Healthy Skepticism Library item: 6442

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Publication type: Journal Article

Peay MY, Peay ER.
Innovation in high risk drug therapy.
Soc Sci Med 1994 Jul; 39:(1):39-52

Abstract:

(Limited to parts of article dealing with promotion.) Drug adoption and innovation appear to constitute a fundamentally different process in the arena of higher risk drugs from that observed in previous studies. Contact with colleagues is an important factor in higher risk drug adoption but consists of two distinct patterns of contact, the doctor as information source and the doctor as information seeker, and these have distinct consequences for drug adoption behaviour. Commercial sources play little or no role in the adoption of higher risk drugs in the doctor’s primary area of expertise but may provide information about new drugs outside that area.

The aim of this study was to identify predictors of the early adoption of high risk drugs by specialists with the expectation that the processes of innovation in this domain differ from those identified for general medical practice. One hundred and fifty-six specialists provided information regarding their awareness and use of each of eight target drugs, selected for their riskiness, and discussed in detail their adoption of one of them. General innovative behaviour, as assessed by awareness and use of the target drugs, as well as early first news of the particular drug discussed, were predictable from formal and informal contact with colleagues. However, the results indicate that two types of contact with colleagues are clearly distinguishable, as an information source and as an information seeker, which are independent and which show different patterns of prediction. Early use of the drug discussed was largely independent of the potential predictors. It is argued that first use of high risk drugs is determined by two factors, preparedness to prescribe the new drug and the presentation of particular circumstances which are appropriate for its use, only the first of which is predictable from the variables ordinarily thought to be involved in innovation. Therefore, if innovation is to be identified with stable characteristics of the practitioner, then this concept must be redefined in terms of knowledge and judgement rather than in terms of a particular behavioural event.

Keywords:
Adult Aged Decision Making Drug Therapy/adverse effects Drug Therapy/utilization* Drug Utilization Female Health Knowledge, Attitudes, Practice Humans Interprofessional Relations Male Middle Aged Physician's Practice Patterns* Physicians/psychology Research Support, Non-U.S. Gov't Risk-Taking* Specialties, Medical *analytic survey/Australia/specialists/new drugs/source of information/safety & risk information/PROMOTION AS A SOURCE OF INFORMATION: DOCTORS