Innovation in high risk drug therapy

The aim of this study was to identify predictors of the early adoption of high risk drugs by specialists with the expectation that the processes of innovation in this domain differ from those identified for general medical practice. One hundred and fifty-six specialists provided information regarding their awareness and use of each of eight target drugs, selected for their riskiness, and discussed in detail their adoption of one of them. General innovative behaviour, as assessed by awareness and use of the target drugs, as well as early first news of the particular drug discussed, were predictable from formal and informal contact with colleagues. However, the results indicate that two types of contact with colleagues are clearly distinguishable, as an information source and as an information seeker, which are independent and which show different patterns of prediction. Early use of the drug discussed was largely independent of the potential predictors. It is argued that first use of high risk drugs is determined by two factors, preparedness to prescribe the new drug and the presentation of particular circumstances which are appropriate for its use, only the first of which is predictable from the variables ordinarily thought to be involved in innovation. Therefore, if innovation is to be identified with stable characteristics of the practitioner, then this concept must be redefined in terms of knowledge and judgement rather than in terms of a particular behavioural event.