[毕尔巴鄂地区初级卫生保健中的诱导处方]

[Induced prescription in primary health care in area Bilbao].

作者信息

Ruiz De Velasco Artaza E, Unzueta Zamalloa L, Fernández Uria J, Santisteban Olabarria M, Lekue Alkorta I

机构信息

Farmacéuticas de AP, Unidad de Farmacia, Comarca Bilbao, Spain.

出版信息

Aten Primaria. 2002 Apr 30;29(7):414-20. doi: 10.1016/s0212-6567(02)70597-0.

DOI:10.1016/s0212-6567(02)70597-0

PMID:12031237

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7688825/

Abstract

MAIN OBJECTIVES

to know the proportion of induced prescription (IP) in Area Bilbao and its source, the proportion of cost IP accounts for, the proportion of IP in the main therapeutic groups, the attitude of GP when requested for prescription and its influence on cost, the proportion of disagreement with requested prescription, the reasons for disagreement, and the proportion with letter from specialist.

SECONDARY OBJECTIVES

to know the proportion of IP in the remaining therapeutic groups, in drugs of low clinical value, in generic drugs and in new drugs with low or no therapeutic improvement.

DESIGN

A descriptive cross-sectional study.Setting. Primary health care.

PARTICIPANTS

Drugs prescribable under National Health Service prescribed by and/or requested to GPs. Main results. 7.922 drugs were analysed. Type of prescription: IP, 48.3% (95% CI, 47.2-49.4); GP prescription (GPP), 50.6% (95% CI, 49.5-51.7); unknown source, 1,1% (95% CI, 0.9-1.3). Main source, public specialist (72.2%), private specialist (16.6%). IP accounted for 62.5% of cost. In the most prescribed therapeutic group, central nervous system (24.2%), IP, 39.8%; GPP, 58.9%; in cardiovascular system (19.1%), IP, 56.2%; GPP, 43.1%. 98.4% of requested prescription was actually prescribed, 1.2% was changed and 0.4%, suppressed. Proportion of disagreement, 11%; reasons for disagreement, no need for medical treatment (23.9%), therapeutic group (34.4%), active ingredient (13.2%), brand name (28.5%). There was a 62.4% with letter from specialist.

CONCLUSIONS

Primary care is not accountable for a substantial proportion of prescription. GP prescribes a considerable proportion of drugs without agreement. It would be necessary a system that allows to separate the cost by care levels and also improve their communication.

摘要

主要目标

了解毕尔巴鄂地区诱导处方（IP）的比例及其来源、IP占成本的比例、主要治疗组中IP的比例、全科医生（GP）在被要求开处方时的态度及其对成本的影响、对所要求处方的不同意比例、不同意的原因以及有专科医生信件的比例。

次要目标

了解其余治疗组、临床价值低的药物、通用药物以及治疗改善低或无治疗改善的新药中IP的比例。

设计

描述性横断面研究。地点：初级卫生保健。

参与者

由全科医生开具和/或要求开具的国家医疗服务体系下可开具的药物。主要结果。分析了7922种药物。处方类型：IP，48.3%（95%置信区间，47.2 - 49.4）；全科医生处方（GPP），50.6%（95%置信区间，49.5 - 51.7）；来源不明，1.1%（95%置信区间，0.9 - 1.3）。主要来源，公立专科医生（72.2%），私立专科医生（16.6%）。IP占成本的62.5%。在处方最多的治疗组中，中枢神经系统（24.2%），IP，39.8%；GPP，58.9%；在心血管系统（19.1%）中，IP，56.2%；GPP，43.1%。98.4%的要求处方实际被开具，1.2%被更改，0.4%被拒绝。不同意比例为11%；不同意的原因，无需治疗（23.9%），治疗组（34.4%），活性成分（13.2%），品牌名称（28.5%）。有专科医生信件的比例为62.4%。