Table 4.
Summary of factors affecting the uptake of new medicines referred to in the reviewed studies
| Identified factor | Number of studies referred to the factor | As facilitator | As barrier | No impact | Citations |
|---|---|---|---|---|---|
| Patient factors | |||||
| Age (younger) | 18 | 11 | 4 | 3 | [22, 25, 28, 32, 35, 51, 52, 58, 60, 63, 70–74, 78, 79, 82, 85] |
| Gender (male) | 12 | 4 | 1 | 7 | [22, 28, 29, 58, 60, 71–74, 78, 79, 82] |
| Ethnicity (White) | 10 | 6 | 1 | 3 | [25, 35, 51, 58, 61, 70, 72, 74, 78, 82] |
| Education level (higher) | 5 | 4 | 1 | [32, 35, 43, 78, 82] | |
| Income (higher) | 11 | 11 | 1 | [22, 25, 32, 45, 47, 50, 51, 71, 80, 82, 85] | |
| Insurance (private or more comprehensive) | 9 | 9 | [22, 25, 35, 45, 58, 62, 72, 74, 78] | ||
| Residential area (urban or more affluent) | 3 | 3 | [43, 70, 85] | ||
| Health condition (more severe & comorbidities) | 13 | 5 | 8 | [22, 28, 34, 35, 46, 51, 63, 72–74, 78, 79, 82] | |
| Polypharmacy | 9 | 3 | 4 | [22, 25, 28, 43, 72, 73, 79] | |
| Patient satisfaction, adherence to current therapy & monitoring | 4 | 4 | [32, 47, 50, 80] | ||
| Response to current therapy (poor) | 3 | 3 | [47, 70, 80] | ||
| Patients request & therapy preferences | 5 | 5 | [47, 50, 61, 69, 80] | ||
| Prescriber factors | |||||
| Age (younger) | 7 | 4 | 2 | 3 | [27, 29, 33, 42, 48, 53, 62] |
| Gender (male) | 6 | 4 | 2 | [23, 29, 42, 48, 62, 85] | |
| Graduating from a top-20 medical or foreign school | 3 | 3 | 2 | [23, 48, 62] | |
| Principal or partner GP | 1 | 1 | [85] | ||
| Specialist or secondary care prescriber | 16 | 13 | 4 | 1 | [22, 24, 28, 29, 33, 35, 41, 42, 47, 48, 59, 61, 62, 73, 75, 78] |
| Non-academic prescriber | 1 | 1 | [23] | ||
| Greater prescribing volume or portfolio breadth | 5 | 5 | [27, 48, 54, 61, 85] | ||
| Knowledge of new medicine | 7 | 7 | [47, 50, 67–69, 80, 86] | ||
| Continuing medical education activities | 1 | 1 | [38] | ||
| Early adopter in the past | 1 | 1 | [27] | ||
| Taking clinical risks & spending less time in consultations | 1 | 1 | [85] | ||
| Medicine factors | |||||
| Efficacy | 6 | 6 | [34, 50, 68, 69, 80, 86] | ||
| Safety concerns (adverse & long-term effects) | 6 | 6 | [44, 47, 50, 68, 80, 86] | ||
| Interactions with food/medicines (less) | 3 | 3 | [47, 68, 80] | ||
| High unit cost | 5 | 5 | 3 | [47, 50, 68, 80, 86] | |
| Therapeutic innovation | 5 | 5 | [41, 48, 50, 60, 80] | ||
| Ease of use & administration | 4 | 3 | 1 | 1 | [47, 50, 69, 80] |
| Reduced monitoring & clinic visits | 2 | 2 | [47, 68] | ||
| Organizational factors | |||||
| Ownership status (private) | 10 | 7 | 2 | 1 | [21, 37, 46, 57, 60, 64, 65, 71, 81, 84] |
| Teaching status | 8 | 1 | 7 | [54, 63–65, 72–74, 77] | |
| Size (larger) | 17 | 11 | 3 | 3 | [33, 35, 37, 46, 48, 51, 57, 60, 65, 68, 72, 75–77, 81, 82, 84] |
| Location (more populated) | 10 | 3 | 3 | 5 | [27, 42, 57, 63, 71–73, 77, 84, 85] |
| Availability of supportive services | 11 | 7 | 4 | [27, 35, 37, 39, 53, 57, 65, 69, 76, 77, 79] | |
| Limited consultation time | 2 | 2 | [67, 69] | ||
| Number of specialists, nurses, or healthcare professionals (higher) | 8 | 8 | [21, 35, 39, 48, 51, 57, 59, 67] | ||
| Care co-ordination (fragmented) | 2 | 2 | [67, 69] | ||
| External environment factors | |||||
| Pharmaceutical detailing | 11 | 11 | 1 | [23, 33, 50, 55, 61, 66, 68, 76, 80] | |
| Formulary or reimbursement restrictions | 10 | 10 | [23, 26, 29–31, 37, 40, 50, 80, 83] | ||
| Peer influence (internal & external) | 14 | 14 | [36, 49, 50, 52, 56, 59, 61, 64, 66, 68, 71, 80, 81, 84] | ||
| Recommended by guideline (international, national, or local) | 6 | 5 | 1 | [50, 64, 67–69, 86] | |
| Scientific literature, websites, & conferences | 6 | 6 | 1 | [32, 34, 50, 68, 76, 80] | |
| Organizational affiliations | 6 | 4 | 2 | [21, 39, 50, 51, 57, 76] | |