Implementation of pharmaceutical alternatives to a toxic drug supply in British Columbia: A mixed methods study

Original research
by
Pauly, Bernadette et al

Release Date

2024

Geography

Canada

Language of Resource

English

Full Text Available

No

Open Access / OK to Reproduce

No

Peer Reviewed

Yes

Objective

Our objective was to describe early implementation of Risk Mitigation Guidance (RMG) among prescribers in BC.

Findings/Key points

Analysis of administrative databases demonstrated limited uptake of the intervention outside large urban centres and a highly specific profile of urban prescribers, with larger and more complex caseloads associated with RMG prescribing. Nurse practitioners were three times more likely to prescribe than general practitioners. Qualitatively, the study identified five themes related to the five CFIR domains: 1) RMG is helpful but controversial; 2) Motivations and challenges to prescribing; 3) New options and opportunities for care but not enough to ‘win the arms race’; 4) Lack of implementation support and resources; 5) Limited infrastructure.

Design/methods

We conducted a convergent mixed methods study drawing population-level linked administrative health data and qualitative interviews with 17 prescribers.

Keywords

Safer supply
Policy/Regulatory
About prescribers
Rural/remote
Barriers and enablers
Hesitancy of prescribers