complex including high-dimensional data will be presented.

Chairpersons:  Ria Benko, Hungary
Gisbert W. Selke
, Germany
 Speaker: Seán Macbride-Stewart, UK
Want to influence prescribing? Make it easy for prescribers to interpret prescription data
 Speaker: Maria Matuz, Hungary
Visualisation of DU data in the scientific literature
 Speaker: Mikael Hoffmann, Sweden
Interactive visualization of drug utilization data – why, how, when, and when not


13.00 – 14.30

WORKSHOP W3T

From Intervention to Implementation – How Can Science Help?

Background

The adoption, spread and impact of evidence generation into routine clinical practice remains a major challenge for healthcare systems worldwide.  Implementation science  can be defined as the “ study of theories, process, models and methods of implementing evidence based practice.”

Aims

To explore how implementation science can be applied to support understanding of the key elements necessary to achieve success in moving from a health intervention study to widespread diffusion across a healthcare system.

Description

This session will begin with an overview of implementation science, (including connection to the common terminology of knowledge management / transfer concept used in healthcare systems),  illustrated by a medicines related case study.  This will be followed by a task where participants will work with an case example to apply an Implementation Framework (propose the IHI Framework – Going to Full Scale” – see below)  to consider the key factors for a successful implementation across a health system- getting evidence into practice.

Case study to work through and complete a known implementation framework tool to enable participants to gain confidence in thinking about taking a study to spread and impact across a health system ( possibly use 2 case studies and have groups looking at different steps in process as unlikely to complete all steps for a case study in timescale given)

Chairpersons:  Marion Bennie, UK
Lisa Pont, Australia
 Speaker: Rachel Bruce, UK
Implementation Science – the Why, What and How?

  

16.00 – 17.30

KEYNOTE LECTURES

The volume and complexity of health data increases. Professor Morris will address how data science research uses innovative ways of linking detailed epidemiological data with biological data at scale. And how this ‘molecule to man approach’ is used to solve current health challenges.

Prof Cunningham-Burley will address some of the social and ethical dimensions of using big data for health and medicine. In particular, talking about public attitudes, preferences and concerns about the use of data in research. Discussing best practices in public engagement in health informatics research.

Chairpersons:  Marion Bennie, UK
  K3T:  Andrew Morris, Professor of Medicine, Director of the Usher Institute  for population Health Sciences and Informatics, Director of the Farr Institute in Scotland, UK
Health Informatics – taking a “molecule to man” approach
  K4T:  Sarah Cunningham Burley, Professor of Medical and Family Sociology, Farr Scotland Public Involvement Lead, UK
Patient Perspective – The Patient and Public Voice – using big data for public benefit

   

                    

                    

FRIDAY 17 NOVEMBER

Scientific Programme Part IV

08.30 – 10.00

PARALLEL SESSION P10F

Inform and Evaluate Health Policy

Background

There are considerable strains on available resources resulting in health authorities and health insurance companies across Europe instigating measures to enhance the quality and efficiency of prescribing. The intention being to try and maintain comprehensive and equitable healthcare for their populations. There is an ongoing need to assess the impact of different health policies in order to plan future policies if needed. Drug utilization research is a key element of this.

Aims

To stimulate debate and discussion regarding the rationale for introducing health policies as well as optimal ways to assess their impact

Description

Keynote lecture from Simon Hurding followed by 4 pertinent abstract presentations

Chairpersons: Brian Godman, UK
Simon Hurding, UK
Speaker Simon Hurding, UK
Lessons learnt in Scotland with introducing policies to improve the quality and efficiency of prescribing – Policy versus Polypharmacy
Abstract 113: Ana Araújo, National Authority of Medicines and Health Products (Infarmed, I.P.), Lisbon, Portugal
Effect of tobacco cessation policies in the consumption of anti-smoking medicines in Portugal
 Abstract 79: Hye-young Kwon, Mokwon University, Daejeon, South Korea
Changes in pharmaceutical expenditures with massive price cuts
 Abstract 204: Sabine Vogler, WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Gesundheit Österreich GmbH (GÖG / Austrian Public Health Institute), Vienna, Austria
Analysis of out-of-pocket payments for medicines in Kyrgyzstan
Abstract 105: Claudia Garcia Serpa Osorio-de-Castro, Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
Out-of-tender medicines procurement in a Brazilian reference cancer institution

   

08.30 – 10.00

PARALLEL SESSION P11F

Citizen Science and DUR

Background

Citizen science is the involvement of the public in scientific research. In the case of DUR, patients and the public are our research partners, being involved in all stages of the research cycle. This could contribute to shaping the research agenda. Results are more likely to be useful, ultimately improving patient care.

Aim

To discuss ways to involve patients and the general public into DUR.

Description

The keynote lecture of Nicky Britten will describe experiences with public involvement in research. This will include presenting an innovative approach developed in Exeter how to involve and embed patients and the general public into the research cycle

Chairpersons: Katja Taxis, The Netherlands
Janet Krska, UK
 Speaker: Nicky Britten, UK
Patient and lay involvement in drug utilisation research
 Abstract 172: Velisha Perumal-Pillay, University Of KwaZulu-Natal, Durban, South Africa
Parents’ and guardians’ perceptions on availability and pricing of medicines and healthcare for children in eThekwini, South Africa – A qualitative study
 Abstract 134: Peter Mol, Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, The Netherlands
Media attention for drug safety issues. A survey of newspapers and social media in the Netherlands (2001 – 2015)
 Abstract 135: Peter Mol, Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, The Netherlands
Which patients and healthcare professionals are interested in an app for reporting adverse drug reactions and receiving drug safety information?
Abstract 38: Johanna Meyer, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria, South Africa
Patients with type-2 diabetes attending a community health centre in Pretoria, South Africa: Do they know how to manage their chronic condition to improve future care?

   

08.30 – 10.00

PARALLEL SESSION P12F

Cardiovascular therapy

Description

In this session researchers from various countries will report results of studies on DUR in the area of cardiovascular diseases.

Chairpersons: Margaret Ryan, UK
Elizabetta Polizzi, Italy
 Abstract 179: Giuseppe Roberto, Agenzia Regionale Di Sanità Della Toscana, Florence, Italy
NSAIDs utilization in a large cohort of Italian elderly with cerebro/cardiovascular disease
 Abstract 155: Janne Sepp, State Agency of Medicines, Estonia, 2Institute of Pharmacy, University of Tartu, Estonia
Co-prescribing of renin-angiotensin system (RAS) acting agents is decreasing in Estonia
 Abstract 13:  Amanj Kurdi, University of Strathclyde, Glasgow, United Kingdom, University of Nottingham, Nottingham, UK
Factors predicting the addition of a second antihypertensive drug in treating hypertension – a longitudinal retrospective cohort study in the UK primary care setting
 Abstract 10: Adele Lallo, Department of Epidemiology, Lazio Regional Health Service, Roma, Italy
Adherence to evidence-based drug therapies after myocardial infarction: is geographic variation related to hospital of discharge or primary-care providers? Methodological challenges and policy perspectives
Abstract 168: Thang Nguyen, University of Groningen, Groningen, The Netherlands, 2Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
Factors associated with physician adherence to prescribing guideline-recommended medications for acute coronary syndrome in Vietnam
Abstract 66: Tanja Mueller, University Of Strathclyde, Glasgow, UK, 2NHS National Services Scotland, Edinburgh, UK
Use of direct oral anticoagulants in patients with atrial fibrillation in Scotland: Applying a coherent framework to drug utilisation studies

 

10.30 – 12.00

PARALLEL SESSION P13F    

Patient Reported Outcome Measures

Background

Patient reported outcome measures (PROMs) , integrated with other clinical healthcare information, have the potential to enable improvements in decision making for individual patient care, service planning and in shaping medicines policy direction.  Data capture of PROMS is not currently part of routine clinical care.

Aims

To present an overview of PROMs in the context of medicines and explore the potential opportunities and challenges with collecting and analyzing PROMs data to support data generation for the purpose of improved patient care.

Description

This session will begin with an overview followed by 3-4 accounts from countries across the world.

Chairpersons: Marion Bennie, UK
Janet Krska, UK
 Speaker: Janet Krska, UK
PROMS – the patient voice in clinical decision making
 Abstract 129: Emma Dunlop Corcoran, University Of Strathclyde, Glasgow, UK
PROMs in cancer care – examination of the current evidence of collection and use in routine clinical practice
 Abstract 153: Roma Maguire, University of Strathclyde, Glasgow, UK
Enabling daily monitoring of chemotherapy toxicity: The Daily Chemotherapy Toxicity self-Assessment Questionnaire (DCTAQ)
 Abstract 211: Hans Wouters, Dept. of Pharmacotherapy, -Epidemiology & -Economics, University Of Groningen, Groningen, The Netherlands, 2 Dept. of General Practice And Elderly Care Medicine, University Medical Center Groningen, Groningen, The Netherlands
Long-term Exposure To Anticholinergic And Sedative Drugs And Cognitive And Physical Function In Later Life
Abstract 154: Janet Krska, Medway School of Pharmacy, UK
Complexity of medicine regimens and patient perceptions of medicine burden

 

10.30 – 12.00

PARALLEL SESSION P14F    

New Medicines: Management of Innovations

Background

There is still considerable unmet need among patients. However, new medicines are typically more expensive than existing ones with prices especially for new oncology medicines and those for orphan diseases up to US$10,000 – 20,000/ patient/ month or more. It is difficult to fund all new medicines giving increasing pressure on resources exacerbated by a growing elderly population  with growing prevalence of chronic diseases. Alongside this, patients in routine clinical care are likely to be more co-morbid and older than those in Phase III clinical trials. Professionals with budget responsibility have to balance a requirement to meet unmet need with new expensive medicines especially in high priority areas with available resources. This requires budgetary planning, discussions with clinicians on the potential role and place of new therapies, as well as follow-up of prescribing to see whether new medicines are being prescribed according to agree guidelines as well as their effectiveness and safety in routine clinical care. Consequently, DU research is crucial going forward.

Aims

To stimulate debate and discussion regarding optimal ways to optimize the managed entry of new premium priced medicines that meet unmet need given increasing budgetary concerns.

Description

Keynote  lecture from Margaret followed by 4 abstracts and discussion

 Chairpersons: Brian Godman, UK
Margaret Ryan, UK
 Speaker: Margaret Ryan, UK
Experiences in Scotland with managing the introduction of new medicines; role of drug utilization research and prescribing initiatives
 Abstract 214: Sabine Vogler, WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Pharmacoeconomics Department, Gesundheit Österreich GmbH (GÖG / Austrian Public Health Institute), Vienna, Austria
Shining some light on confidential arrangements: Relevance of discounts for pharmaceutical pricing in European countries
 Abstract 142: Brian Godman, Strathclyde Institute of Pharmacy and Biomedical Sciences, Glasgow, United Kingdom, Division of Clinical Pharmacology, Karolinska Institute, Stockholm, Sweden
The implementation of managed entry agreements in Central and Eastern Europe: Findings and implications for future policies
 Abstract 69: Sabine Vogler, Pharmacoeconomics Department, Austrian Public Health Institute, Vienna, Austria, 2WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Vienna, Austria
How do average prices of high-cost medicines in Europe develop in the years following marketing authorisation?
Abstract 189: Gisbert W. Selke, Wissenschaftliches Institut der AOK, Berlin, Germany
Biologicals: Possibilities and limitations of efficiency gains through biosimilars. An analysis of the German market 2004–2016 using health care funds claims data

 

 10.30 – 12.00

PARALLEL SESSION P15F   

DUR across the World 

Description

In this unique session, researchers from across the globe will report on DUR studies. We will cover Brazil, Canada, Indonesia, Australia, South Africa and Kenya.

Chairpersons: Katja Taxis, The Netherlands
Jane Robertson, UK
 Abstract 3: Rachel Magarinos-Torres, Federal University of the State of Rio de Janeiro (UFF), Niteroi, Brazil
Essential medicines list implementation dynamics: a case study using Brazilian federal medicines expenditures
 Abstract 209: Daniala Weir, McGill University, Montreal, Canada
Medications Prescribed, Stopped and Modified at Hospital Discharge and Filled Medications in the Community: Failure to Follow in-Hospital Medication Changes and Adverse Health Outcomes 30-days Post Hospital Discharge
 Abstract 191: Elfride Sianturi, University Of Groningen, Groningen, The Netherlands, Universitas Cenderawasih, Papua, Indonesia
Association between Stigma, Beliefs about Medicines and Adherence to Antiretroviral Therapy: A Cross Sectional Study in People Living with HIV (PLHIV) in Papua, Indonesia
Abstract 173: Lisa Pont, Centre For Health Systems And Safety Research, University of Technology , Sydney, Australia
De-prescribing of antipsychotics in residential aged care
Abstract 125: Johanita Burger, North-West University (Potchefstroom Campus), Potchefstroom, South Africa
Appropriate and non-medical use of methylphenidate by residence students at a South African tertiary institution
Abstract 51: Margaret Oluka, Department of Pharmacology & Pharmacognosy, School of Pharmacy, University of Nairobi, Nairobi, Kenya
Incidence and Determinants of Medication Errors among Paediatric In-Patients at a Rural Referral Hospital in Kenya


Scientific Programme Part V

13.00 – 14.30

SYMPOSIUM S4F     

Predictive Analytics, Patient Level Drug Exposure

Background

As health systems become more digitalised the volume and complexity of information grows rapidly and presents the opportunity to use (real-time) analytical methods to better characterize and predict factors/attributes of patients/consumers associated with a particular outcome e.g. adherence to medicines, unintended/ intended clinical outcome. Such intelligence can be used to design new clinical decision support tools and target health interventions to patient subgroups or even individuals. This session will present an introduction to prediction methods suitable for use in large scale administrative/clinical datasets with illustration of application within the hospital (cardiovascular risk), primary health care (risk of healthcare associated infection) and community setting (stating adherence).

Aims

To illustrate the application of different predictive analytics approaches and methods to large individual level datasets to inform advancements in clinical practice.

Chairpersons: Gabriel Sanfélix-Gimeno, Spain
Marion Bennie, UK
Speaker: Gabriel Sanfélix-Gimeno, Spain
Predicting adherence using electronic databases: methods and novel predictors
 Speaker: Chris Robertson, UK
Using linked databases and predictive methods to identify individuals at high risk of a healthcare associated infection
Speaker: Rolf Groenwold, The Netherlands
Predictive modelling in electronic health records to improve guideline adherence: an example of cardiovascular risk management

 

13.00 – 14.30

WORKSHOP W5F

Role of DUR in Comparative Effectiveness Research

 

Chairpersons: Björn Wettermark, Sweden
Catherine Sermet, France
 Speaker: Petra Denig, The Netherlands
Linking drug prescription data to clinical outcomes: from group to individual treatment response
 Speaker: Thomas Cars, Sweden
Electronic health records, propensity scores and sensitivity analyses in comparative effectiveness research

 

13.00 – 14.30

WORKSHOP W6F

CNC Guidelines and Checklist

Background

As part of the educational section, pitfalls and sources of bias related to CNC studies were handled. For the development of the guidelines, we started from published CNC studies trying to identify all requirements needed for a comprehensive description of included data. On the other hand, all possible sources of bias were carefully investigated and discussed. Based on these findings, we developed a checklist as a guidance in the design of new CNC studies and as a tool in the review process of submitted CNC studies.

Aims

To briefly present the checklist and the Good Practice Guidelines for designing, conducting, reporting and reviewing CNC studies

To learn more about the sources of bias in conducting CNC studies by the practical use of the CNC checklist while reviewing a published CNC study

To discuss this experience during a panel discussion

Description

As introduction, the history of the development of CNC guidelines will be presented as well as the deliverables prepared by the working group. The CNC paper that will be used for the review process will be presented and the use of the checklist will be explained. The audience will be divided in working  groups of 6-8 persons to fill in the checklist. The workshop will end with a panel discussion where the completed checklists and the problems encountered will be discussed.

Workshop: Review of the paper in the working groups guided by the CNC checklist

Chairpersons:     Monique Elseviers, Belgium
Veronika Wirtz, USA
 Speaker: Carlos Duran, Belgium
Introduction: Development of Good Practice Guidelines for CNC studies
 Speaker: Yared Santa Ana-Tellez, Spain/ Mexico
Presentation of the CNC checklist and guidelines
 Speaker: Monique Elseviers, Belgium
Presentation of the paper selected for the review and practical organization of the review process in the working groups
 Speaker: Robert Vander Stichele, Belgium
Panel discussion of the results of the review process and the problems encountered while using the CNC checklist

 

16.00 – 17.30

KEYNOTE SPEECH K5F

Drug Utilization and Health Policy from a Global Perspective

Over the last decade new opportunities for drug utilization research (DUR) are emerging mainly driven by the implementation of electronic information systems across many healthcare settings providing large quantity of high quality data. At the same time, increased patient involvement in health care is posing novel research questions and the global focus is shifting towards scaling access to quality care and increasing efficiency. The three speakers will address those opportunities each from their perspective. Furthermore, challenges will be discussed. DUR is instrumental in generating evidence to inform clinical practice and policy decisions, but it is facing challenges: across many low and middle income countries eHealth remains a future prospect. Even in those regions where eHealth is providing high quality data, there is the need for DUR to evolve. Finally, DUR has often operated in isolation from other health service research.

Promoting DUR as a key input for practice and policy decisions will take leadership from researchers and practitioner, collaboration with different decision-makers, posing relevant research questions and developing innovative ways to leverage big data.

Chairperson: Marion Bennie, UK
 Speaker:  Katja Taxis, University of Groningen, The Netherlands  
 Speaker:  Veronika Wirtz, Boston University, USA
 Speaker:  Lisa Pont, Centre For Health Systems And Safety Research, University of Technology , Sydney, Australia

 

CLOSING CEREMONY

Speaker: Marion Bennie, UK
Prize winners: Monique Elseviers (posters)