학술논문

Adoption of new medicines in primary care: A comparison between the uptake of new oral anticoagulants and diabetes medicines.
Document Type
Article
Source
British Journal of Clinical Pharmacology. Mar2024, Vol. 90 Issue 3, p819-827. 9p.
Subject
*ORAL medication
*ANTICOAGULANTS
*HYPOGLYCEMIC agents
*INTRACLASS correlation
*PRIMARY care
*MULTILEVEL models
*DRUGS
*REGRESSION analysis
Language
ISSN
0306-5251
Abstract
Aims: To gain insight in the uptake and practice variation in the prescription of 2 new medicine groups for common conditions in primary care (direct‐acting oral anticoagulants [DOACs] and incretin‐based therapies) from introduction, around 2007, to 2019 and the correlation between the adoption of those medicines in primary care. Methods: Prescription data from general practices in the Dutch Nivel Primary Care Database from 2007 to 2019 were used. The percentage of patients with prescriptions for DOACs of all patients with prescriptions for DOACs and vitamin K antagonists was calculated per practice per year, as was the percentage of patients prescribed incretin‐based therapies as a proportion of all patients with diabetes medication. Multilevel models were used to estimate practice variation for DOACs and incretin‐based therapies, expressed as intraclass correlation coefficients. Linear regression analysis was used to study the association between the prescription of DOACs and incretin‐based therapies. Results: Per year, 46–424 general practices and 179 933–1 654 376 patients were included. In 2019, the mean percentage of patients per practice using DOACs or incretin‐based therapies was 54.9 and 9.7%, respectively. The intraclass correlation coefficient decreased from 0.75 to 0.024 for DOACs and from 0.33 to 0.074 for incretin‐based medicines during the study period. No clear correlation was found between the prescription of DOACs and incretin‐based therapies. Conclusion: DOACs and incretin‐based therapies have different adoption profiles and practice variation is large, especially in the years before these medicines were introduced in guidelines. Early adopters of both medicine classes differ. [ABSTRACT FROM AUTHOR]