Influences on physician recommendation for imatinib mesylate in chronic phase chronic myeloid leukemia patients.

摘要

In May 2001, FDA approved imatinib mesylate (Trade name: Gleevec) for chronic myeloid leukemia (CML). Physicians currently vary to a great extent in their acceptance of imatinib mesylate as a standard therapy and as a valid innovative alternative to allogeneic stem cell transplantation (alloSCT), a widely used conventional therapy in the last few decades in chronic phase CML patients. Currently factors influencing physician recommendation for imatinib mesylate are not understood very well, Roger's model of adoption could be useful to study physician recommendation for imatinib mesylate.; Objective. To determine whether innovation characteristics, communication channels, physician characteristics and social system characteristics have a significant influence on physician recommendation for imatinib mesylate in chronic phase CML patients.; Methods. The American Society of Clinical Oncology database was used as the sampling frame to randomly select one thousand one hundred hematologists/oncologists for the mail survey. A series of vignettes describing patients with chronic phase CML was used to measure physician recommendation for imatinib mesylate. The main survey procedure used a modified Dillman's method. Multiple regression using ordinary least squares (OLS) was the method of analysis with a cumulative score of physician recommendation for imatinib mesylate as the dependent variable. The independent variables included perceived relative advantage in efficacy, perceived relative advantage in non-clinical parameters, peer influence, professional centrality, promotional and scientific mass media channels, years in practice, specialty, past experience, social system characteristics and control variables.; Results. A total of 305 responses were received giving a response rate of 28.7%. Of these, 65 responses were from physicians not treating CML, dead or retired physicians, making the usable response rate about 29%. The overall model was found to be significant. Perceived relative advantage in efficacy, peer influence, past experience and academic affiliation were found to be significant positive influences on physician recommendation for imatinib mesylate in chronic phase CML patients. Specialty in transplantation had a significant negative influence on physician recommendation for imatinib mesylate in chronic phase CML patients.; Conclusion. Roger's model of adoption of innovation is useful to explain physician recommendation for imatinib mesylate in chronic phase CML patients.