Barriers and facilitators to the uptake of new medicines into clinical practice: a systematic review

Abstract Background Implementation and uptake of novel and cost-effective medicines can improve patient health outcomes and healthcare efficiency. However, the uptake of new medicines into practice faces a wide range of obstacles. Earlier reviews provided insights into determinants for new medicine...

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Autores principales:	Kristina Medlinskiene, Justine Tomlinson, Iuri Marques, Sue Richardson, Katherine Stirling, Duncan Petty
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	New medicines Uptake Implementation Systematic review Innovation implementation Healthcare organizations Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/8b3f82aff19c4c03a2d36163e6cdcb63
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spelling	oai:doaj.org-article:8b3f82aff19c4c03a2d36163e6cdcb632021-11-07T12:10:50ZBarriers and facilitators to the uptake of new medicines into clinical practice: a systematic review10.1186/s12913-021-07196-41472-6963https://doaj.org/article/8b3f82aff19c4c03a2d36163e6cdcb632021-11-01T00:00:00Zhttps://doi.org/10.1186/s12913-021-07196-4https://doaj.org/toc/1472-6963Abstract Background Implementation and uptake of novel and cost-effective medicines can improve patient health outcomes and healthcare efficiency. However, the uptake of new medicines into practice faces a wide range of obstacles. Earlier reviews provided insights into determinants for new medicine uptake (such as medicine, prescriber, patient, organization, and external environment factors). However, the methodological approaches used had limitations (e.g., single author, narrative review, narrow search, no quality assessment of reviewed evidence). This systematic review aims to identify barriers and facilitators affecting the uptake of new medicines into clinical practice and identify areas for future research. Method A systematic search of literature was undertaken within seven databases: Medline, EMBASE, Web of Science, CINAHL, Cochrane Library, SCOPUS, and PsychINFO. Included in the review were qualitative, quantitative, and mixed-methods studies focused on adult participants (18 years and older) requiring or taking new medicine(s) for any condition, in the context of healthcare organizations and which identified factors affecting the uptake of new medicines. The methodological quality was assessed using QATSDD tool. A narrative synthesis of reported factors was conducted using framework analysis and a conceptual framework was utilised to group them. Results A total of 66 studies were included. Most studies (n = 62) were quantitative and used secondary data (n = 46) from various databases, e.g., insurance databases. The identified factors had a varied impact on the uptake of the different studied new medicines. Differently from earlier reviews, patient factors (patient education, engagement with treatment, therapy preferences), cost of new medicine, reimbursement and formulary conditions, and guidelines were suggested to influence the uptake. Also, the review highlighted that health economics, wider organizational factors, and underlying behaviours of adopters were not or under explored. Conclusion This systematic review has identified a broad range of factors affecting the uptake of new medicines within healthcare organizations, which were grouped into patient, prescriber, medicine, organizational, and external environment factors. This systematic review also identifies additional factors affecting new medicine use not reported in earlier reviews, which included patient influence and education level, cost of new medicines, formulary and reimbursement restrictions, and guidelines. Registration PROSPERO database (CRD42018108536).Kristina MedlinskieneJustine TomlinsonIuri MarquesSue RichardsonKatherine StirlingDuncan PettyBMCarticleNew medicinesUptakeImplementationSystematic reviewInnovation implementationHealthcare organizationsPublic aspects of medicineRA1-1270ENBMC Health Services Research, Vol 21, Iss 1, Pp 1-28 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	New medicines Uptake Implementation Systematic review Innovation implementation Healthcare organizations Public aspects of medicine RA1-1270
spellingShingle	New medicines Uptake Implementation Systematic review Innovation implementation Healthcare organizations Public aspects of medicine RA1-1270 Kristina Medlinskiene Justine Tomlinson Iuri Marques Sue Richardson Katherine Stirling Duncan Petty Barriers and facilitators to the uptake of new medicines into clinical practice: a systematic review
description	Abstract Background Implementation and uptake of novel and cost-effective medicines can improve patient health outcomes and healthcare efficiency. However, the uptake of new medicines into practice faces a wide range of obstacles. Earlier reviews provided insights into determinants for new medicine uptake (such as medicine, prescriber, patient, organization, and external environment factors). However, the methodological approaches used had limitations (e.g., single author, narrative review, narrow search, no quality assessment of reviewed evidence). This systematic review aims to identify barriers and facilitators affecting the uptake of new medicines into clinical practice and identify areas for future research. Method A systematic search of literature was undertaken within seven databases: Medline, EMBASE, Web of Science, CINAHL, Cochrane Library, SCOPUS, and PsychINFO. Included in the review were qualitative, quantitative, and mixed-methods studies focused on adult participants (18 years and older) requiring or taking new medicine(s) for any condition, in the context of healthcare organizations and which identified factors affecting the uptake of new medicines. The methodological quality was assessed using QATSDD tool. A narrative synthesis of reported factors was conducted using framework analysis and a conceptual framework was utilised to group them. Results A total of 66 studies were included. Most studies (n = 62) were quantitative and used secondary data (n = 46) from various databases, e.g., insurance databases. The identified factors had a varied impact on the uptake of the different studied new medicines. Differently from earlier reviews, patient factors (patient education, engagement with treatment, therapy preferences), cost of new medicine, reimbursement and formulary conditions, and guidelines were suggested to influence the uptake. Also, the review highlighted that health economics, wider organizational factors, and underlying behaviours of adopters were not or under explored. Conclusion This systematic review has identified a broad range of factors affecting the uptake of new medicines within healthcare organizations, which were grouped into patient, prescriber, medicine, organizational, and external environment factors. This systematic review also identifies additional factors affecting new medicine use not reported in earlier reviews, which included patient influence and education level, cost of new medicines, formulary and reimbursement restrictions, and guidelines. Registration PROSPERO database (CRD42018108536).
format	article
author	Kristina Medlinskiene Justine Tomlinson Iuri Marques Sue Richardson Katherine Stirling Duncan Petty
author_facet	Kristina Medlinskiene Justine Tomlinson Iuri Marques Sue Richardson Katherine Stirling Duncan Petty
author_sort	Kristina Medlinskiene
title	Barriers and facilitators to the uptake of new medicines into clinical practice: a systematic review
title_short	Barriers and facilitators to the uptake of new medicines into clinical practice: a systematic review
title_full	Barriers and facilitators to the uptake of new medicines into clinical practice: a systematic review
title_fullStr	Barriers and facilitators to the uptake of new medicines into clinical practice: a systematic review
title_full_unstemmed	Barriers and facilitators to the uptake of new medicines into clinical practice: a systematic review
title_sort	barriers and facilitators to the uptake of new medicines into clinical practice: a systematic review
publisher	BMC
publishDate	2021
url	https://doaj.org/article/8b3f82aff19c4c03a2d36163e6cdcb63
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Barriers and facilitators to the uptake of new medicines into clinical practice: a systematic review

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