De Las Cuevas Carlos, Sanz Emilio J, De La Fuente Juan A
Department of Psychiatry, University of La Laguna, Tenerife, Canary Islands, Spain.
Pharmacoepidemiol Drug Saf. 2002 Sep;11(6):515-22. doi: 10.1002/pds.715.
To assess the antidepressant prescribing patterns of community psychiatrists, and the prescriptions issued by general practitioners and private physicians during 1999 in order to analyse and discuss the intensity and sources of variations between doctors.
All reimbursed prescriptions for antidepressants written in 1999 by community psychiatrists and general practitioners working for the Canary Islands Health Service at Santa Cruz de Tenerife were collected from official sources. Prescriptions were available individualized for each psychiatrist but were collected globally for the others. Drugs were classified according to the Anatomic Therapeutic Chemical (ATC-1999 edition) System and use was quantified in terms of defined daily doses (DDDs). As an indicator of the quality of drug prescribing, the DU90% was used.
The total use of antidepressant in Tenerife was 21.4 DDD/1000 inhabitants/day. The most frequently prescribed substances were fluoxetine, paroxetine and sertraline, which accounted for 58% of all prescriptions. Each psychiatrist used between 10 and 20 different substances and between 15 and 26 different trade names. Prescribing by general practitioners mirrored that of psychiatrist, and private doctors (mainly psychiatrist) were found to have a different pattern of prescribing with higher use of new and uncommon antidepressants. Psychiatrists acknowledge the pressures of promotion by the pharmaceutical industry and half of them recognize a personal relationship with some 'company representatives'.
There is a remarkable degree of variation in antidepressant prescribing by psychiatrists and general practitioners, this is due to economic and social factors as much as to morbidity differences.
评估社区精神科医生的抗抑郁药处方模式，以及1999年全科医生和私人医生开具的处方，以便分析和讨论医生之间差异的强度和来源。
从官方来源收集了1999年特内里费岛圣克鲁斯市加那利群岛卫生服务中心的社区精神科医生和全科医生开具的所有可报销抗抑郁药处方。处方针对每位精神科医生单独提供，但其他医生的处方则汇总收集。药物根据解剖治疗化学（ATC - 1999版）系统进行分类，并以限定日剂量（DDD）来量化使用情况。作为药物处方质量的指标，使用了DU90%。
特内里费岛抗抑郁药的总使用量为21.4 DDD/1000居民/天。最常开具的药物是氟西汀、帕罗西汀和舍曲林，占所有处方的58%。每位精神科医生使用10至20种不同的药物以及15至26种不同的商品名。全科医生的处方情况与精神科医生相似，而私人医生（主要是精神科医生）的处方模式不同，他们更多地使用新型和不常见的抗抑郁药。精神科医生承认制药行业促销带来的压力，其中一半人承认与一些“公司代表”有个人关系。
精神科医生和全科医生在抗抑郁药处方方面存在显著差异，这在很大程度上是由经济和社会因素以及发病率差异导致的。
