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Research in the Pipeline

Policy Makers Don't Shrug When Atlas Arrives

With patents on many of the 1990s blockbuster drugs – such as the cholesterol fighting Lipitor™ – expiring and lower-cost generics becoming available, policy makers will be looking to the next edition of the Canadian Rx Atlas for evidence-based information on how to control costs. Dr. Steve Morgan of the University of British Columbia has published two editions, tracking patterns in prescription drug use and highlighting factors such as population age that drive variations in provinces’ spending. Researchers who want to delve deeper into specific issues – for example, the inappropriate long-term use of benzodiazepines such as Ativan™ or Xanax™ – consult the Atlas, as do public interest groups and patient advocacy organizations. It has become a trusted resource for provincial and territorial health ministries: the Western Premiers cited the Atlas in 2009 upon announcing joint drug-purchasing policies. The third iteration, due in May of 2013, will deal with issues related to sex and gender in prescription drug utilization, access and affordability.

Study Proves Some Hearts Need Special Care

Thanks to advances in surgery, so many more children with congenital heart defects are surviving that there are now more adults than kids with the condition. The Canadian Consensus Conference on Adult Congenital Heart Defects (ACHD) recommends these adult patients, who now number at least 100,000 and who can present a variety of cardiac lesions, get ongoing specialized care at hospitals designated as ACHD centres. However, even though there are ACHD centres across Canada, fewer than 17,000 patients seek specialized care. A CIHR-funded study that McGill University’s Dr. Ariane Marelli first presented to the American Heart Association Conference in late 2011 showed that increased referrals to designated ACHD treatment centres led to a significant decrease in mortality rates. The findings, soon to be published, will inform policy and recommendations, support the promotion of specialized ACHD care and, ultimately, make life better for ACHD patients.

MOXXI Helps Doctors Decide How to Tailor Treatments/Reduce Risks

What began a decade ago as a CIHR-funded project to apply technology to make drug prescribing safer is helping to deliver more personalized, patient-centred health care. Led by Dr. Robyn Tamblyn of McGill University, researchers with MOXXI (the Medical Office of the 21st Century) started gathering data in 2003 from Quebec’s health insurance agency to create a community-based clinical information system. They now have 210 doctors and 95,000 patients signed on in Montreal and Quebec City. Researchers are pilot-testing computer-based surveillance algorithms that can analyze non-modifiable factors (e.g.: chronic health conditions such as diabetes) and modifiable ones (various drug prescriptions/doses) to produce a risk/benefit assessment doctors can use in deciding how to best care for patients. Early results are promising: a 2012 study showed that using MOXXI-driven “computerized prescribing decision support” could reduce injuries – such as those sustained in falls – for older people who take psychotropic drugs.