de Vries C S, Duggan C A, Tromp T F, de Jong-van den Berg L T
Department of Social Pharmacy and Pharmacoepidemiology, University Centre for Pharmacy, Groningen University Institute for Drug Exploration, The Netherlands.
Drug Saf. 1999 Sep;21(3):153-60. doi: 10.2165/00002018-199921030-00001.
Despite our knowledge regarding the efficacy, tolerability and optimal use of drugs, suboptimal prescribing still occurs. In view of all the factors that influence prescribing, this is not surprising. The focus of drug tolerability has changed from 'choosing the best alternative' when a drug is prescribed, to a balanced decision incorporating various different treatments from separate healthcare providers. This article reviews strategies that may influence prescribing behaviour and discusses practical considerations for achieving optimal prescribing in view of tolerability concerns. The patient has a major influence on prescribing and, with the current diversification of healthcare, the patient now controls prescribing behaviour more than ever before. Communication between healthcare providers consequently assumes a vital role. If messages are to be coherent and transferable, it is increasingly important that healthcare workers communicate effectively with one another regarding patients, prescribing patterns, and drug tolerability issues.
尽管我们了解药物的疗效、耐受性和最佳使用方法，但仍存在处方不合理的情况。鉴于影响处方的所有因素，出现这种情况并不奇怪。药物耐受性的重点已从开药时“选择最佳替代药物”转变为综合来自不同医疗服务提供者的各种不同治疗方法的平衡决策。本文回顾了可能影响处方行为的策略，并讨论了鉴于耐受性问题实现最佳处方的实际考虑因素。患者对处方有重大影响，并且随着当前医疗保健的多样化，患者现在比以往任何时候都更能控制处方行为。因此，医疗服务提供者之间的沟通起着至关重要的作用。如果信息要连贯且可传递，那么医护人员就患者、处方模式和药物耐受性问题相互之间进行有效沟通就变得越来越重要。
