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Review
. 2023 Aug;46(2):24-28.
doi: 10.18773/austprescr.2023.010.

Medicines stewardship

Elizabeth Su  1   2   3   4 , David Fl Liew  1   2   3   4 , Jane Donnelly  1   2   3   4 , Rohan A Elliott  1   2   3   4
Affiliations
Review

Medicines stewardship

Elizabeth Su et al. Aust Prescr. 2023 Aug.

Abstract

Medicines stewardship refers to coordinated strategies and interventions to optimise medicines use, usually within a specific therapeutic area. Medicines stewardship programs can reduce variations in practice and improve patient outcomes. Therapeutic domains for medicines stewardship are chosen to address frequently used drug classes associated with a high risk of adverse outcomes. Some examples include antimicrobial, opioid analgesic, anticoagulation and psychotropic stewardship. Common elements of successful stewardship programs include multidisciplinary leadership, stakeholder engagement, tailored communication strategies, behavioural changes, implementation science methodologies, and ongoing program monitoring, evaluation and reporting. Medicines stewardship is a continual quality improvement process that requires ongoing support and resources, as well as clinician and consumer engagement, to remain sustainable. It is critical for hospital-based medicines stewardship programs to consider impacts on care in the community when making and communicating changes to patient therapy. This ensures that stewardship efforts are sustained across transitions of care.

Keywords: anticoagulation stewardship; antimicrobial stewardship; medicines stewardship; opioid analgesic stewardship; psychotropic stewardship; quality use of medicines.

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Conflict of interest statement

Conflicts of interest: David Liew is a member of the Drug Utilisation Subcommittee of the Pharmaceutical Benefits Advisory Committee.

References

    1. Brinkerhoff DW, Cross HE, Sharma S, Williamson T. Stewardship and health systems strengthening: an overview. Public Adm Dev 2019;39:4-10. 10.1002/pad.1846 - DOI
    1. Veillard JH, Brown AD, Barış E, Permanand G, Klazinga NS. Health system stewardship of National Health Ministries in the WHO European region: concepts, functions and assessment framework. Health Policy 2011;103:191-9. 10.1016/j.healthpol.2011.09.002 - DOI - PubMed
    1. World Health Organization. Travis P, Egger D, Davies P, Mechbal A. Towards better stewardship: concepts and critical issues. Geneva: World Health Organization; 2002. https://apps.who.int/iris/handle/10665/339291 [cited 2023 Jul 1]
    1. Zavaleta KW, Philpot LM, Cunningham JL, Gazelka HM, Geyer HL, Rismeyer DL, et al. Why we still prescribe so many opioids: A qualitative study on -barriers and facilitators to prescribing guideline implementation. J Opioid Manag 2021;17:115-24. 10.5055/jom.2021.0622 - DOI - PubMed
    1. Australian Commission on Safety and Quality in Health Care. Antimicrobial stewardship in Australian health care. Sydney: ACSQHC; 2022. https://www.safetyandquality.gov.au/publications-and-resources/resource-... [cited 2023 Jul 1]

FURTHER READING

    1. Council of Australian Therapeutic Advisory Groups. Getting it right: guiding principles for medicines stewardship programs. CATAG; 2022. https://catag.org.au/resource/medicines-stewardship [cited 2023 Jul 1]

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