The problem is obtaining knowledge: a qualitative analysis of provider barriers and accelerators to rapid adoption of new treatment in a public health emergency

Abstract

Granted by the U.S. Food and Drug Administration, an Emergency Use Authorization (EUA) can only be utilized upon declaration that a specialized set of circumstances exist which justify the authorization. In 2020, the COVID-19 pandemic demanded rapid communication strategies to promote treatment options available through EUA. Despite the authorizations of available monoclonal antibody (mAb) treatments in November 2020, their rate of adoption among health care providers in the U.S. remained low well into 2021. This study examines the accelerators and barriers to provider adoption of COVID-19 treatment so that future adoption of treatments in emerging public health emergencies may be better communicated and hastened. We established a framework informed by adoption accelerators and barriers identified by Diffusion of Innovations (DoI) Theory and conducted a study during the rapidly evolving COVID-19 public health emergency. Most DoI public health research focuses on chronic health issues and has yet to be applied to provider adoption of new treatment under EUA. Through a series of guided interviews with health care providers, primarily physicians or nurse practitioners that were responsible for referring COVID-19 patients, we extracted tools, processes, or other mechanisms (accelerators) and barriers to validate against our DoI framework and fill the gap regarding emergency situations. Our research found that providers supported by large health systems were more inclined to adoption, due to many contributing factors such as the availability of collaborative support and availability of information. Further, communicating evidence-based summaries of treatment options and related processes was also critical to adoption.