Stakeholders' views on the routine use of n-of-1 trials to improve clinical care and to make resource allocation decisions for drug use

Nikles, Jane, Mitchell, Geoffrey K., Clavarino, Alexandra, Yelland, Michael J. and Del Mar, Christopher B. (2010) Stakeholders' views on the routine use of n-of-1 trials to improve clinical care and to make resource allocation decisions for drug use. Australian Health Review, 34 1: 131-136. doi:10.1071/AH09654

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Author Nikles, Jane
Mitchell, Geoffrey K.
Clavarino, Alexandra
Yelland, Michael J.
Del Mar, Christopher B.
Title Stakeholders' views on the routine use of n-of-1 trials to improve clinical care and to make resource allocation decisions for drug use
Journal name Australian Health Review   Check publisher's open access policy
ISSN 0156-5788
1449-8944
Publication date 2010-03
Sub-type Article (original research)
DOI 10.1071/AH09654
Volume 34
Issue 1
Start page 131
End page 136
Total pages 6
Place of publication Collingwood, VIC, Australia
Publisher C S I R O Publishing
Collection year 2011
Language eng
Subject 1117 Public Health and Health Services
1605 Policy and Administration
Abstract N-of-1 trials are empirical formal tests using a within-patient randomised, double-blind, cross-over comparison of drug and placebo (or another drug), which we adapted to study individual patients’ responses as a clinical tool to guide clinical management. We administered semi-structured interviews to gauge stakeholder perspectives on the possibility of using routine n-of-1 trials for this purpose. Stakeholders included government and non-government health care sector, and patient, clinician and consumer, organisations. Stakeholders supported more widespread implementation of n-of-1 trials, in a targeted fashion, with some caveats. Barriers to their widespread implementation included constraints on doctors’ time, doctors’ acceptance, drug company acceptance, patient willingness, and cost. Strategies for overcoming barriers included conditional Pharmaceutical Benefits Scheme listing if cost-effective. There was little consensus on which model of n-of-1 trial implementation would be most effective. We discuss different approaches to addressing the several concerns raised to enable widespread introduction of n-of-1 trials into routine clinical practice as a decision tool. Copyright © 2011 ProQuest LLC. All rights reserved
Keyword Attention-deficit/Hyperactivity disorder
Perspectives
Stimulants
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Medicine Publications
 
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Created: Sun, 18 Apr 2010, 00:07:52 EST