Bringing Citizen-Led Research to Life Through the Landscape of - - PowerPoint PPT Presentation

▶
bringing citizen led research to life through the
SMART_READER_LITE
LIVE PREVIEW

Bringing Citizen-Led Research to Life Through the Landscape of - - PowerPoint PPT Presentation

Sep 30, 2023 218 likes •511 views

Bringing Citizen-Led Research to Life Through the Landscape of Prescription on Stimulant Use Report 2019 CADTH Symposium April 15, 2019 Mina Tadrous Ontario Drug Policy Research Network www.odprn.ca @ODPRN_Research Disclosures I have no

slide-1
SLIDE 1

Bringing Citizen-Led Research to Life Through the Landscape of Prescription

  • n Stimulant Use Report

2019 CADTH Symposium April 15, 2019

Mina Tadrous Ontario Drug Policy Research Network

@ODPRN_Research www.odprn.ca

slide-2
SLIDE 2

Disclosures

  • I have no actual or potential conflict of interest in

relation to this topic or presentation

  • This study was funded by:

– Ontario Ministry of Health and Long Term Care (MOHLTC) Health System Research Fund (HSRF) – Ontario SPOR SUPPORT Unit – This study was also supported by ICES

2

slide-3
SLIDE 3

About the ODPRN

Network of clinical researchers from across Ontario interested in drug policy research Launched in 2008: Funded through research grants Primary Objective: Provide high quality, relevant drug research to Ontario’s policy-makers in a timely manner on an as-needed basis

The Ontario Drug Policy Research Network

slide-4
SLIDE 4

ODPRN Structure

4

slide-5
SLIDE 5

Citizens’ Panel Vision

Purpose

  • Suggest, prioritize and select research topics
  • Ensure relevance of research from a patient/citizen perspective
  • Provide input on proposed policy recommendations
  • Contextualize research findings
  • Advise and support dissemination strategies

through personal and professional networks

4/23/2019 5

To improve Ontario drug policy and healthcare through the integration of patient and citizen perspectives at all stages

  • f the research process.
slide-6
SLIDE 6

Meet the Citizen’s Panel

4/23/2019 6

slide-7
SLIDE 7

4/23/2019 7

  • 18-22 members to-date

– 63% average attendance rate

Expectations

  • Attend bi-monthly meetings
  • Attend annual in-person

meeting

  • Term of Office

– ~2 years – Option for renewal

Membership

slide-8
SLIDE 8

Representation

4/23/2019 8

18 - 25 5% 26 - 35 35% 36 - 45 15% 46 - 55 20% 56 - 65 15% 66 - 75 10%

Age groups

Female 65% Male 35%

Gender

slide-9
SLIDE 9

Representation

Professional Background

4/23/2019 9

Black Caribbean/Af rican/African Canadian 14% Latin American 9% South Asian 10% White [PERCENTAG E]

Cultural/Ethnic Background

slide-10
SLIDE 10

4/23/2019 10

slide-11
SLIDE 11

4/23/2019 11

slide-12
SLIDE 12

PANEL-LED PROJECT

Landscape of Prescription Stimulant Use in Ontario

4/23/2019 12

slide-13
SLIDE 13

Stimulants

  • Controlled substance commonly used treatment of ADHD

– Increase in utilization, especially in the adult population – Concern over safety – Misuse/diversion, cardiovascular concerns, long-term impact

  • Patient expectation of differences between brand and

generics

4/23/2019 13

Generic name Tradename Amphetamine mixture Adderall XR (+ generics) Dextro-amphetamine Dexedrine, Dexedrine Spansule Lis-dexamfetamine Vyvanse Methylphenidate Concerta (+ generics) Ritalin, Ritalin SR (+generics) Biphentin

slide-14
SLIDE 14

Process

4/23/2019 14

Identify Topic

  • Mental health and

addiction

Develop Process

  • Sub-committee

Design and Refine

  • Proposed

methods

slide-15
SLIDE 15

Process

4/23/2019 15

Design and Refine Analyze and Interpret

  • Developed key

messages

Report and Evaluate

  • Methods
  • Future

research

slide-16
SLIDE 16

Landscape of Prescription Stimulant Use

4/23/2019 16

slide-17
SLIDE 17

Landscape of Prescription Stimulant Use

17

slide-18
SLIDE 18

Interpreting Results

18

slide-19
SLIDE 19

Landscape of Prescription Stimulant Use

4/23/2019 19

slide-20
SLIDE 20

Landscape of Prescription Stimulant Use

4/23/2019 20

Uptake Metrics Page views 1,107 Number of users 699 Average time on page 2 min 51 sec

slide-21
SLIDE 21

4/23/2019 21

Facilitators

  • Developed important

questions relevant to citizens

  • Improves knowledge of

public access to certain drugs

  • Determines research

priorities of joint interest to policymakers and general public Barriers

  • Representative

population Insights

  • Resource and time

intensive

  • Background knowledge

and contextualizing the research

Lessons Learned

slide-22
SLIDE 22

Acknowledgments

Tara Gomes

St Michael’s Hospital

Dana Shearer

St Michael’s Hospital

Diana Martins

St Michael’s Hospital

Samantha Singh

ICES

David N. Juurlink

Sunnybrook Research Institute

Muhammad M. Mamdani

St Michael’s Hospital

22

Report Citation:

  • Martins D, Greaves S, Tadrous M, Shearer D,

et al on behalf of the ODPRN Citizens’

  • Panel. Landscape of Prescription Stimulant

Use: Patterns, Trends and Geographic Variation in Ontario, Canada. Toronto: Ontario Drug Policy Research Network; September 2018.

slide-23
SLIDE 23

Extra slides

4/23/2019 23

slide-24
SLIDE 24

Interpreting Results

24

Characteristics of Stimulant Users in 2016

Characteristic

Prevalent User (N=118,561) New User (N=49,953) Total (N=168,514)

Age group

0-18 57,897 (48.8%) 21,359 (42.8%) 79,256 (47.0%) 19-24 14,859 (12.5%) 8,034 (16.1%) 22,893 (13.6%) 24-44 26,012 (21.9%) 12,931 (25.9%) 38,943 (23.1%) 45-64 16,849 (14.2%) 6,049 (12.1%) 22,898 (13.6%) 65+ 2,795 (2.4%) 1,426 (2.9%) 4,221 (2.5%) Missing 149 (0.1%) 154 (0.3%) 303 (0.2%)

Sex

Male 76,205 (64.3%) 30,056 (60.2%) 106,261 (63.1%) Female 42,207 (35.6%) 19,743 (39.5%) 61,950 (36.8%) Missing 149 (0.1%) 154 (0.3%) 303 (0.2%)

Formulation Dispensed

Long acting 106,126 (89.5%) 43,633 (87.3%) 149,759 (88.9%) Immediate release 12,435 (10.5%) 6,320 (12.7%) 18,755 (11.1%)

Stimulant Dispensed

Dextroamphetamine 7,399 (6.2%) 1,859 (3.7%) 9,258 (5.5%) Lisdexamfetamine 32,852 (27.7%) 15,492 (31.0%) 48,344 (28.7%) Methylphenidate 72,996 (61.6%) 32,169 (64.4%) 105,165 (62.4%) Mixed-Salt Amphetamine 17,819 (15.0%) 6,545 (13.1%) 24,364 (14.5%)

Recent physician visit

Psychiatrist 20,548 (17.3%) 12,790 (25.6%) 33,338 (19.8%) Pediatrician 22,359 (18.9%) 10,900 (21.8%) 33,259 (19.7%) General/Family Physician 59,652 (50.3%) 34,846 (69.8%) 94,498 (56.1%) Specialist 71,211 (60.1%) 30,955 (62.0%) 102,166 (60.6%)

Initial prescriber

General/Family Physician 58,788 (49.6%) 24,414 (48.9%) 83,202 (49.4%) Psychiatrist 21,545 (18.2%) 11,026 (22.1%) 32,571 (19.3%) Pediatrician 32,874 (27.7%) 11,051 (22.1%) 43,925 (26.1%) Missing 2,361 (2.0%) 1,703 (3.4%) 4,064 (2.4%) Other 2,993 (2.5%) 1,759 (3.5%) 4,752 (2.8%)

slide-25
SLIDE 25

Interpreting Results

Characteristics of Stimulant Users in 2016, by Age

Characteristic

Total (N=168,514) Age 0-18 (N=79,256) Age 19-24 (N=22,893) Age 25-44 (N=38,943) Age 45-64 (N=22,898) Age 65+ (N=4,221)

Sex

Male 106,261 (63.1%) 57,838 (73.0%) 13,830 (60.4%) 21,450 (55.1%) 11,031 (48.2%) 2,112 (50.0%) Female 61,950 (36.8%) 21,418 (27.0%) 9,063 (39.6%) 17,493 (44.9%) 11,867 (51.8%) 2,109 (50.0%) Missing 303 (0.2%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%)

Recent physician visit

Psychiatrist 33,338 (19.8%) 10,139 (12.8%) 4,652 (20.3%) 10,428 (26.8%) 7,181 (31.4%) 938 (22.2%) Pediatrician 33,259 (19.7%) 32,130 (40.5%) N/A N/A N/A N/A General/Family Physician 94,498 (56.1%) 32,536 (41.1%) 15,531 (67.8%) 27,386 (70.3%) 16,014 (69.9%) 3,031 (71.8%) Specialist 102,166 (60.6%) 58,011 (73.2%) 9,013 (39.4%) 18,510 (47.5%) 13,543 (59.1%) 2,929 (69.4%)

Initial prescriber

General/Family Physician 83,202 (49.4%) 24,319 (30.7%) 16,203 (70.8%) 25,923 (66.6%) 13,865 (60.6%) 2,757 (65.3%) Psychiatrist 32,571 (19.3%) 9,302 (11.7%) 4,600 (20.1%) 10,316 (26.5%) 7,362 (32.2%) 934 (22.1%) Pediatrician 43,925 (26.1%) 42,234 (53.3%) N/A N/A N/A N/A Missing 4,064 (2.4%) 1,789 (2.3%) 612 (2.7%) 989 (2.5%) 543 (2.4%) 123 (2.9%) Other 4,752 (2.8%) 1,612 (2.0%) 499 (2.2%) 1,302 (3.3%) 941 (4.1%) 389 (9.2%)

Potential Inappropriate Use

Any NMS warning flag in 2016 18,047 (10.7%) 5,688 (7.2%) 2,183 (9.5%) 6,057 (15.6%) 3,380 (14.8%) 716 (17.0%) Early re-fill 13,314 (7.9%) 5,308 (6.7%) 1,727 (7.5%) 3,681 (9.5%) 2,072 (9.0%) 507 (12.0%) Double doctoring 5,512 (3.3%) 415 (0.5%) 491 (2.1%) 2,821 (7.2%) 1,527 (6.7%) 253 (6.0%) Poly-pharmacy 2,275 (1.4%) 125 (0.2%) 259 (1.1%) 1,396 (3.6%) 451 (2.0%) 44 (1.0%) Opioid prescription in 2016 28,138 (16.7%) 3,763 (4.7%) 3,415 (14.9%) 10,582 (27.2%) 8,460 (36.9%) 1,886 (44.7%) >3 stimulant prescriptions and >3 opioid prescriptions in 2016 10,497 (6.2%) 80 (0.1%) 519 (2.3%) 4,959 (12.7%) 4,192 (18.3%) 741 (17.6%)

slide-26
SLIDE 26

Interpreting Results

26

5 10 15 20 25

Rate per 1000 population

Rate of stimulant users by Public Health Unit (PHU)

slide-27
SLIDE 27

Interpreting Results

27

2 4 6 8 10 12 14 16 18 20 Erie St. Clair South West Waterloo Wellington Hamilton Niagara Haldimand Brant Central West Mississauga Halton Toronto Central Central Central East South East Champlain North Simcoe Muskoka North East North West

Rate per 1000 population

Rate of stimulant users by Local Health Integration Unit (LHIN)