From: Barriers and facilitators to the uptake of new medicines into clinical practice: a systematic review
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, 70,71,72,73,74, 78, 79, 82, 85] |
 Gender (male) | 12 | 4 | 1 | 7 | |
 Ethnicity (White) | 10 | 6 | 1 | 3 | |
 Education level (higher) | 5 | 4 |  | 1 | |
 Income (higher) | 11 | 11 |  | 1 | |
 Insurance (private or more comprehensive) | 9 | 9 |  |  | |
 Residential area (urban or more affluent) | 3 | 3 |  |  | |
 Health condition (more severe & comorbidities) | 13 | 5 | 8 |  | |
 Polypharmacy | 9 | 3 | 4 |  | |
 Patient satisfaction, adherence to current therapy & monitoring | 4 | 4 |  |  | |
 Response to current therapy (poor) | 3 | 3 |  |  | |
 Patients request & therapy preferences | 5 | 5 |  |  | |
Prescriber factors | |||||
 Age (younger) | 7 | 4 | 2 | 3 | |
 Gender (male) | 6 | 4 |  | 2 | |
 Graduating from a top-20 medical or foreign school | 3 | 3 |  | 2 | |
 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 |  |  | |
 Knowledge of new medicine | 7 | 7 |  |  | |
 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 |  |  | |
 Safety concerns (adverse & long-term effects) | 6 |  | 6 |  | |
 Interactions with food/medicines (less) | 3 | 3 |  |  | |
 High unit cost | 5 | 5 |  | 3 | |
 Therapeutic innovation | 5 | 5 |  |  | |
 Ease of use & administration | 4 | 3 | 1 | 1 | |
 Reduced monitoring & clinic visits | 2 | 2 |  |  | |
Organizational factors | |||||
 Ownership status (private) | 10 | 7 | 2 | 1 | |
 Teaching status | 8 |  | 1 | 7 | |
 Size (larger) | 17 | 11 | 3 | 3 | [33, 35, 37, 46, 48, 51, 57, 60, 65, 68, 72, 75,76,77, 81, 82, 84] |
 Location (more populated) | 10 | 3 | 3 | 5 | |
 Availability of supportive services | 11 | 7 |  | 4 | |
 Limited consultation time | 2 |  | 2 |  | |
 Number of specialists, nurses, or healthcare professionals (higher) | 8 | 8 |  |  | |
 Care co-ordination (fragmented) | 2 |  | 2 |  | |
External environment factors | |||||
 Pharmaceutical detailing | 11 | 11 |  | 1 | |
 Formulary or reimbursement restrictions | 10 |  | 10 |  | |
 Peer influence (internal & external) | 14 | 14 |  |  | |
 Recommended by guideline (international, national, or local) | 6 | 5 |  | 1 | |
 Scientific literature, websites, & conferences | 6 | 6 | 1 |  | |
 Organizational affiliations | 6 | 4 | 2 |  |