Unique project bridges the evidence/practice gap

Helping Australia’s war veterans and war widows to use medicines wisely has helped reduce hospital admissions and increased informed decision-making.

Just as importantly, it has allowed the Sansom Institute to develop a way of translating research into action (bridging the all-too-common evidence/practice gap) that could become a model for other organisations and settings.

For 10 years, researchers and educators in the Quality Use of Medicines and Pharmacy Research Centre have delivered the Department of Veterans’ Affairs (DVA) Veterans’ MATES (Medicines Advice and Therapeutics Education Services) program under contractual arrangements.

Four times a year they write to veterans, their GPs and the nation’s pharmacists to pass on the findings and implications of their research into a selected topic. The information is tailored to the recipient’s needs and, in the case of GPs, is specific to each of the veterans or widows they treat, while also being relevant to their other older patients.

Topics can be general – such as osteoporosis or incontinence – or deal with a particular medication or scenario. All topics are selected by the research team, with approval from an external reference group. Some interventions seek to increase the use of specific medicines, others to reduce it.

There is a strong focus on encouraging regular reviews of each individual’s medication regime to ensure medication use is as good as it can be.

“We don’t set out to tell people what to do; we provide concise information and a flag to issues or situations they may want to look at and consider,” said project manager Tammy Le Blanc. “There is so much happening, so many changes, that it is hard even for GPs to keep up.”

The response has been very positive. Stakeholder evaluations included in a review of the program published late last year showed that on average 80% of veterans and widows, 80% of GPs and 93% of pharmacists found the information they received useful or very useful.

In a previous review, more than 60% of doctors reported that at least one of the their patients identified in a Veterans’ MATES communication warranted a review of their therapy based on the advice and information provided.

Success has been driven by combining informed, targeted research with attention to modern theories around behaviour change and the delivery of information. The program is supported by a national call centre and a dedicated website.

At the heart of the research is the DVA’s database of some 220,000 veterans or widows and millions of individual entries. Claims for prescriptions, blood tests, visits to a doctor and hospital admissions are recorded, providing the ability to track changes and trends in great detail.

That has meant bringing on board people with the specialised skills to work with such huge amounts of data and thus tease out the questions that need asking and answering. The now 15-strong Veterans’ MATES team includes some of the best pharmacological epidemiologists in the country.

Areas of study and research

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