Influences on oncologists' adoption of new agents in adjuvant chemotherapyof breast cancer

Purpose: Lithe is known about how oncologists' adopt new treatments for bre ast cancer. This study investigated influences on oncologists' adoption of paclitaxel as adjuvant chemotherapy for early-stage breast cancer, 9 months after presentation of phase III data suggesting improved disease-free and overall survival when paclitaxel was added to doxorubicin and cyclophospham ide for such patients. Methods: Self-reported data were collected with a mail survey of a random s ample of 1,200 oncologists practicing in the United States. Using pagers' m odel, we measured four types of influences on adoption of innovation: (1)co mmunication channels, (2) innovation characteristics, (3) a practitioner's social system, and (4) physician characteristics. Multiple regression analy sis assessed the associations between oncologist adoption of paclitaxel for early-stage breast cancer patients and variables representing the modeled influences on adoption. Results: On average, respondents (n = 181) reported having adopted paclitax el for 37% of their early-stage breast cancer patients. The overall model w ar significant, with seven variables associated (P less than or equal to .0 5) with adoption of paclitaxel. Significant influences on adoption included use of symposia as a therapy information source, physician experience with paclitaxel to treat late-stage breast cancer, and perceived advantage in e fficacy of paclitaxel. Conclusion: As new modalities become available to treat cancer, it is vital to understand what factors influence oncologists and patients when choosin g to use them. Those parties interested in fostering the adoption of new br east cancer treatments should address features of communication channels (e g, use of symposia), characteristics of new treatments (eg, perceived advan tage in efficacy), physicians' social systems (eg, patient requests), and c haracteristics of potential adapters (eg, previous experience with the trea tment).