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Moving Evidence into Policy & PracticeThe New Brunswick“Test Strip” StoryBronwyn Davies, Executive Director, Primary Health Care, Dept of HealthHeidi Liston, Director of Drug Utilization, Pharmaceutical Services, Dept of HealthMary Astle, Program Consultant, Income Support Programs, Dept of Social DevelopmentStephanie Smith, NB Liaison Officer, CADTHCADTH SymposiumMay 2013
Speaker DisclosuresNone of the presenters have real or potential conflicts to disclose.
Moving Evidence into Policy & Practice:CAN YOU GET THERE FROM HERE?World ofPRACTICE&POLICYEVIDENCE
Learning Objectives• To share our “change story”related to BGTS policydevelopments in NB.• To highlight collaborative efforts acrossgovernment departments and with keystakeholders to support and implement thechange process.• To share the change challenges/lessons learnedand considerations for moving forward.
Successful Change: 3 Stage ProcessOur Change Story: 3 Basic Chapters1.The Prologue to Change– Motivating a change mindset1.The Change– Making it happen1.Supporting the Change– Keeping it going; revisiting the mindset
The Prologue to Change: Creatingthe Story• Evidence• Fiscal Reality
Diabetes in New BrunswickSource: New Brunswick Diabetes Cost Model, CDA
• Time• Change Leaders• Creating a Roadmap• Population TargetThe Prologue to Change: Creatingthe Story
• ImplementationTeamThe Prologue to Change: Creatingthe StoryEvidence /Evidence /DataDataAdministrativeAdministrativeRequirementsRequirementsPolitical WillPolitical Will CommunicationCommunication
Chapter 2: The ChangeHarmonize and update policies (benefit coverage forBGTS for clients of the Dept. Social Development)•Expanded access for BGTS•Standardized policy for all SD clients•Guidelines on BGTS use and quantity to more closely alignwith evidence yet accommodate special circumstances : New“Request Form”•Expanded approval processes to other care providers•Simplified, streamlined access and approval processes
The Change: Test Strips GuidelinesType 2 Diabetes –Patient CategoryAnnualAllowanceExceptional CircumstancesNewly DiagnosedType 2 receiving noanti-diabetes drugs50 stripsTwo additional requests of 50 strips becausepatient has Acute illness, significant change in routine orchanges in drug dose or regimen Poorly controlled or unstable blood glucoselevels History of, or increased risk of, hypoglycemia Occupation in which hypoglycemia poses asafety hazard Trying to become pregnant.Receiving oral anti-diabetes drugs100 strips(up to 50 stripsevery 6months)Specific, identified medical need: MD or NP can requestadditional strips in writing
Chapter 3: The Never Ending Story• More story-telling– Province Wide Education Program• Diabetes NB CoPosis® Online Module: June/13– Opportunities in other practice settings• Reinforcing the change• Responding to inquiries, requests• Monitoring• More change ahead?
Lessons Learned• Appreciation for the Evolutionof Change• The Power of :– Partnerships (DTG, CADTH)– Communication– Collaboration– Consultation/Consensus-Building– Policy