As part of our “Throwback Thursday” blog series, we’re taking a look at a topic that’s currently in the news and tagging it with previous research, videos or commentaries in a relevant way. As the saying goes, “what’s old is new again” – and we hope you enjoy our wonky twist on #TBT.
January is International Quality of Life Month, and an often important component of many patients’ overall health and well-being is the use of pharmaceuticals to treat their conditions. Over the past decade, growing numbers of patients have benefited from new medicines and research, thanks to an accelerated pace in medical discovery and innovation. Although these findings can better patients’ lives, the health care system has not always kept pace when it comes to adapting these learnings and putting them into practice.
According to a 2001 Institute of Medicine report, application of new medical knowledge into practice takes an average of 17 years.
What accounts for this delay, and what factors are most influential in order for evidence to be more rapidly adopted? According to a National Pharmaceutical Council (NPC) study, “When Is Evidence Sufficient for Decision-Making? A Framework for Understanding the Pace of Evidence Adoption,” that was published in the July 2013 issue of the Journal of Comparative Effectiveness Research (and our Throwback Thursday pick), there are several reasons.
The study looked at three well-documented cases in which new information was disseminated to the public—statins, drug-eluting stents and bone marrow transplantation for breast cancer. The authors developed a framework to determine which factors were most influential in changing clinical practice. The framework includes the following considerations:
- Validity, reliability and maturity of the science: Is the current understanding of the particular condition and its treatment understood well enough so that new information can be taken into account?
- Economic drivers that might influence adoption: Who is paying for the treatment? Is it being reimbursed? What marketing or detailing efforts were influential?
- Rapid (or slow) incorporation into practice guidelines: How quickly—or slowly—were the results accepted by groups that develop guidelines?
- Communication: Are the results being amplified by major media outlets, celebrities or social media?
- Patients’ and providers’ ability to apply results to their needs: Can patients or providers apply published evidence to their decisions?
The overall goal of the framework is to encourage consideration of the critical factors that affect adoption and help to optimize the pace with which new treatments and new findings about treatments are brought into routine clinical practice. [Check out our archived webinar for a broader discussion of this study.]
In related research, RAND Associate Policy Researcher Dr. Justin Timbie examined the barriers that hinder the adoption of evidence into clinical practice. NPC spoke with Dr. Timbie in a 2012 interview in which he cited the misalignment of financial incentives, ambiguity of comparative effectiveness research (CER) results, cognitive biases, failure of CER design to address the needs of end-users, and limited use of decision support by patients and clinicians as key factors.