Progress in practice - The UKCPA autumn symposium was held in Blackpool on November 19-21, 1999
The culture of evidence-based medicine and its training were strong in Canada, said Ms CHRISTINE CLARK (Liverpool John Moores university) who gave the Zeneca Pharma award lecture. In the UK, within pharmacy, evidence-based medicine could be strengthened and there were many opportunities for pharmacists to develop it. Opportunities for pharmacists in the UK included the development and implementation of evidence-based guidelines, a national health technology assessment programme and room for pharmacists to work within the Cochrane Collaboration, said Ms Clark.
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Christine Clark (right) receives her award from Sarah Richards (Astra Zeneca) |
A less positive view of evidence-based medicine came from the Canadian Medical Association (CMA), said Ms Clark. It supported evidence-based medicine in principle but was concerned that it threatened clinical freedom and that it resulted from an ulterior motive (perhaps in cost control). The CMA had a programme to disseminate clinical prescribing guidelines. These were put on a database to allow individual institutions to decide which to use from the large number available. The CMA was not involved in writing guidelines. The Canadian Co-ordinating Office for Health Technology Assessment (CCOHTA) produced advisory documents, but there was no obligation to follow them. It identified topics for systematic reviews which were then undertaken in- house or commissioned from experienced reviewers. Unlike the UK equivalent, CCOHTA was not able to commission primary research and it also suffered from a limited budget. Dr Jill Sanders (president, CCOHTA) had told Ms Clark that: "The UK stands out as a place where a national, think-tank approach has been adopted."
It was impossible to say which country was stronger within evidence-based medicine, concluded Ms Clark. Canada did some things very well and the UK did some things very well; both were related to their historical strengths.