{"title":"2022年在加拿大实施新冠病毒抗病毒治疗Nirmatrelvir/Ritonavir (PaxlovidTM)：关键促进因素和挑战的定性分析","authors":"Aklile Workneh, Camilia Thieba, Nadine Sicard","doi":"10.14745/ccdr.v51i08a03","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 antiviral Nirmatrelvir/Ritonavir (Paxlovid<sup>TM</sup>, N/R) was approved for use in Canada in January 2022, with the Government of Canada assuming a procurement role and provinces, territories, and federal departments implementing usage within their respective healthcare systems. The objective of this analysis is to describe how N/R was implemented across various jurisdictions in the first six months after it was available for use and identify promising implementation practices.</p><p><strong>Methods: </strong>Fourteen semi-structured discussions in small group settings were conducted with jurisdictional representatives involved in the implementation of N/R. A descriptive analysis of the eligibility criteria and service delivery model was conducted. A thematic analysis using the Consolidated Framework for Implementation Research and cluster analysis of the codes were then undertaken on NVivo 12 to identify key themes.</p><p><strong>Results: </strong>Overall, the eligibility criteria were similar across jurisdictions, and three types of service delivery models were identified. Ten main themes emerged as facilitators and eight as challenges to the implementation. Partnership, collaboration, communication and flexibility were among the facilitators identified, while the complexity of the intervention (e.g., drug-drug interactions), perceived evidence gaps in effectiveness by prescribers, and resource limitations were identified as key implementation challenges.</p><p><strong>Conclusion: </strong>While there were jurisdictional variations in the implementation of N/R, communication and collaboration, and the availability of rapid testing for COVID-19 emerged as key facilitators. Drug-drug interactions, resource pressures and limited evidence were some of the key challenges. Overall, these facilitators and challenges were similar across jurisdictions and may help inform future therapeutic implementation plans for pandemic preparedness.</p>","PeriodicalId":94304,"journal":{"name":"Canada communicable disease report = Releve des maladies transmissibles au Canada","volume":"51 8","pages":"303-311"},"PeriodicalIF":0.0000,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410835/pdf/","citationCount":"0","resultStr":"{\"title\":\"Implementation of the COVID-19 antiviral therapy Nirmatrelvir/Ritonavir (Paxlovid<sup>TM</sup>) across Canada in 2022: A qualitative analysis of key facilitating factors and challenges.\",\"authors\":\"Aklile Workneh, Camilia Thieba, Nadine Sicard\",\"doi\":\"10.14745/ccdr.v51i08a03\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The COVID-19 antiviral Nirmatrelvir/Ritonavir (Paxlovid<sup>TM</sup>, N/R) was approved for use in Canada in January 2022, with the Government of Canada assuming a procurement role and provinces, territories, and federal departments implementing usage within their respective healthcare systems. The objective of this analysis is to describe how N/R was implemented across various jurisdictions in the first six months after it was available for use and identify promising implementation practices.</p><p><strong>Methods: </strong>Fourteen semi-structured discussions in small group settings were conducted with jurisdictional representatives involved in the implementation of N/R. A descriptive analysis of the eligibility criteria and service delivery model was conducted. A thematic analysis using the Consolidated Framework for Implementation Research and cluster analysis of the codes were then undertaken on NVivo 12 to identify key themes.</p><p><strong>Results: </strong>Overall, the eligibility criteria were similar across jurisdictions, and three types of service delivery models were identified. Ten main themes emerged as facilitators and eight as challenges to the implementation. Partnership, collaboration, communication and flexibility were among the facilitators identified, while the complexity of the intervention (e.g., drug-drug interactions), perceived evidence gaps in effectiveness by prescribers, and resource limitations were identified as key implementation challenges.</p><p><strong>Conclusion: </strong>While there were jurisdictional variations in the implementation of N/R, communication and collaboration, and the availability of rapid testing for COVID-19 emerged as key facilitators. Drug-drug interactions, resource pressures and limited evidence were some of the key challenges. Overall, these facilitators and challenges were similar across jurisdictions and may help inform future therapeutic implementation plans for pandemic preparedness.</p>\",\"PeriodicalId\":94304,\"journal\":{\"name\":\"Canada communicable disease report = Releve des maladies transmissibles au Canada\",\"volume\":\"51 8\",\"pages\":\"303-311\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-08-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410835/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Canada communicable disease report = Releve des maladies transmissibles au Canada\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14745/ccdr.v51i08a03\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/8/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canada communicable disease report = Releve des maladies transmissibles au Canada","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14745/ccdr.v51i08a03","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
Implementation of the COVID-19 antiviral therapy Nirmatrelvir/Ritonavir (PaxlovidTM) across Canada in 2022: A qualitative analysis of key facilitating factors and challenges.
Background: The COVID-19 antiviral Nirmatrelvir/Ritonavir (PaxlovidTM, N/R) was approved for use in Canada in January 2022, with the Government of Canada assuming a procurement role and provinces, territories, and federal departments implementing usage within their respective healthcare systems. The objective of this analysis is to describe how N/R was implemented across various jurisdictions in the first six months after it was available for use and identify promising implementation practices.
Methods: Fourteen semi-structured discussions in small group settings were conducted with jurisdictional representatives involved in the implementation of N/R. A descriptive analysis of the eligibility criteria and service delivery model was conducted. A thematic analysis using the Consolidated Framework for Implementation Research and cluster analysis of the codes were then undertaken on NVivo 12 to identify key themes.
Results: Overall, the eligibility criteria were similar across jurisdictions, and three types of service delivery models were identified. Ten main themes emerged as facilitators and eight as challenges to the implementation. Partnership, collaboration, communication and flexibility were among the facilitators identified, while the complexity of the intervention (e.g., drug-drug interactions), perceived evidence gaps in effectiveness by prescribers, and resource limitations were identified as key implementation challenges.
Conclusion: While there were jurisdictional variations in the implementation of N/R, communication and collaboration, and the availability of rapid testing for COVID-19 emerged as key facilitators. Drug-drug interactions, resource pressures and limited evidence were some of the key challenges. Overall, these facilitators and challenges were similar across jurisdictions and may help inform future therapeutic implementation plans for pandemic preparedness.
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