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  • 标题:Influence of physician networks on prescribing a new ingredient combination in heart failure: a longitudinal claim data-based study
  • 本地全文:下载
  • 作者:Christine Arnold ; Jan Koetsenruijter ; Johanna Forstner
  • 期刊名称:Implementation Science
  • 印刷版ISSN:1748-5908
  • 电子版ISSN:1748-5908
  • 出版年度:2021
  • 卷号:16
  • DOI:10.1186/s13012-021-01150-y
  • 语种:English
  • 出版社:BioMed Central
  • 摘要:Background Since 2016, the combination of sacubitril/valsartan, which combines an angiotensin receptor and neprilysin inhibitor (ARNI), has been recommended in the guidelines for the treatment of heart failure. The adoption of new drugs may be influenced by collaboration and exchange between physicians. We aimed to determine whether characteristics of the professional networks of prescribing physicians were associated with the prescribing of ARNI in Germany. Methods We conducted a longitudinal analysis based on claims data in 2016–2018 in Germany. The characteristics of ambulatory care physicians’ networks were determined in the analysis of the patient-sharing networks of physicians in 2017. Binary logistic regression analysis with the outcome ‘prescribes ARNI in 2018’ (present or absent) was carried out, using network characteristics as predictors, adjusted for specialty and sociodemographic characteristics of physicians. Results The network analysis included 8370 physicians, who had 144,636 connections. Prescribers had more connections to other physicians compared to non-prescribers (median 31 vs. 23). Regression analysis showed that the numbers of linkages to prescribers of ARNI were positively associated with prescribing ARNI. For 6–10 connections, the average marginal effect (AME) was 0.04 (confidence interval [CI
  • 关键词:Medication prescribing; Chronic heart failure; Ambulatory care; Social network analysis; Implementation science
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