%0 Journal Article
%T Clinician
%A David C Currow
%A Katherine Clark
%A Linda Brown
%A Meera R Agar
%A Nikki McCaffrey
%A Rachel Campbell
%J Palliative Medicine
%@ 1477-030X
%D 2018
%R 10.1177/0269216318778460
%X Translating research evidence into clinical practice often has a long lag time. To determine the impact of a phase III randomised controlled trial on palliative care clinicians¡¯ self-reported practice change. Online survey about use of octreotide in managing inoperable malignant bowel obstruction due to cancer or its treatments distributed in November 2016, 2£¿years after the first publication of the study in a peer-reviewed journal. Demographic, self-reported practice and the reasons underpinning this were collected. Responses were aggregated to ¡®practice modified¡¯ or ¡®practice not modified¡¯. A multinomial regression model explored predictors of practice change. Members of the Australian New Zealand Society of Palliative Medicine. Response rate was 20.8% (106/509): 55.6% were aged >50£¿years, 56.5% were female and 77% had previously prescribed octreotide for this clinical indication. Out of 106 respondents, 52 (49.1%) indicated modified practice (60.9% of those who had previously prescribed octreotide in this setting). In those who reported practice change, most frequently octreotide was now used when other therapies failed; for not changing practice, ¡®more confirmatory evidence was needed¡¯ was most often cited. In the regression model, older age (clinician age£¿=£¿50¨C59£¿years; relative risk£¿=£¿0.147; 95% confidence interval£¿=£¿0.024¨C0.918; p£¿=£¿0.04) and having practices with lower proportions of people treated with octreotide (0%¨C20%; relative risk£¿=£¿0.039; 95% confidence interval£¿=£¿0.002¨C0.768; p£¿=£¿0.033) predicted greater self-reported practice change. Clinician-reported change in practice in the survey is seen in the majority of respondents. This suggests that there is a cohort of ¡®early adopters¡¯ within palliative care practice as new evidence becomes available
%K Practice change
%K implementation science
%K phase III clinical trial
%K randomised controlled trial
%K malignant bowel obstruction
%K octreotide
%K somatostatin analogues
%U https://journals.sagepub.com/doi/full/10.1177/0269216318778460