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Table 4 Summary of factors affecting the uptake of new medicines referred to in the reviewed studies

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

[22, 28, 29, 58, 60, 71,72,73,74, 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, 72,73,74, 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, 67,68,69, 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, 63,64,65, 72,73,74, 77]

 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

[27, 42, 57, 63, 71,72,73, 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, 29,30,31, 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, 67,68,69, 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]