Background: Translating evidence into clinical knowledge and improved health is challenging. A collective impact approach, bringing together stakeholders through common goals, deploying mutually reinforcing activities and shared measurement systems, provides a framework for more effective translation. The Targeted Therapies Alliance (TTA) designed, developed and implemented a national program in Australia to improve the quality use of biological medicines using a collective impact approach to achieve better health outcomes for people with inflammatory arthritis, inflammatory bowel disease and psoriasis. The TTA included nine member organisations and four affiliate organisations representing consumer and clinical audiences, program development expertise and implementation capability.
Objectives: Program objectives were to optimise (1) first-line disease-modifying antirheumatic drug (DMARD) therapy; (2) first-choice biologic; (3) biosimilar prescribing and dispensing; (4) biologic dosage; and (5) glucocorticoid and analgesic use.
Methods: Steps included (1) consortium development with key stakeholders; (2) research and review of practice/behavioural drivers; (3) using behavioural change theory and implementation science to codesign program objectives, key messages and strategy; (4) development and testing interventions with audiences; and (5) promotion of interventions via consortium channels.
Results: Seventy interventions supporting key messages were implemented between September 2020 and September 2022 for consumers, rheumatologists, gastroenterologists, dermatologists, immunologists, pharmacists, nurses and hospital/jurisdictional decision-makers. They were applicable to specialist practices, private and public hospitals, hospital and community pharmacies, consumers in these settings and wherever self-management occurred. All resources were available from a dedicated hub (www.nps.org.au/bdmards) with links to TTA member websites, and vice versa. Endorsed national living guidelines were an engagement point for the rheumatology program addressing priority questions for rheumatologists and providing the basis for developing interventions for health professionals and consumers. Positive impacts on knowledge, confidence and practice/behaviour were seen across all therapeutic areas, despite already high levels of knowledge and practice in some areas. Outcome evaluation should be performed in 2025, ~24 months after program implementation.
Conclusions: The consortium-based approach provided a collaborative model for developing a multifaceted program addressing multiple perspectives to optimise DMARD use.
Patient, public and/or healthcare consumer involvement: Consumers were partners in all stages: governance, research, program design, intervention design, testing, implementation and evaluation.