von Ferber L, Luciano A, Köster I, Krappweis J
Primary Health Care Research Unit, Faculty of Medicine, University of Düsseldorf, Germany.
Int J Clin Pharmacol Ther Toxicol. 1992 Nov;30(11):453-5.
Drugs in primary health care are often prescribed for nonrational reasons. Drug utilization research investigates the prescription of drugs with an eye to medical, social and economic causes and consequences of the prescribed drug's utilization. The results of this research show distinct differences in drug utilization in different age groups and between men and women. Indication and dosage appear irrational from a textbook point of view. This indicates nonpharmacological causes of drug utilization. To advice successfully changes for the better quality assessment groups of primary health care physicians get information about their established behavior by analysis of their prescriptions. The discussion and the comparisons in the group allow them to recognize their irrational prescribing and the social, psychological and economic reasons behind it. Guidelines for treatment are worked out which take into account the primary health care physician's situation. After a year with 6 meetings of the quality assessment groups the education process is evaluated by another drug utilization analysis on the basis of the physicians prescription. The evaluation shows a remarkable improvement of quality and cost effectiveness of the drug therapy of the participating physicians.
初级卫生保健中的药物处方往往存在不合理的原因。药物利用研究着眼于药物使用的医学、社会和经济原因及后果来调查药物处方情况。这项研究结果表明，不同年龄组以及男性和女性之间在药物利用方面存在明显差异。从教科书的角度来看，用药指征和剂量似乎不合理。这表明了药物利用的非药理学原因。为了成功地建议初级卫生保健医生群体做出改善质量的改变，通过分析他们的处方来了解他们既有的行为。小组内的讨论和比较使他们能够认识到自己不合理的处方行为及其背后的社会、心理和经济原因。制定出考虑到初级卫生保健医生情况的治疗指南。在质量评估小组召开6次会议的一年之后，根据医生的处方通过另一项药物利用分析对教育过程进行评估。评估显示，参与研究的医生的药物治疗质量和成本效益有了显著提高。
