Kozyrskyj Anita, Raymond Colette, Racher Amber
Faculty of Pharmacy and Medicine, Department of Community Health Sciences and Pediatrics and Child Health, Manitoba Centre for Health Policy, University of Manitoba, 210 Pharmacy Bldg, Winnipeg, MB, Canada.
Eur J Clin Pharmacol. 2007 Jun;63(6):597-604. doi: 10.1007/s00228-007-0277-5. Epub 2007 Mar 23.
The diffusion of innovations model proposes that early adopters of innovation influence others. This study was undertaken to determine if early prescribers and users of newly marketed drugs had different sociodemographic and professional characteristics as compared to majority and late users and prescribers.
After market availability in Manitoba, Canada, of celecoxib, alendronate, clopiodogrel and pantoprazole, time to first prescriptions was determined. Early, majority and late adopters of the new drug were characterized by this diffusion time. The prescription, health and prescriber records were compared across adopter categories. The likelihood of being an early or late prescriber or user of the new medications according to patient demographic characteristics, physician factors (specialty and place of training) and neighborhood income was determined with polytomous logistic regression.
Celecoxib demonstrated a much more rapid uptake into routine use than the other drugs. More than 300 Manitoba physicians prescribed celecoxib within two weeks of market availability. Early prescribers of celecoxib were more likely than majority prescribers to be general practitioners (OR = 1.81, 95%CI: 1.40-2.35) and have hospital affiliations (OR = 1.35, 95%CI: 1.03-1.77). Early users of celecoxib were more likely than the majority to have arthritic conditions, have a high income and have paid out-of-pocket for their prescription. For alendronate, clopidogrel and pantoprazole, only prescription drug coverage predicted adopter category. Early prescribers of one new drug were not early prescribers of the other new drugs.
No common group of patients or physicians who were early prescribers or users of all four medications was described.
创新扩散模型提出,创新的早期采用者会影响他人。本研究旨在确定新上市药物的早期开处方者和使用者与大多数使用者及开处方者以及晚期使用者和开处方者相比,是否具有不同的社会人口统计学和专业特征。
在加拿大曼尼托巴省塞来昔布、阿仑膦酸盐、氯吡格雷和泮托拉唑上市后,确定首次处方时间。通过这种扩散时间来界定新药的早期、大多数和晚期采用者。对不同采用者类别之间的处方、健康和开处方者记录进行比较。采用多分类逻辑回归确定根据患者人口统计学特征、医生因素(专业和培训地点)以及社区收入成为新药早期或晚期开处方者或使用者的可能性。
与其他药物相比,塞来昔布进入常规使用的速度要快得多。超过300名曼尼托巴省的医生在该药上市两周内就开出了塞来昔布的处方。塞来昔布的早期开处方者比大多数开处方者更有可能是全科医生(比值比=1.81,95%置信区间:1.40-2.35),并且隶属于医院(比值比=1.35,95%置信区间:1.03-1.77)。塞来昔布的早期使用者比大多数使用者更有可能患有关节炎、收入高且自掏腰包支付处方费用。对于阿仑膦酸盐、氯吡格雷和泮托拉唑,只有处方药保险能预测采用者类别。一种新药的早期开处方者并非其他新药的早期开处方者。
未发现同时是所有四种药物早期开处方者或使用者的共同患者群体或医生群体。