Abstract
Objective
To analyse associations between indicators for adoption of new drugs and to test the hypothesis that physicians’ early adoption of new drugs is a personal trait independent of drug groups.
Methods
In a population-based cohort study using register data, we analysed the prescribing of new drugs by Danish general practitioners. Angiotensin-II antagonists, triptans, selective cyclo-oxygenase-2 antagonists and esomeprazol were used in the assessment. As indicators of new drug uptake, we used adoption time, cumulative incidence, preference proportion, incidence rate and prescription cost and volume. For each measure, we ranked the general practices. Ranks were pair-wise plotted, and Pearson’s correlation coefficient (r) was calculated. Next, we analysed the correlation between ranks across different drug classes.
Results
For all indicators, the general practitioners’ adoption of one group of drugs was poorly associated with adoption of others (r≤0.49), indicating that early adoption of one type of drugs is not associated with early adoption of another. For all drug groups, adoption time adjusted for practice size was only weakly associated with other indicators (r: −0.56 to −0.27). Indicators, based on cost and volume of drugs, were highly correlated (r: 0.96–0.99), and the others correlated reasonably well (r: 0.51–0.91).
Conclusions
Within drug groups, indicators of drug adoption, except for adoption time, correlate reasonably well. However, the theory that physicians’ early adoption of new drugs is a personal trait independent of the type of drug could not be confirmed. The notion of the early-drug-adopting general practitioner may be mistaken.
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References
Department of Health (2003) Delivering the NHS plan—expenditure report. Department of Health publications, London
The National Institute for Health Care Management Research and Educational Foundation (2001) Prescription drug expenditure 2000: the upward trend continues. The Institute, Washington, DC
The National Institute for Health Care Management Research and Educational Foundation (2002) Changing patterns of pharmaceutical innovation. The Institute, Washington DC
Pearson SA, Ross-Degnan D, Payson A, Soumerai SB (2003) Changing medication use in managed care: a critical review of the available evidence. Am J Manag Care 9(11):715–731
NHS Centre for Reviews and Dissemination (1999) Getting evidence into practice. Effective Health Care, University of York, York
Granados A, Jonsson E, Banta HD, Bero L, Bonair A, Cochet C et al (1997) EUR-ASSESS project subgroup report on dissemination and impact. Int J Technol Assess Health Care 13(2):220–286
Rogers EM (1995) Diffusion of innovations. The Free Press, New York
Coleman JS, Katz E, Menzel H (1966) Medical innovation: a diffusion study. The Bobbs-Merrill Co., Indianapolis
Lomas J (1994) Teaching old (and not so old) Docs new tricks: effective ways to implement research findings. In: Dunn EV et al (eds) Disseminating new knowledge and having an impact on practice. Sage Publication, Newbury Park
Haines A, Donald A (1998) Making better use of research findings. BMJ 317:72–75
Groves KEM, Fanagan PS, MacKinnon NJ (2002) Why physicians start or stop prescribing a drug: literature review and formulary implications. Formulary 37:186–194
DeCherney GS (1999) Accelerating acceptance. Physician Exec 25:32–38
Moulding NT, Silagy CA, Weller DP (1999) A framework for effective management of change in clinical practice: dissemination and implementation of clinical practice guidelines. Qual Health Care 8:177–183
Steffensen FH, Sorensen HT, Olesen F (1999) Diffusion of new drugs in Danish general practice. Fam Pract 16:407–413
Gaist D, Sorensen HT, Hallas J (1997) The Danish prescription registries. Dan Med Bull 44:445–448
WHO Collaborating Centre for Drug Statistics Methodology (2002) Guidelines for ATC classification and DDD assignment. WHO Collaborating Centre, Oslo
Hosmer DW, Lemeshow S (1999) Applied survival analysis: regression modelling of time to event data. Wiley, New York
Sondergaard J, Andersen M, Vach K, Kragsrup J, Maclure M, Gram LF (2002) Detailed postal feedback about prescribing to asthma patients combined with a guideline statement showed no impact: a randomised controlled trial. Eur J Clin Pharmacol 58:127–132
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An erratum to this article can be found at http://dx.doi.org/10.1007/s00228-005-0899-4
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Dybdahl, T., Andersen, M., Søndergaard, J. et al. Does the early adopter of drugs exist? A population-based study of general practitioners’ prescribing of new drugs. Eur J Clin Pharmacol 60, 667–672 (2004). https://doi.org/10.1007/s00228-004-0797-1
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DOI: https://doi.org/10.1007/s00228-004-0797-1