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How To Speed Up the Adoption of Medical Innovations

If a given innovation in therapy is proven to improve patient outcomes; then presumably, the sooner a physician prescribes the therapy, the better, for patients and for healthcare. So, how can one speed up the adoption rate of innovations potentially beneficial to clinical practice and patient care?

Creating awareness for medical innovations is relatively easy to achieve through various channels, such as advertising. But, more importantly, what is it that influences adoption of it?

Pivotal influence comes from evidence, and from those that champion the evidence. This makes all the difference for great innovations, or sometimes simple solutions that never come to be adopted as widely as they should. It was how the diffusion and adoption of the new antibiotic, tetracycline, spread widely in the 1950s. Trust forms the basis for the adoption of innovations – what evidence counts towards building that trust, and the opinions of the thought leaders in the field on the value of the innovation.

Dissemination of high-quality communication and evidence garnered from conclusions of a Cochrane review, peer-reviewed work from clinical opinion leaders published in a prestigious journal, allows the adoption of medical innovations to spread more widely through appropriate communication channels such as reprints.

Besides speeding up the adoption of latest medical innovation, reprints can revive classic drugs at the stage of decline in its life cycle. Some classic drugs such as Panadol continue to prolong its product life cycle through evidence-based clinical trials that reinforce the drug’s effectiveness in different therapeutic areas.

Here’s a list of recent studies in Asia Pacific to start us off embracing new conclusions in the medical field:

Renoprotective Effects of Atorvastatin Compared With Pravastatin on Progression of Early Diabetic NephropathyJournal of Diabetes InvestigationOfficial Journal of the Asian Association for the Study of DiabetesThe strength of the study, conducted on patients recruited over the years of 2008 – 2010 from hospitals in Japan, is that it is a direct comparison between atorvastatin andpravastatin with respect to their effect on renal function. Several studies have indicated that statins suppress the progression of diabetic nephropathy. However, few reports have directly compared the renoprotective effects between potent and conventional statins.
A meta-analysis comparing the efficacy of entecavir and tenofovir for the treatment of chronic hepatitis B infectionThe Journal of Clinical PharmacologyJournal of the American College of Clinical PharmacologyThe efficacy of entecavir and tenofovir in patients with chronic hepatitis B (HBV) is inconsistent. To address this issue, a meta-analysis was conducted based on a current review of the recent literature addressing the efficacy and safety of entecavir and tenofovir in Chinese- and English-language publications.
Effects of the N/L-Type Calcium Channel Blocker Cilnidipine on Nephropathy and Uric Acid Metabolism in Hypertensive Patients With Chronic Kidney Disease (J-CIRCLE Study)The Journal of Clinical HypertensionOfficial Journal of The World Hypertension LeagueEffects of switching from amlodipine (L-type CCB) to cilnidipine(N/L-type CCB) on BP, renal function, serum uric acid level, and uric acid metabolism in hypertensive patientswith chronic kidney disease (CKD) were analyzed; with results suggesting that switching from amlodipine to cilnidipine results in a significant reduction in urinary albumin/creatinine ratio (ACR) as well as significant reduction in uric acid production. Thus, cilnidipine is more useful than amlodipine in improving albuminuria and uric acid metabolism in hypertensive patients with CKD.
Efficacy and safety of interferon treatment in elderly patients with chronic hepatitis C in Japan: A retrospective study using the Japanese Interferon DatabaseHepatology ResearchOfficial Journal of Japan Society of HepatologyAlthough interferon (IFN) treatment in elderly patients with chronic hepatitis C virus (HCV) infection has increased with the aging Japanese population, few studies have examined the efficacy and safety of IFN treatment in this population. This study investigates the efficacy and safety of IFN treatment in elderly patients with chronic HCV infection using the Japanese Interferon Database.
Efficacy and safety of dapagliflozin monotherapy in Japanese patients with type 2 diabetes inadequately controlled by diet and exerciseDiabetes, Obesity and MetabolismThe aim of the present phase III study was to provide additional insight into the clinical profile of dapagliflozin inJapanese patients. The study concluded that Dapagliflozin (5 and 10 mg) was well tolerated and effective in reducing HbA1c, FPG and body weight over 24 weeks in Japanese patients with T2DM inadequately controlled by diet and exercise.
Non-antiplatelet effect of Clopidogrel: Improving endothelial function in Chinese healthy subjects with different CYP2C19 genotypeClinical and Experimental Pharmacology and Physiology High Blood Pressure Research Council of Australia, the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists and the Australian Physiological Society It is the first time to report that clopidogrel improves endothelial function in healthy Chinese subjects, which is irrelated with CYP2C19 genotype and independent of antiplatelet action.
PPARD rs2016520 Polymorphism Affects Repaglinide Response in Chinese Han Patients with Type 2 Diabetes MellitusClinical and Experimental Pharmacology and PhysiologyHigh Blood Pressure Research Council of Australia, the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists and the Australian Physiological Society   Recent studies have described the importance of PPARD in regulating the secretion and resistance of insulin. However, little is known as to the impacts of PPARD genetic polymorphism on the efficacy of repaglinide. Therefore, the current study was designed to investigate the associations of PPARD rs2016520 polymorphism with T2DM susceptibility and repaglinide therapeutic efficacy in Chinese Han T2DM patients. Findings suggest that PPARD rs2016520 polymorphism may influence the therapeutic effect of repaglinide rather than T2DM susceptibility in Chinese Han T2DM patients.
Effect of Nicorandil in patients with heart failure: a systematic review and meta-analysisCardiovascular TherapeuticsIt is unclear whether nicorandil, a metabolic therapeutic drug, can be applied clinically to therapy of heart failure (HF). This meta-analysis evaluated therapeutic effects of nicorandil on HF patients. The study concludes the use of nicorandil in HF patients exerts substantial beneficial effects, suggesting that it may be an additional therapeutic agent for HF.
A systematic review and meta-analysis of the i-gel® vs laryngeal mask airway in childrenAnaesthesiaJournal of the Association of Anaesthetists of Great Britain & IrelandA systematic review of randomised controlled trials of the i-gel vs different types of laryngeal mask airway in children concluded that the clinical performance of the i-gel and LMA was similar, except for three outcomes that favoured the i-gel.
Ezetimibe combined with standard diet and exercise therapy improves insulin resistance and atherosclerotic markers in patients with metabolic syndromeJournal of Diabetes Investigation –Official Journal of the Asian Association for the Study of DiabetesEzetimibe combined with standard diet and exercise therapy improves not only body weight and atherogenic lipid profiles but also insulin resistance, blood pressure, and anthropometric factors in metabolic syndrome in a local-dwelling Japanese.   Interestingly, the improvement of insulin resistance had no correlation with that of other metabolic components.
The glycemic efficacies of insulin analogue regimens according to baseline glycemic status in Korean patients with type 2 diabetes: sub-analysis from the A1chieve® studyInternational Journal of Clinical PracticeThe study compared the glucose-lowering effectiveness of insulin analogues and their combination according to baseline glycemic status in patients with type 2 diabetes (T2D) from the A1chieve® study conducted in Korea; and concluded that for optimal glycaemic control, a basal-bolus regimen may be adequate for Korean patients with poorly controlled T2D (HbA1c ≥ 9.0%).
Weekly rituximab consolidation following four cycles of R-CHOP induction chemotherapy in very elderly patients with diffuse large B-cell lymphoma: Consortium for improving survival of lymphoma study (CISL)European Journal of HaematologyFifty-one patients were enrolled between June 2010 and September 2013 at 15 institutions in South Korea. No serious toxicities were reported during rituximab consolidation. Weekly rituximab consolidation following four cycles of R-CHOP21 resulted in an acceptable response with high tolerability and could be a good compromise between efficacy and safety for elderly DLBCL patients.
The pharmacokinetics of metformin and concentrations of HbA1C and lactate in Indigenous and non-Indigenous Australians with type 2 diabetes mellitusBritish Journal of Clinical Pharmacology – A Journal of the British Pharmacological SocietyThe study aimed at comparing the pharmacokinetics of metformin between diabetic Australian Indigenous (Aboriginal and Torres Strait Islander) and non-Indigenous patients found that there were no significant differences in the pharmacokinetics of metformin or plasma concentrations of lactate between Indigenous and non-Indigenous patients with T2DM. Further studies are required in Indigenous patients with CLCR <30 ml min-1.
Tamsulosin versus tamsulosin plus tadalafil as medical expulsive therapy for lower ureteric stones: A randomized controlled trialInternational Journal of Urology – Official Journal of the Japanese Urological AssociationA study undertaken in western India aimed to compare the efficacy of tamsulosin versus tamsulosin plus tadalafil as medical expulsive therapy for lower ureteric stones. The study concluded that medical expulsive therapy for distal ureteric stones using tamsulosin plus tadalafil is safe, effective and well tolerated.   Furthermore, tadalafil provides the additional advantage of improving erectile dysfunction when this condition coexists with a lower ureteric stone.

For reprint opportunities, and other channels to influence through education, please contact us at corporatesalesasia@wiley.com

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