| Abstract [eng] |
Data used in drug utilization research (DUR) is routinely collected from sales data, reimbursement databases, disease registries, or electronic health records, with databases varying in characteristics, content, and accessibility between countries. The aim of this study is to determine whether the maturity of drug utilization (DU) databases used in DUR could be appraised and, if so, to build a maturity appraisal tool. This Master thesis is a part of the DURDAM project (1). In the master thesis it was aimed to explore the components of DU databases for their ability to assess maturity and to gain consensus on the key attributes needed to develop a national maturity appraisal tool. Five research objectives were created to fulfil the overall aim: to identify and recruit international experts in DUR, to collate information on DU data available worldwide, to identify key attributes and characteristics of DU databases that explain the completeness and comprehensiveness of DU data, to draft statements to assess the maturity of DU databases and to build consensus among international experts on the key attributes of DU data for a national DU database maturity appraisal tool. In this project database maturity was defined as comprehensiveness, completeness, and accessibility for DUR studies. Initially, three rounds of a Modified Delphi consensus process were utilized to develop a maturity assessment tool. Recruitment targeted 20 to 30 participants with at least five years of DUR experience and English proficiency. A list of statements on the maturity dimensions was developed following open or semi-open questions in a Qualtrics questionnaire in Round 1. The relevance of listed dimensions of the maturity scales was ranked by a 7-point Likert scale on importance for inclusion (from “strongly disagree” to “strongly agree”) in Round 2. Selected maturity-related statements/groups/statements were used to reach consensus in Round 3. E-Delphi, a platform developed by Finnish future research institutions including the University of Turku Futures Research Centre and Society for Futures Research, was used for the modified Delphi process. In the next phase, the usability, acceptability and validity of the developed DU Databases Appraisal Tool will be tested. Results included the identification and purposeful sampling of 60 potential participants to ensure global representation, with 22 participants successfully recruited. These participants included clinical academics, healthcare professionals, and policymakers, achieving gender balance and a broad age range. Information on each participant's country's health system was captured, along with data on drug use and its availability for DU analysis. Ten statements relating to DU database maturity were formulated, addressing comprehensiveness, completeness, and accessibility. Consensus was achieved on the primary endpoint with over 75% agreement on the proposed statements, with 13 participants providing feedback and 11 (85%) expressing support for all statements. Conclusions indicated that a modified Delphi consensus process was successfully conducted to select a core set of characteristics for DU databases. A consensus was established among a group of international experts regarding mature database attributes, leading to the development of a framework for the DUR maturity appraisal tool. Following steps include accessibility testing and validation of the DU Databases Appraisal Tool. |
