Abstract:
BACKGROUND AND OBJECTIVE:The uptake of new medicines is slower in the UK than in many other countries. Previous research found that cost and price have little influence on general practitioner (GP) behaviour, but recent UK government policy may have heightened cost-consciousness. Focussing on new medicines, this review aimed to explore the determinants of uptake, the causes of geographical variations, and the influence of price, cost and financial incentives on prescribing behaviour. METHODS:Two separate searches were conducted on nine electronic databases. Strategy 1, an update of a previous review, used key terms for primary care physicians, uptake, medicines and 'new'. Strategy 2 focussed on terms relating to incentives and prescribing. Records were screened for eligibility and data from relevant papers were extracted using Bonair and Persson's typology for determinants of the diffusion of innovation, which classified influences into three groups: actors, structural/environmental characteristics and product characteristics. RESULTS:The searches identified 550 records and 28 studies were included in the updated review. Prescribing of new medicines needs to be understood in the context of individual patient-centred care, which is characterized by stability and continuity. Hospital doctors, pharmaceutical representatives and prescribing advisers are all influential, but GP attitudes towards these actors vary and there are notable differences between high and low prescribers of new pharmaceuticals. Support systems can help provide appropriate guidance and increase the uptake of new medicines by identifying patients who may benefit from pharmaceutical therapy. There is evidence of a shift in GP attitudes towards central policy initiatives, with doctors slowly accepting the need for external scrutiny and national standards. Although cost does appear to inform prescribing decisions, it is typically of lower importance than both safety and efficacy concerns and does not represent a significant barrier to uptake of new medicines. The impact of financial incentives on prescribing behaviour remains unclear, but is unlikely to be straightforward. No evidence exploring the reasons for geographical variations in GP uptake of new medicines was found. CONCLUSION:General practitioner care has historically been patient-centred, and it is unclear whether and how GPs consider the impact of their decisions upon the wider patient population. Incorporating cost considerations into GP decision making is one way to reflect the broader impact of individual treatment decisions. Current UK government policies use incentives to improve quality and encourage financial responsibility. Although these initiatives may help foster cost-consciousness, there is a risk that unintended consequences may ensue. Therefore, future policy evaluations should assess benefits, harms and costs so that the overall impact is transparent.
journal_name
J Clin Pharm Therjournal_title
Journal of clinical pharmacy and therapeuticsauthors
Mason Adoi
10.1111/j.1365-2710.2008.00875.xsubject
Has Abstractpub_date
2008-02-01 00:00:00pages
1-10issue
1eissn
0269-4727issn
1365-2710pii
JCP875journal_volume
33pub_type
杂志文章,评审abstract:OBJECTIVE:To describe the current practice of Israeli paediatricians regarding acetaminophen dosing. METHODS:A cross-sectional survey among 200 paediatricians. The paediatricians were questioned of the recommended dose of acetaminophen, and whether they give prescriptions for acetaminophen and instruct their patients ...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.2005.00661.x
更新日期:2005-10-01 00:00:00
abstract::The prevailing major theory of Alzheimer's disease (AD) is that insoluble amyloid beta-peptide (Abeta) found in the cerebral plaques characteristic of the disease is causative or is at least a contributing factor. According to this theory, inhibition of aberrant Abeta production should prevent or at least limit the ex...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2710.2002.00415.x
更新日期:2002-06-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:We report a special case of fenofibrate-induced acute severe DILI with sudden onset and rapid recovery, which is different from those in the LiverTox database. CASE SUMMARY DESCRIPTION:The acute severe DILI occurred within only 4 days after fenofibrate initial treatment for hypertriglycerid...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type:
doi:10.1111/jcpt.13042
更新日期:2020-02-01 00:00:00
abstract::Antimicrobials are frequently used to prevent infections. Principles of prophylaxis, and antimicrobial prophylaxis in surgery, tuberculosis, acquired immunodeficiency syndrome, influenza A, traveller's diarrhoea, malaria, recurrent otitis media, Haemophilus influenzae type b infection, pertussis, rheumatic fever, and ...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.1996.tb01147.x
更新日期:1996-08-01 00:00:00
abstract::The shelf-life of vancomycin in infusion fluids was studied using high-performance liquid chromatographic (HPLC) methods. Vancomycin was stable (loss in potency less than 10%) for 47 days and 29 days, respectively, when dissolved in water-for-injections BP at 25 degrees C and stored in plastic syringes (Becton Dickins...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.1995.tb00705.x
更新日期:1995-12-01 00:00:00
abstract::A single dose pharmacokinetic study was conducted on two sustained-release formulations (75 mg) of indomethacin (Indocid capsules 'A' and Indogesic tablets 'B'). The study was carried out on 22 healthy male volunteers, who received a single oral dose (75 mg) of each product according to a randomized crossover design. ...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1365-2710.1994.tb00816.x
更新日期:1994-10-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Budesonide, an oral glucocorticoid indicated for the treatment of Crohn's disease, rarely interferes with the hypothalamic-pituitary-adrenal axis because more than 80% of it is metabolized by cytochrome P450 enzymes. CASE SUMMARY:A 33-year-old female patient diagnosed with Crohn's disease, ...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type:
doi:10.1111/jcpt.12312
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:In our original study based on five monozygotic twin pairs and seven same-sex sib pairs, we previously showed that genetic factors contribute to body weight gain induced by the atypical antipsychotic clozapine. We aim to study this further by including patients treated with the atypical antipsy...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.2009.01084.x
更新日期:2010-04-01 00:00:00
abstract::This study examined out-patients' interpretation of prescription instructions at a community hospital. The results showed a wide range of misinterpretation with respect to drug name, dose schedule, and auxiliary labels. Age level, education and financial status emerged as the most significant variables associated with...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.1992.tb01280.x
更新日期:1992-04-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of the reconstitution methods for the commercial amphotericin B preparation with respect to particulate contamination. METHODS:The particle counts in amphotericin B solutions reconstituted according to three different methods and amphotericin B fluids made with intravenous fluids af...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1046/j.1365-2710.2001.00328.x
更新日期:2001-04-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:To assess the equivalent efficacy of two or more treatments, clinical relevance must be adequately established, but there appears to be some confusion between clinical relevance and differences in absolute risk reduction or effect size, which quantifies the size of the difference between two...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.12243
更新日期:2015-04-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Carvedilol is the standard of care for heart failure (HF) patients. Carvedilol is partially metabolized by the highly polymorphic enzyme, CYP2D6. To reach an effective dose while avoiding adverse drug reactions (ADRs), testing of CYP2D6 genotype prior to carvedilol initiation may be consider...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.12154
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:To report three cases of alopecia induced by the anticoagulant enoxaparin in cerebral venous thrombosis (CVT) patients. CASE SUMMARY:Three female patients were treated initially with direct intrasinus urokinase, and then followed by low-molecular-weight heparin (LMWH) enoxaparin at 1 mg/kg given subcutaneous...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.2006.00769.x
更新日期:2006-10-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:The development of rapid diagnostics has revolutionized antimicrobial stewardship with efforts targeting earlier de-escalation or discontinuation of antibiotics. The respiratory viral panel (RVP) is one tool quickly able to detect common viral and bacterial pathogens using polymerase chain r...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,评审
doi:10.1111/jcpt.13326
更新日期:2020-12-05 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:5-Azacitidine (AZA) is an agent widely used to treat myelodysplastic syndrome (MDS). CASE DESCRIPTION:We herein report an 83-year-old woman diagnosed with MDS who was treated with AZA. She tolerated the first cycle of AZA; however, severe adverse events involving haemorrhagic enteritis with...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type:
doi:10.1111/jcpt.13146
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Although the kinetic behaviour of tramadol has been described, the present study is the first to our knowledge, to report specifically on the population pharmacokinetic modelling of tramadol hydrochloride. METHODS:The parametric Iterative Two-stage Bayesian Population Model (IT2B) program foll...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 临床试验,杂志文章
doi:10.1111/j.1365-2710.2004.00590.x
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:Emerging antibiotic resistance in common pathogens is a worldwide problem known to be related to inappropriate overuse of antibiotics. Wide variability in antibiotic use throughout the world is because of various factors, including socio-cultural differences. OBJECTIVE:To study the rate of antibiotic prescr...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.2008.00960.x
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:Patients' own medications (POM) are medications that patients have obtained in the community setting and bring to the hospital when admitted. The practice of using POMs has not been well studied. OBJECTIVE:To identify benefits, risks and other impacts on the use of POM in hospitals. METHODS:A systematic se...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2710.2006.00773.x
更新日期:2006-12-01 00:00:00
abstract::This study investigated chemical and pharmaceutical equivalence of 11 brands of pyrimethamine-sulphadoxine combination tablets sold on the Tanzanian market. Physical and chemical tests were performed for all the 11 brands. These tests included hardness test, friability, disintegration, dissolution, weight uniformity a...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.2005.00687.x
更新日期:2005-12-01 00:00:00
abstract::Parenterals, sterile preparations intended to be injected in man or animal, should be free from pyrogenic substances which are able to raise the thermostatic setting in the hypothalamus. This article gives an up-to-date review of the principal detection and quantification methods for these agents, with special attenti...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2710.1987.tb00531.x
更新日期:1987-08-01 00:00:00
abstract::A number of drugs have been reported to cause neuromuscular blockade and/or to increase weakness in myasthenia gravis. We report on two patients, treated with felodipine and nifedipine for arterial hypertension, who presented with an exacerbation of their myasthenia gravis and a myasthenic syndrome or exacerbation of ...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1046/j.1365-2710.1998.00172.x
更新日期:1998-10-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Linezolid, a member of the oxazolidinone class of antibacterial drugs, is approved by the US Food and Drug Administration (FDA) for the treatment of vancomycin-resistant Enterococcus faecium infections, nosocomial and community-acquired pneumonia, as a part of anti tubercular regimen and com...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type:
doi:10.1111/jcpt.13069
更新日期:2020-04-01 00:00:00
abstract::The primary aim of this study was to assess patterns of prescribing of analgesic medications in a primary care setting in South Africa. Medication records of 47,103 patients for the year 1995 were retrospectively reviewed. Analgesic agents represented 12.3% of the total number and 14.2% of the total cost of all the pr...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1046/j.1365-2710.1997.96175961.x
更新日期:1997-02-01 00:00:00
abstract:WHAT IS KNOWN:The neonatal intensive care units (NICUs) are at the highest risk of drug dose error of all hospital wards. NICUs also have the most complicated prescription modalities. The computerization of the prescription process is currently recommended to decrease the risk of preventable adverse drug effects (pADEs...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.12474
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The optimal administration of liquid medications requires accurate dose delivery. This is particularly important in the treatment of infants and children, as well as elderly people, who are more sensitive to dosage errors. Previous studies revealed significant dosage inaccuracies with measuring...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.2009.01082.x
更新日期:2010-06-01 00:00:00
abstract::A stability-indicating reversed phase high-performance liquid chromatographic assay for prazosin was developed to investigate the feasibility of a transdermal dosage form. The assay enabled detection of drug concentrations down to 0.05 microgram/ml and the quantification of the drug in both permeation fluids and in ex...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2710.1992.tb01262.x
更新日期:1992-02-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Pulmonary sarcomatoid carcinoma (PSC) is characterized by dismal prognosis and resistance to platinum-based chemotherapy. The immune checkpoint inhibitors showed promising efficacy in the treatment of PSC. Camrelizumab is a programmed cell death protein 1 inhibitor; however, current evidence...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type:
doi:10.1111/jcpt.13234
更新日期:2020-12-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Far more patients are now surviving cancer than ever before because of major advances in the diagnosis and treatment of primary and metastatic malignancy. Adjuvant chemotherapeutic drug and combination regimens have contributed to the success. However, persistent residual adverse effects inv...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2710.2010.01208.x
更新日期:2011-08-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:Despite the widespread use of proton pump inhibitors (PPIs), little is known about the appropriateness of treatment according to the indications reported by patients and their involvement in the process of treatment discontinuation. In patients who are unlikely to benefit, the medication sho...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.12371
更新日期:2016-04-01 00:00:00
abstract:WHAT IS KNOWN AND OBJECTIVE:New first-in-class (FIC) drugs with novel mechanisms of action may be highly effective, but lack adequate safety information, and therefore may be associated with crucial post-marketing safety issues. The objective of this study was to evaluate the post-marketing risk of FIC drug with compar...
journal_title:Journal of clinical pharmacy and therapeutics
pub_type: 杂志文章
doi:10.1111/jcpt.13096
更新日期:2020-06-01 00:00:00