PhD defence M. (Marloes) Dankers

New medicines in primary care

Perspectives and practices of healthcare professionals

Rational use of new medicines is important, both in terms of quality of care and healthcare costs. Marloes Dankers has studied the perspectives and practices of primary care healthcare professionals towards new medicines, divided into three subtopics:

•    Preferences of healthcare professionals for endpoints and cutoff values for clinical relevance in the evaluation of new medicines. Healthcare professionals are more strict than official organisations. A medicine that is considered clinically relevant by official organisations does therefore not necessarily reflect healthcare professionals’ perspectives on clinical relevance.

•    Factors influencing the decision to prescribe new medicines. The attitude of healthcare professionals towards new medicines is important, and the pharmaceutical industry tries to influence this attitude.

•    Prescription patterns of new medicines. Large variation between general practices exists. These differences cannot be explained by different patient or practice characteristics.

Dankers draws two important conclusions: 1. The uptake of new medicines in primary care is not easy to predict. Prescription patterns vary among new medicines, and the prescription of new medicines cannot be adequately explained by differences between patients and practices. No association between the prescription of different groups of new medicines exists. 2. Scientific evidence plays a limited role in the decision of healthcare providers to prescribe new medicines. Healthcare providers experience difficulties in interpreting and estimating realistic benefits and risks of new medicines. Individual attitudes of healthcare professionals are important in the decision to prescribe new medicines. The pharmaceutical industry influences decisions with various strategies.

Promotores Prof.dr. C.E.M.J. van Dijk