Patterns and predictors of physician adoption of new cardiovascular drugs.
Patterns and predictors of physician adoption of new cardiovascular drugs.
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DOI：
10.1016/j.hjdsi.2017.09.004
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发表时间：
2018-03
期刊：
影响因子：
--
通讯作者：
Donohue JM
中科院分区：
文献类型：
--
作者：
Anderson TS;Lo-Ciganic WH;Gellad WF;Zhang R;Huskamp HA;Choudhry NK;Chang CH;Richards-Shubik S;Guclu H;Jones B;Donohue JM
关于医生采用新的心血管药物的方法以及不同新奇药物之间的采用情况如何，我们知之甚少。使用IMS Health的Xponent™数据库中的处方数据，我们创建了一个由宾夕法尼亚州所有初级保健医生（PCP）和心脏病专家组成的队列，他们在2007年至2011年期间定期处方抗凝剂，降压药和他汀类药物。我们检查了三种新奇不同的新型心血管药物的处方：达比加群、阿利吉伦和匹伐他汀。结果是每种新药的快速采用，由基于组的轨迹模型检测到的早期和持续的每月处方定义，由医生在市场推出的前15个月内。5，953名医生定期处方每类药物。大多数医生（63.8%）在前15个月采用了零种新药，35.0%的医生迅速采用了一种或两种新药，1.2%的医生迅速采用了所有三种新药。与阿利吉仑（10.5%）或匹伐他汀（8.0%）相比，医生更有可能迅速采用最新的药物达比加群（27.3%）。医生专业和性别是最一致的预测收养。与PCP相比，心脏病专家更有可能快速采用达比加群（调整后比值比8.90，95%置信区间7.42-10.67; P<0.001）、阿利克林（2.05，CI 1.56 - 2.69; P<0.001）和匹伐他汀（3.44，CI 2.60-4.57; P<0.001）。女性医生不太可能采用达比加群（0.71，CI 0.59-0.85; P <0.001）和阿利吉仑（0.64，CI 0.49-0.83; P <0.001）。医生们对最近推出的心血管药物的处方各不相同。虽然大多数医生没有迅速采用任何新的心血管药物，药物的新奇和心脏病学的培训与更大的采用。
Little is known about physicians’ approaches to adopting new cardiovascular drugs and how adoption varies between drugs of differing novelty. Using data on dispensed prescriptions from IMS Health’s Xponent™ database, we created a cohort of all primary care physicians (PCPs) and cardiologists in Pennsylvania who regularly prescribed anticoagulants, antihypertensives and statins from 2007 to 2011. We examined prescribing of three new cardiovascular drugs of differing novelty: dabigatran, aliskiren and pitavastatin. Outcomes were rapid adoption of each new drug, defined by early and sustained monthly prescribing detected by group-based trajectory models, by physicians within the first 15 months of marketplace introduction. 5,953 physicians regularly prescribed each drug class. The majority of physicians (63.8%) adopted zero new drugs in the first 15 months, 35.0% rapidly adopted one or two, and 1.2% rapidly adopted all three. Physicians were more likely to rapidly adopt the most novel drug, dabigatran (27.3%), than aliskiren (10.5%) or pitavastatin (8.0%). Physician specialty and sex were the most consistent predictors of adoption. Compared to PCPs, cardiologists were more likely to rapidly adopt dabigatran (Adjusted Odds Ratio 8.90, 95% confidence interval 7.42–10.67; P<0.001) aliskerin (2.05, CI 1.56 to 2.69; P<0.001) and pitavastatin (3.44, CI 2.60–4.57; P<0.001). Female physicians were less likely to adopt dabigatran (0.71, CI 0.59–0.85; P <0.001) and aliskiren (0.64, CI 0.49–0.83; P <0.001). Physicians vary in their prescribing of recently-introduced cardiovascular drugs. Though most physicians did not rapidly adopt any new cardiovascular drugs, drug novelty and cardiology training were associated with greater adoption.
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影响因子：
5.7
作者：
Ryskina, Kira L.;Dine, C. Jessica;Epstein, Andrew J.
通讯作者：
Epstein, Andrew J.
DOI：
10.1176/appi.ps.201200186
发表时间：
2013-04-01
期刊：
Psychiatric services (Washington, D.C.)
影响因子：
--
作者：
Huskamp HA;O'Malley AJ;Horvitz-Lennon M;Taub AL;Berndt ER;Donohue JM
通讯作者：
Donohue JM
影响因子：
37.8
作者：
Mosca, L;Linfante, AH;Simpson, SL
通讯作者：
Simpson, SL
影响因子：
39.2
作者：
Alexander, G. Caleb;O'Connor, Alec B.;Stafford, Randall S.
通讯作者：
Stafford, Randall S.
影响因子：
3
作者：
BENSING, JM;VANDENBRINKMUINEN, A;DEBAKKER, DH
通讯作者：
DEBAKKER, DH