Health Policy Issues and Priority Research Topics Related to Access and Use of Medicines in Iran: A Qualitative and Consensus Development Study
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Abstract
Background: Access to medicines needs to be fully integrated with health financing, human resource planning, service delivery, information and governance systems. We aimed to explore key themes for the identification of priority policy research questions in the area of access to and use of medicines.Methods: We interviewed a purposeful sample of twenty participants in Iran. The interviewees were selected from diverse stakeholders and the listing comprised of the Ministry of Heath, Departments of Health, Industry, Researchers, Development Partners, Advocates, Clinicians, Pharmacists and Private Providers. Qualitative data was analyzed using the framework approach. We then conducted a nominal group technique meeting to reach consensus on research priorities.Results: Seven themes explain important access to medicine policy and practice issues: health sector organization, health sector pharmaceutical policies, health system financing/ insurance system, drug distribution system in the country, individual, household and community level, health care providers, and policies beyond the health sector. As a result of the consensus development process, 17 research priorities related to access to and use of medicines were identified.Conclusion: The key informant interviews clearly demonstrate that the majority of policy concerns were not addressed. There was a mismatch between the concerns and research, and hence the outcomes of this study can contribute to developing a research agenda for improving access to and appropriate use of medicines.
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2. Bigdeli M, Jacobs B, Tomson G, Laing R, Ghaffar A, Dujardin B, et al. Access to medicines from a health system perspective. Health Policy Plan. 2013; 28(7):692-704. [DOI:10.1093/heapol/czs108] [PMID] [PMCID]
3. Le Grand A, Hogerzeil HV, Haaijer-Ruskamp FM. Intervention research in rational use of drugs: A review. Health Policy Plan. 1999; (2)89-102. [DOI:10.1093/heapol/14.2.89] [PMID]
4. Beilby JJ, Silagy CA. Trials of providing costing information to general practitioners: A systematic review. Med J Aust. 1997; 167(2):8992. [DOI:10.5694/j.1326-5377.1997.tb138787.x] [PMID]
5. Pippalla RS, Riley DA, Chinburapa V. Influencing the prescribing behavior of physicians: A metaevaluation. J Clin Pharm Ther. 1995(4):189-98. [DOI:10.1111/j.1365-2710.1995.tb00648.x] [PMID]
6. Force MG. Delivering on the global partnership for achieving the millennium development goals. New York: United Nations; 2008.
7. Cameron A, Ewen M, Ross-Degnan D, Ball D, Laing R. Medicine prices, availability, and affordability in 36 developing and middle-income countries: A secondary analysis. Lancet. 2009; 373(9659):2409. [DOI:10.1016/S0140-6736(08)61762-6]
8. World Health Organization (WHO) medicines strategy: Countries at the core: 2004-2007. Genèva: World Health Organization, 2004.
9. Shankar PR. Medicines use in primary care in developing and transitional countries: fact book summarizing results from studies reported between 1990 and 2006. Bull World Health Organ. 2009; 87(10):804-5. [DOI:10.2471/BLT.09.070417] [PMCID]
10. World Health Organization. Scaling up research and learning for health systems: Now is the time: Report of a high level task force. Geneva: World Health Organization; 2009.
11. Rashidian A, Eccles MP, Russell I. Falling on stony ground? A qualitative study of implementation of clinical guidelines ‘prescribing recommendations in primary care. Health Policy. 2008; 85(2):14861. [DOI:10.1016/j.healthpol.2007.07.011] [PMID]
12. Abolhallaje M, Ramezanian M, Abolhasani N, Salarian Zade H, Hamidi H, Bastani P. Iranian health financing system: Challenges and opportunities. World Appl Sci J. 2013; 22(5):662-6.
13. Zaidi S, Bigdeli M, Aleem N, Rashidian A. Access to essential medicines in Pakistan: Policy and health systems research concerns. PLOS One. 2013; 8(5):1-10. [DOI:10.1371/journal.pone.0063515] [PMID] [PMCID]
14. Rashidian A, Jahanmehr N, Jabbour S, Zaidi S, Soleymani F, Bigdeli M. Bibliographic review of research publications on access to and use of medicines in low-income and middle-income countries in the Eastern Mediterranean Region: Identifying the research gaps. BMJ Open. 2013; 3(10):1-10. [DOI:10.1136/bmjopen-2013-003332] [PMID] [PMCID]
15. Berendes S, Heywood P, Oliver S, Garner P. Quality of private and public ambulatory health care in low and middle income countries: Systematic review of comparative studies. PLOS Med. 2011; 8(4):1-10. [DOI:10.1371/journal.pmed.1000433] [PMID] [PMCID]
| Files | ||
| Issue | Vol 4 No 1/2 (2018) | |
| Section | Original Article(s) | |
| Keywords | ||
| Access to medicine Health policy issues Qualitative research | ||
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How to Cite
1.
Rashidian A, Soleymani F, Jahanmehr N. Health Policy Issues and Priority Research Topics Related to Access and Use of Medicines in Iran: A Qualitative and Consensus Development Study. JPPM. 2018;4(1/2):32-42.
