Implementation and uptake of novel and cost-effective medicines can improve patient
health outcomes and healthcare efficiency. However, the relative uptake of new
medicines recommended by the National Institute for Health and Care Excellence often
lags behind other comparative countries’ health systems. One example is the uptake
of direct oral anticoagulants (DOACs) for stroke prevention in atrial fibrillation, which
was slow and had a high level of unexplained variation across different health
economies in England. This research aimed to explore barriers and enablers to the
uptake of DOACs from the perspectives of patients, healthcare professionals, and key
stakeholders by conducting systematic and narrative reviews and semi-structured
interviews. Data collected from 21 patients, 23 healthcare professionals, and 23 key
stakeholders recruited from three different health economies was analysed using the
Framework method. The findings identified a range of intersecting factors acting as
barriers and/or enablers to the uptake DOACs. While there were a wide range of
experiences and views, an agreement between patients and healthcare
professionals/key stakeholders on several identified factors was observed. Attributes
of the innovation, characteristics of patients and prescribers, local health economy
readiness for change, implementation process, and external health system context
were suggested as influences. Mapping of the findings to the Diffusion of Innovations
in Service Organisations model identified 11 components for a future toolkit
development to facilitate uptake of nationally recommended new medicines. This
thesis highlighted the role of patients, consideration of all costs associated with new
medicines, and compatibility with the health economy’s care model impact on the
uptake.
| Identifer | oai:union.ndltd.org:BRADFORD/oai:bradscholars.brad.ac.uk:10454/18976 |
| Date | January 2021 |
| Creators | Medlinskiene, Kristina |
| Contributors | Petty, Duncan R., Stirling, K., Richardson, Sue, Fylan, Beth, Rattray, Marcus |
| Publisher | University of Bradford, School of Pharmacy and Medical Sciences, Faculty of Life Sciences |
| Source Sets | Bradford Scholars |
| Language | English |
| Detected Language | English |
| Type | Thesis, doctoral, PhD |
| Rights | <a rel="license" href="http://creativecommons.org/licenses/by-nc-nd/3.0/"><img alt="Creative Commons License" style="border-width:0" src="http://i.creativecommons.org/l/by-nc-nd/3.0/88x31.png" /></a><br />The University of Bradford theses are licenced under a <a rel="license" href="http://creativecommons.org/licenses/by-nc-nd/3.0/">Creative Commons Licence</a>. |
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