The Role of Physician Networks in the Adoption of New Prescription Drugs.

医生网络在采用新处方药中的作用。

基本信息

批准号：
8557631
负责人：
JULIE Marie DONOHUE
金额：
$ 76.49万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-08-15 至 2017-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8557631
关键词：
Academic Detailing Adopted Adoption Adult Affect Behavior Benefits and Risks Budgets Cardiovascular Diseases Caring Case Mixes Characteristics Chronic Data Data Analyses Data Set Development Diabetes Mellitus Diffusion Drug Prescriptions Drug usage Enrollment Evidence Based Medicine Evidence based treatment Exhibits Face Health Status Health system Healthcare Heart failure Hospital Referrals Hospitals Hyperlipidemia Institution Intervention Learning Link Location Measurement Measures Medical Medicare Medicare/Medicaid Medicine Morbidity - disease rate Myocardial Ischemia Names Pathway Analysis Patient Care Patients Pennsylvania Pharmaceutical Preparations Pharmacotherapy Physician&apos s Role Physicians Play Positioning Attribute Process Residencies Rest Role Services Socioeconomic Status Source Speed Stroke Techniques Technology Therapeutic Time Training Variant beneficiary cost evidence base improved medical specialties mortality non-drug peer peer influence pressure prevent programs public health relevance tool uptake

项目摘要

DESCRIPTION (provided by applicant): Medications to treat and prevent cardiovascular disease (CVD) have substantially reduced CVD-related morbidity and mortality; however, their diffusion has been uneven. Physicians have been slow to adopt some evidence-based treatments and have rapidly adopted others of low value. Use of newer, brand name drugs is much higher in some regions in the US and suggests that physicians in those regions are rapid adopters of new drugs. Yet the determinants of physician adoption of new medications are poorly understood. Physicians are likely to turn to their peers for information on drugs' uses, benefits and risks. Network analysis offers an analytic framework and measurement techniques for understanding how physicians learn from each other about new treatments. Our long-term objective is to understand the role of physician networks in technology diffusion. To accomplish this objective, we propose two specific aims. First, we will examine the association at the local-level between physician adoption of new medications and prescription drug spending and total non-drug medical spending. We will measure the rate and speed of adoption among nearly all physicians in Pennsylvania of 5 new drugs used for CVD or diabetes introduced in recent years. We will obtain data on prescribing for nearly all of Pennsylvania's 50,000 physicians. We will also obtain Medicare and Medicaid claims data for the more than 2 million adults in the state who are covered by these programs. Second, we will examine the influence of multiple types of professional networks, physician characteristics, patient characteristics, and institutions on physician adoption of new medications. In particular, we will assess the influence on physician adoption of new drugs of physician networks formed during training (e.g., residency program), in organizations (e.g., medical groups, hospitals), and through the sharing (referral) of patients. Understanding the role of these networks will guide dissemination of interventions such as academic detailing to improve the quality and efficiency of pharmacotherapy. Medicare and Medicaid are key settings for studying network effects because they provide coverage to the most vulnerable and because the costs of these programs exert substantial pressure on public budgets.

描述（由申请人提供）：治疗和预防心血管疾病（CVD）的药物显着降低了 CVD 相关的发病率和死亡率；然而，它们的传播并不均衡。医生们在采用一些基于证据的治疗方法方面进展缓慢，并迅速采用了其他低价值的治疗方法。在美国的一些地区，新型品牌药物的使用率要高得多，这表明这些地区的医生很快就会采用新药。然而，人们对医生采用新药的决定因素知之甚少。医生可能会向同行寻求有关药物用途、益处和风险的信息。网络分析提供了一个分析框架和测量技术，用于了解医生如何相互学习新疗法。我们的长期目标是了解医生网络在技术传播中的作用。为了实现这一目标，我们提出两个具体目标。首先，我们将研究地方一级医生采用新药与处方药支出和非药物医疗支出总额之间的关联。我们将衡量宾夕法尼亚州几乎所有医生对近年来推出的 5 种用于治疗 CVD 或糖尿病的新药的采用率和速度。我们将获得宾夕法尼亚州几乎所有 50,000 名医生的处方数据。我们还将获得该州超过 200 万成年人受这些计划覆盖的医疗保险和医疗补助索赔数据。其次，我们将研究多种类型的专业网络、医生特征、患者特征和机构对医生采用新药的影响。特别是，我们将评估培训期间（例如住院医师计划）、组织（例如医疗团体、医院）以及通过患者共享（转介）形成的医生网络对医生采用新药的影响。了解这些网络的作用将指导干预措施的传播，例如学术细节，以提高药物治疗的质量和效率。医疗保险和医疗补助是研究网络效应的关键环境，因为它们为最弱势群体提供保险，而且这些计划的成本对公共预算造成了巨大压力。