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Background and History

Origins of EQIP

In 2004, the BC Ministry of Health and the BC Medical Association (BCMA) signed an agreement to explore, evaluate and implement appropriate initiatives aimed at optimizing effective prescribing. This agreement was the first of its kind in Canada. EQIP reflects the lessons and best practices of analogous better prescribing programs in Australia, New Zealand, and the United Kingdom.

EQIP was also informed by the findings of a team of researchers from the University of Victoria and Harvard Medical School who in 2002 began conducting focus groups and interviewing BC physicians on methods to improve prescribing. This research, funded by Canadian Institutes of Health Research (CIHR) and the National Institutes in Health (NIH) in the United States, explored physician prescribing practices, the effectiveness of different educational tools and the potential of incentives.

The first phase of the research, carried out between 2002-2003, involved telephone interviews with 210 BC general practitioners (GPs). Key findings were that:

  • The majority of GPs interviewed indicated a willingness to make savings through prescribing changes, but largely rejected direct incentives or compensation, preferring benefits to their patients.
  • Most felt that GPs need appropriate educational tools at the time of prescribing to help them make cost effective treatment choices.
  • Most were also open to receiving individualized feedback on their prescribing if it could be done for educational, not punitive purposes.

The second phase of the research, carried out between 2005-2006, involved interviews with 280 physicians about patient handouts and chart inserts. The aim was to solicit feedback from physicians on educational materials for patients that could be inserted in charts ready for their next visits. The materials included drug price information and drug risk/benefit summaries.

  • Feedback on the materials was positive, providing that the messages were kept clear and simple.
  • 70% of physicians surveyed indicated that they would refer to the pricing information when prescribing.

Research from BC and other jurisdictions suggests that providing BC physicians with targeted education, prescribing feedback and appropriate incentives to optimize prescribing could result in substantial savings. The Education for Quality Improvement in Patient Care program, called EQIP, was established in 2006 to explore this opportunity.