Market penetration of new drugs in one United Kingdom region: implications for general practitioners and administrators.

McGavock, Hugh; Webb, C H; Johnston, G. D.; Milligan, Eleanor

doi:10.1136/bmj.307.6912.1118

Cited by 50 publications

(24 citation statements)

References 9 publications

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“…20,26 While the prescription of -blockers for heart failure patients has steadily increased since 1996, their use in primary care is still low. Since many CHF patients have coexisting cardiovascular conditions such as hypertension or myocardial infarction for which -blockers are also indicated, 23,24 it is possible that -blockers prescribed to the CHF patients in this study were actually for the treatment of comorbid conditions rather than for CHF. One factor contributing to the slow adoption of the new clinical trial evidence for -blockers is that these have traditionally been contraindicated for use in heart failure patients.…”

Section: Discussionmentioning

confidence: 99%

Trends in prescribing for heart failure in Dutch primary care from 1996 to 2000

Pont

Sturkenboom²,

Gilst

et al. 2003

Pharmacoepidemiology and Drug

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SUMMARYPurpose The aim of this study is to explore trends in primary care prescribing for chronic heart failure (CHF) over a 5-year period (1996)(1997)(1998)(1999)(2000). Methods This study consisted of repeated cross-sectional surveys in a dynamic cohort from the Integrated Primary Care Information (IPCI) primary care database. The cohort comprised all patients aged ! 55 years with a CHF diagnosis and prescribed a cardiovascular medication during the study period. The point prevalence per calendar year was determined for each of the main drug groups used to treat CHF. Results The study population consisted of 3121 CHF patients. Small increases were seen in the percentage of CHF patients prescribed spironolactone (4.6%, 95% CI: 2.3-6.9%), -blockers (6.1%, 95% CI: 2.6-9.5%) and angiotensin II antagonists (6.8%, 95% CI: 5.1-8.6%) during the study period, while the prescribing of digoxin decreased (À4.4%, 95% CI: À8.2 to À0.7). Prescribing of diuretics (difference: À0.7% 95% CI: À2.7-4.2) and ACE inhibitors (difference: 4.0% 95% CI: À0.1-8.2%) remained unchanged. Conclusions Prescription of some drug groups for CHF increased. However, given the new scientific evidence that has emerged in past 15 years regarding CHF pharmacotherapy, the changes observed were less than expected.

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Section: Discussionmentioning

confidence: 99%

Trends in prescribing for heart failure in Dutch primary care from 1996 to 2000

Pont

Sturkenboom²,

Gilst

et al. 2003

Pharmacoepidemiology and Drug

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“…Despite efforts to promote rational prescription, worldwide examples of inappropriate use of medicines have been repeatedly documented (e.g., despite knowing the risk factors that predispose to NSAIDs-induced gastric toxicity, omeprazol+NSAIDs continue to be compulsively prescribed even in young patients without risk factors [10,11]; frequently antihypertensive drugs are the only therapeutic approach offered without any attempts to modify the patient's lifestyle [12]; or old well-known useful medicines tend to be traded for newly marketed and less evaluated medicines, even without them having shown superiority when compared with the older ones [13,14]). …”

Section: Disappointing Realitymentioning

confidence: 99%

The use of drugs is not as rational as we believe… but it can’t be! The emotional roots of prescribing

Figueras

2011

Eur J Clin Pharmacol

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“…Adoption rates of new drugs vary among physicians and by type of drug (Dybdahl, Andersen, Sondergaard, Kragstrup, & Kristiansen, 2004;Inman & Pearce, 1993;McGavock, Webb, Johnston, & Milligan, 1993;Steffensen, Sorensen, & Olesen, 1999;Tamblyn, McLeod, Hanley, Girard, & Hurley, 2003). The adoption of new treatments in clinical practice is the result of many factors.…”

Section: Introductionmentioning

confidence: 99%

Determinants for the adoption of angiotensin II receptor blockers by general practitioners

Greving

Denig

Veen

et al. 2006

Social Science & Medicine

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Results of studies conducted 10-20 years ago show the prominence of commercial information sources in the adoption process of new drugs. Over the past decade, there has been a growing emphasis on practicing evidence-based medicine in drug prescribing. This raises the question whether professional information sources currently counterbalance the influence of commercial information sources in the adoption process. The aim of this study was to identify determinants influencing the adoption of a new drug class, the angiotensin II receptor blockers (ARBs), by general practitioners (GPs) in The Netherlands. A retrospective study was conducted to assess prevalent ARB prescribing for hypertensive patients using the Integrated Primary Care Information (IPCI) database. We conducted a survey among all GPs who participated in the IPCI project in 2003 to assess their exposure to commercial and professional information sources, perceived benefits and risks of ARBs, perceived influences of the professional network, and general characteristics. Multilevel logistic regression was applied to identify determinants of ARB adoption while adjusting for patient characteristics. Data were obtained from 70 GPs and 9470 treated hypertensive patients. A total of 1093 patients received ARBs (12%). GPs who reported frequent use of commercial information sources were more likely to prescribe ARBs routinely in preference to other antihypertensives, whereas GPs who used a prescribing decision support system and those who were involved in pharmacotherapy education were less likely to prescribe ARBs. Other factors that were associated with higher levels of ARB adoption included a more positive perception of ARBs regarding their effectiveness in lowering blood pressure, and working in single-handed practices or in rural areas. Aside from determinants related to the patient population, adoption of a new drug class among Dutch GPs is still determined more by their reliance on promotional information than by their use of professional information sources. r

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Market penetration of new drugs in one United Kingdom region: implications for general practitioners and administrators.

Abstract: Objective-To determine the use of new drugs in one United Kingdom region.

Cited by 50 publications

References 9 publications

Trends in prescribing for heart failure in Dutch primary care from 1996 to 2000

Trends in prescribing for heart failure in Dutch primary care from 1996 to 2000

The use of drugs is not as rational as we believe… but it can’t be! The emotional roots of prescribing

Determinants for the adoption of angiotensin II receptor blockers by general practitioners

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