Adoption of new medicines in primary care: A comparison between the uptake of new oral anticoagulants and diabetes medicines

Aims To gain insight in the uptake and practice variation in the prescription of 2 new medicine groups for common conditions in primary care (direct‐acting oral anticoagulants [DOACs] and incretin‐based therapies) from introduction, around 2007, to 2019 and the correlation between the adoption of th...

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Published in:British journal of clinical pharmacology 2024-03, Vol.90 (3), p.819-827
Main Authors: Dankers, Marloes, Hek, Karin, Mantel‐Teeuwisse, Aukje K., Dijk, Liset, Nelissen‐Vrancken, Marjorie H. J. M. G.
Format: Article
Language:English
Subjects:
Administration, Oral
anticoagulants
Anticoagulants - therapeutic use
Atrial Fibrillation - drug therapy
diabetes
Diabetes Mellitus - chemically induced
Factor Xa Inhibitors - adverse effects
Humans
Hypoglycemic Agents - therapeutic use
Incretins
pharmacotherapy
prescribing
primary care
Primary Health Care
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Summary:Aims To gain insight in the uptake and practice variation in the prescription of 2 new medicine groups for common conditions in primary care (direct‐acting oral anticoagulants [DOACs] and incretin‐based therapies) from introduction, around 2007, to 2019 and the correlation between the adoption of those medicines in primary care. Methods Prescription data from general practices in the Dutch Nivel Primary Care Database from 2007 to 2019 were used. The percentage of patients with prescriptions for DOACs of all patients with prescriptions for DOACs and vitamin K antagonists was calculated per practice per year, as was the percentage of patients prescribed incretin‐based therapies as a proportion of all patients with diabetes medication. Multilevel models were used to estimate practice variation for DOACs and incretin‐based therapies, expressed as intraclass correlation coefficients. Linear regression analysis was used to study the association between the prescription of DOACs and incretin‐based therapies. Results Per year, 46–424 general practices and 179 933–1 654 376 patients were included. In 2019, the mean percentage of patients per practice using DOACs or incretin‐based therapies was 54.9 and 9.7%, respectively. The intraclass correlation coefficient decreased from 0.75 to 0.024 for DOACs and from 0.33 to 0.074 for incretin‐based medicines during the study period. No clear correlation was found between the prescription of DOACs and incretin‐based therapies. Conclusion DOACs and incretin‐based therapies have different adoption profiles and practice variation is large, especially in the years before these medicines were introduced in guidelines. Early adopters of both medicine classes differ.
ISSN:0306-5251
1365-2125
DOI:10.1111/bcp.15959