Medication management: Perceptions and opinions of Canadian hospital executives

Background: Issues relating to access to new medications, medication safety, and the quality of medication use are important to many Canadian hospital executives and managers. Objective: To obtain the opinions of hospital executives and managers about medication management issues. Methods: A survey instrument was developed and pilot-tested with input from key informant interviews and the Canadian College of Health Service Executives (CCHSE). The survey was sent by e-mail and regular mail to a randomized stratified sample from the CCHSE membership of 250 middle managers and 250 executives at the CEO or vice-president level. The responses to the survey questions and underlying themes from respondents' comments were analyzed using multivariate statistical techniques and content analysis. The results of these analyses are reported in relation to respondents' demographic characteristics. Results: In total, 272 (56.1%) of the 485 surveys delivered were completed and returned. The respondents reported that changes in physician prescribing habits constituted the most important factor influencing demand for pharmaceuticals. The pharmacy department of the respondent's organization was listed as the top source of information about medications, and clinical practice guidelines and disease management programs were chosen as the top 2 methods to optimize the use of pharmaceuticals. Respondents considered appropriateness of drug use, medication errors, and proper drug utilization as the drug-related issues with the highest perceived importance. About 58% of respondents felt that their organizations were getting value for the money spent on drugs. Conclusions: This study provided insight into the perceptions of Canadian hospital executives and managers related to one of the most important issues that they face today - management of pharmaceuticals. There was remarkable consistency in responses across the demographic variables included in the survey. Further work is needed to determine the type of education related to medication management that executives and managers need, suitable methods for providing that education and the career stages at which it is appropriate to do so.