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本文引用的文献

1
[Sociocultural aspects of the genesis of personality disorders].[人格障碍成因的社会文化因素]
Actas Esp Psiquiatr. 2001 Jan-Feb;29(1):47-57.
2
[Factors conditioning prescription in primary care].[基层医疗中影响处方开具的因素]
Aten Primaria. 2001 Jan;27(1):43-8. doi: 10.1016/s0212-6567(01)78772-0.
3
Benzodiazepine prescribing by GP registrars. A trial of educational outreach.全科医生培训生开具苯二氮䓬类药物处方情况。一项教育推广试验。
Aust Fam Physician. 2000 Nov;29(11):1104-7.
4
[Benzodiazepine prescription at a health center: prevalence, its use and user characteristics].[某健康中心的苯二氮䓬类药物处方：患病率、使用情况及使用者特征]
Aten Primaria. 2000 Feb 15;25(2):107-10. doi: 10.1016/s0212-6567(00)78472-1.
5
The effect of panel membership and feedback on ratings in a two-round Delphi survey: results of a randomized controlled trial.两轮德尔菲调查中专家组成员和反馈对评分的影响：一项随机对照试验的结果
Med Care. 1999 Sep;37(9):964-8. doi: 10.1097/00005650-199909000-00012.
6
Prescribing benzodiazepines--a critical incident study of a physician dilemma.
Soc Sci Med. 1999 Aug;49(4):459-67. doi: 10.1016/s0277-9536(99)00133-1.
7
General practitioners' perceptions of effective health care.全科医生对有效医疗保健的看法。
BMJ. 1999 Jun 5;318(7197):1532-5. doi: 10.1136/bmj.318.7197.1532.
8
[Determinants of clinical decision making in primary care: opinion of physicians].
Aten Primaria. 1998 Nov 15;22(8):505-13.
9
[Factors affecting drug prescriptions by the primary care physician].[基层医疗医生开具药物处方的影响因素]
Aten Primaria. 1998 Oct 15;22(6):391-8.
10
Understanding the culture of prescribing: qualitative study of general practitioners' and patients' perceptions of antibiotics for sore throats.理解处方文化：关于全科医生和患者对咽喉痛使用抗生素看法的定性研究
BMJ. 1998 Sep 5;317(7159):637-42. doi: 10.1136/bmj.317.7159.637.

[影响苯二氮䓬类药物处方的因素及改善其使用的措施：基层医疗医生的德尔菲研究]

[Factors that affect the prescription of benzodiazepines and actions to improve their use: a Delphi study of primary care doctors].

作者信息

Fernández Alvarez T, Gómez Castro M J, Baides Morente C, Martínez Fernández J

机构信息

Médico especialista en Medicina Familiar y Comunitaria. Centro de Salud de La Magdalena-Carriona. Area III del INSALUD. Avilés (Asturias). Spain.

出版信息

Aten Primaria. 2002 Sep 30;30(5):297-303. doi: 10.1016/s0212-6567(02)79031-8.

DOI:10.1016/s0212-6567(02)79031-8
PMID:12372211
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7684192/
Abstract

OBJECTIVES

To identify the factors that affect the prescription of benzodiazepines and similar drugs and the actions that can be taken to reduce their prescription.Design. Consensus method. Delphi technique.

SETTING

Four primary care areas in Asturias. Participants. 39 doctors from primary care teams agreed voluntarily to take part in the study, and 32 completed the study. They belonged to 20 health centres.

METHOD

They were sent by mail three questionnaires one after the other. The second and third questionnaires were worked out on the basis of the analysis of the information from the replies to the preceding questionnaire. Those who did not send in a reply were reminded by phone.

RESULTS

The 5 most influential factors in benzodiazepine prescription were agreed: reduction in the threshold of tolerance of emotional discomfort; increase of the prevalence of pathologies; lack of time in the consulting-room; social and economic conditioning factors; properties of the benzodiazepine family. The 5 most important actions that could reduce prescription of these drugs were agreed: general health education; reduction in case loads; making doctors more conscious of prescribing correctly; strengthening the social support network; doctors fomenting use of effective alternative treatments.

CONCLUSIONS

The prescription of benzodiazepines and their analogues is a multi-factorial action with social and psychological roots. The action most voted on to reduce their prescription was general health education.

摘要

目的

确定影响苯二氮䓬类药物及类似药物处方的因素，以及可采取的减少此类药物处方的措施。设计：共识方法。德尔菲技术。

背景

阿斯图里亚斯的四个初级保健区域。参与者：来自初级保健团队的39名医生自愿同意参与研究，32人完成了研究。他们隶属于20个健康中心。

方法

依次通过邮件向他们发送三份问卷。第二份和第三份问卷是根据对前一份问卷回复信息的分析制定的。未回复者会接到电话提醒。

结果

就苯二氮䓬类药物处方中5个最具影响力的因素达成共识：对情绪不适的耐受阈值降低；疾病患病率增加；诊室时间不足；社会和经济制约因素；苯二氮䓬类药物家族的特性。就可减少这些药物处方的5项最重要措施达成共识：开展全面健康教育；减少工作量；提高医生正确开处方的意识；加强社会支持网络；医生鼓励使用有效的替代疗法。

结论

苯二氮䓬类药物及其类似物的处方是一个具有社会和心理根源的多因素行为。在减少其处方方面得票最多的措施是开展全面健康教育。