Document Detail


How quickly do physicians adopt new drugs? The case of second-generation antipsychotics.
MedLine Citation:
PMID:  23280376     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The authors examined physician adoption of second-generation antipsychotic medications and identified physician-level factors associated with early adoption.
METHODS: The authors estimated Cox proportional-hazards models of time to adoption of nine second-generation antipsychotics by 30,369 physicians who prescribed antipsychotics between 1996 and 2008, when the drugs were first introduced, and analyzed the total number of agents prescribed during that time. The models were adjusted for physicians' specialty, demographic characteristics, education and training, practice setting, and prescribing volume. Data were from IMS Xponent, which captures over 70% of all prescriptions filled in the United States, and the American Medical Association Physician Masterfile.
RESULTS: On average, physicians waited two or more years before prescribing new second-generation antipsychotics, but there was substantial heterogeneity across products in time to adoption. General practitioners were much slower than psychiatrists to adopt second-generation antipsychotics (hazard ratios (HRs) range .10-.35), and solo practitioners were slower than group practitioners to adopt most products (HR range .77-.89). Physicians with the highest antipsychotic-prescribing volume adopted second-generation antipsychotics much faster than physicians with the lowest volume (HR range .15-.39). Psychiatrists tended to prescribe a broader set of antipsychotics (median=6) than general practitioners and neurologists (median=2) and pediatricians (median=1).
CONCLUSIONS: As policy makers search for ways to control rapid health spending growth, understanding the factors that influence physician adoption of new medications will be crucial in the efforts to maximize the value of care received by individuals with mental disorders as well as to improve medication safety.
Authors:
Haiden A Huskamp; A James O'Malley; Marcela Horvitz-Lennon; Anna Levine Taub; Ernst R Berndt; Julie M Donohue
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Psychiatric services (Washington, D.C.)     Volume:  64     ISSN:  1557-9700     ISO Abbreviation:  Psychiatr Serv     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-04-01     Completed Date:  2013-09-20     Revised Date:  2014-04-02    
Medline Journal Info:
Nlm Unique ID:  9502838     Medline TA:  Psychiatr Serv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  324-30     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Antipsychotic Agents / therapeutic use*
Drug Utilization
Female
General Practice / methods
Group Practice
Humans
Male
Middle Aged
Neurology / methods
Pediatrics / methods
Physician's Practice Patterns / statistics & numerical data*
Proportional Hazards Models
Psychiatry / methods
Retrospective Studies
Time Factors
United States
Grant Support
ID/Acronym/Agency:
P30 MH090333/MH/NIMH NIH HHS; R01 MH087488/MH/NIMH NIH HHS; R01 MH093359/MH/NIMH NIH HHS; R01 MH093359/MH/NIMH NIH HHS; R01HS017695/HS/AHRQ HHS; R34 MH082682/MH/NIMH NIH HHS
Chemical
Reg. No./Substance:
0/Antipsychotic Agents
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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