Schumock Glen T, Walton Surrey M, Park Hayley Y, Nutescu Edith A, Blackburn Juan C, Finley Jamie M, Lewis Richard K
Center for Pharmacoeconomic Research, and Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL 60612-7230, USA.
Ann Pharmacother. 2004 Apr;38(4):557-62. doi: 10.1345/aph.1D390. Epub 2004 Feb 13.
Strategies to control the quality and cost of medication use are largely dependent on the ability to alter selection of medications. Previous models of prescribing behavior have focused on physicians. In the hospital setting, clinical pharmacists and formulary committee members are also key players in drug therapy decision-making. Differences between physicians, formulary committee members, and clinical pharmacists have not been compared. Knowledge of these differences could have importance in predicting the effectiveness of strategies designed to influence drug use in this setting.
To describe and compare the opinions of physicians, clinical pharmacists, and formulary committee members with respect to key factors that influence medication prescribing in community hospitals.
Physicians, clinical pharmacists, and formulary committee members were solicited to participate. A trained interviewer administered a standardized questionnaire designed to elicit opinions of participants regarding the importance of factors thought to influence drug prescribing. Responses were described using descriptive statistics, and differences between the groups were determined by post hoc analysis.
A total of 150 individuals participated in the study. Safety, effectiveness, formulary status, and restrictions on prescribing were considered highly influential by all participants. Physicians rated the availability of drug samples and personal experience higher (more influential on prescribing) than clinical pharmacists and formulary committee members. Clinical pharmacists and formulary committee members rated the influence of recommendations by clinical pharmacists, prescribing guidelines, and cost or cost comparisons higher than physicians. Factors that were drug-related or that involved policy-related programs tended to be more influential than indirect factors.
Those who seek to implement programs to alter medication use should recognize and employ factors that are most influential in the decision-making process. Further, it may be important to consider differences that exist between key participants in the medication use process.
控制药物使用质量和成本的策略很大程度上取决于改变药物选择的能力。以往的处方行为模型主要关注医生。在医院环境中，临床药师和处方集委员会成员也是药物治疗决策的关键参与者。医生、处方集委员会成员和临床药师之间的差异尚未进行比较。了解这些差异对于预测旨在影响该环境中药物使用的策略的有效性可能具有重要意义。
描述并比较医生、临床药师和处方集委员会成员对于影响社区医院药物处方的关键因素的看法。
邀请医生、临床药师和处方集委员会成员参与。一名经过培训的访谈者发放一份标准化问卷，旨在引出参与者对被认为影响药物处方的因素的重要性的看法。使用描述性统计来描述回答，并通过事后分析确定组间差异。
共有150人参与了该研究。所有参与者都认为安全性、有效性、处方集状态和处方限制具有高度影响力。医生对药物样品的可得性和个人经验的评分高于临床药师和处方集委员会成员（对处方的影响更大）。临床药师和处方集委员会成员对临床药师的建议、处方指南以及成本或成本比较的影响的评分高于医生。与药物相关或涉及政策相关项目的因素往往比间接因素更具影响力。
那些寻求实施改变药物使用的项目的人应该认识并采用在决策过程中最具影响力的因素。此外，考虑药物使用过程中关键参与者之间存在的差异可能很重要。
