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dc.contributor.authorPersaud, Nav
dc.contributor.authorLee, Taehoon
dc.contributor.authorAhmad, Haroon
dc.contributor.authorLi, Winny
dc.contributor.authorTaglione, Michael Sergio
dc.contributor.authorRajakulasingam, Yathavan
dc.contributor.authorUmali, Norman
dc.contributor.authorBoozary, Andrew
dc.contributor.authorGlazier, Richard H
dc.contributor.authorGomes, Tara
dc.contributor.authorHwang, Stephen W
dc.contributor.authorJüni, Peter
dc.contributor.authorLaw, Michael
dc.contributor.authorMamdani, Muhammad M
dc.contributor.authorManns, Braden
dc.contributor.authorMartin, Danielle
dc.contributor.authorMorgan, Steve
dc.contributor.authorOh, Paul
dc.contributor.authorPinto, Andrew David
dc.contributor.authorShah, Baiju R
dc.contributor.authorSullivan, Frank M.
dc.contributor.authorThorpe, Kevin E
dc.contributor.authorTu, Karen
dc.contributor.authorLaupacis, Andreas
dc.identifier.citationPersaud , N , Lee , T , Ahmad , H , Li , W , Taglione , M S , Rajakulasingam , Y , Umali , N , Boozary , A , Glazier , R H , Gomes , T , Hwang , S W , Jüni , P , Law , M , Mamdani , M M , Manns , B , Martin , D , Morgan , S , Oh , P , Pinto , A D , Shah , B R , Sullivan , F M , Thorpe , K E , Tu , K & Laupacis , A 2017 , ' Protocol for a randomised controlled trial evaluating the effects of providing essential medicines at no charge : the Carefully seLected and Easily Accessible at No Charge Medicines (CLEAN Meds) trial ' , BMJ Open , vol. 7 , no. 5 , e015686 .
dc.identifier.otherPURE: 250237738
dc.identifier.otherPURE UUID: 90178f70-439d-4700-bc23-4d51be081c9d
dc.identifier.otherPubMed: 28611089
dc.identifier.otherScopus: 85020488476
dc.identifier.otherORCID: /0000-0002-6623-4964/work/34245813
dc.descriptionNP, RHG and ADP were supported as Clinician Scientists by the Department of Family and Community Medicine at the University of Toronto and at St Michael's Hospital. NP is supported by a fellowship from Physicians Services Incorporated Foundation. KT was supported as a Clinician Scientist by the Department of Family and Community Medicine at the University of Toronto and at Toronto Western Hospital. ML received salary support through a Canada Research Chair and a Michael Smith Foundation for Health Research Scholar Award.en
dc.description.abstractIntroduction : Cost-related non-adherence to medicines is common in low-income, middle-income and high-income countries such as Canada. Medicine non-adherence is associated with poor health outcomes and increased mortality. This randomised trial will test the impact of a carefully selected list of essential medicines at no charge (compared with usual medicine access) in primary care patients reporting cost-related non-adherence. Methods and analysis : This is an open-label, parallel two-arm, superiority, individually randomised controlled trial conducted in three primary care sites (one urban, two rural) in Ontario, Canada, that was codesigned by a community guidance panel. Adult patients (≥18 years) who report cost-related non-adherence to medicines are eligible to participate in the study. Participants will be randomised to receive free and convenient access to a carefully selected list of 125 essential medicines (based on the WHO's Model List of Essential Medicines) or usual means of medicine access. Care for patients in both groups will otherwise be unchanged. The primary outcome of this trial is adherence to appropriately prescribed medicines. Secondary outcomes include medicine adherence, appropriate prescribing, blood pressure, haemoglobin A1c, low-density lipoprotein cholesterol, patient-oriented outcomes and healthcare costs. All participants will be followed for at least 12 months. Ethics and dissemination : Ethics approval was obtained in all three participating sites. Results of the main trial and secondary outcomes will be submitted for publication in a peer-reviewed journal and discussed with members of the public and decision makers. Trial registration number : NCT02744963.
dc.relation.ispartofBMJ Openen
dc.rights© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
dc.subjectRA0421 Public health. Hygiene. Preventive Medicineen
dc.subjectSDG 3 - Good Health and Well-beingen
dc.titleProtocol for a randomised controlled trial evaluating the effects of providing essential medicines at no charge : the Carefully seLected and Easily Accessible at No Charge Medicines (CLEAN Meds) trialen
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.description.statusPeer revieweden

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