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全科医生和精神科医生开具苯二氮䓬类药物处方相关的争议性问题。

Controversial issues associated with the prescription of benzodiazepines by general practitioners and psychiatrists.

作者信息

de las Cuevas Carlos, Sanz Emilio José

机构信息

Department of Psychiatry, University of La Laguna, Santa Cruz de Tenerife, Spain.

出版信息

Med Sci Monit. 2004 Jul;10(7):CR288-93. Epub 2004 Jun 29.

Abstract

BACKGROUND

Benzodiazepines are commonly used psychotropics frequently applied in ways not fully supported by the present state of scientific knowledge. These departures are usually based on considerations of clinical practice characteristics seldom fully acknowledged by Evidence Based Medicine.

MATERIAL/METHODS: To assess the basic knowledge that sustains the prescription of benzodiazepines, a questionnaire about its use composed of twelve statements which are either "right" or "wrong" was given to a representative sample of 194 general practitioners and 34 psychiatrists working for the Canary Islands Health Service. The correctness of the statements were evaluated against literature sources and the answers were analyzed according to those results.

RESULTS

None of the participants answered all statements correctly. Six statements were incorrectly answered by more than 50%, another three by more than 40%, and only the remaining three were failed by less than 20% of the sample. If a score had been developed for each professional, general practitioners would have achieved a mean score of 4.9 points out of 10, whereas psychiatrists would have had a mean score of 6.1 out of 10.

CONCLUSIONS

Benzodiazepines are commonly used, safe and efficacious drugs, but the knowledge shown by health professionals with ample experience is not in agreement with the current state of knowledge on the matter. To better use these useful and old drugs, up-to-date knowledge is needed. Along the same line, the scientific knowledge related to an adequate psychoactive drug prescription should be revised, giving more importance to real circumstances from clinical practice.

摘要

背景

苯二氮䓬类药物是常用的精神药物,其使用方式常常未得到当前科学知识水平的充分支持。这些偏离通常基于临床实践特点的考量,而循证医学很少充分认可这些特点。

材料/方法:为评估支撑苯二氮䓬类药物处方的基本知识,向加那利群岛卫生服务机构工作的194名全科医生和34名精神科医生的代表性样本发放了一份关于其使用的问卷,问卷由12条陈述组成,这些陈述非“正确”即“错误”。根据文献来源评估陈述的正确性,并根据结果分析答案。

结果

没有参与者正确回答所有陈述。超过50%的人答错了6条陈述,超过40%的人答错了另外3条,只有其余3条陈述样本中答错的比例不到20%。如果为每个专业人员制定一个分数,全科医生在10分中平均得分为4.9分,而精神科医生在10分中平均得分为6.1分。

结论

苯二氮䓬类药物是常用的、安全有效的药物,但经验丰富的卫生专业人员所展现的知识与该问题的当前知识水平不一致。为了更好地使用这些有用的老药,需要最新的知识。同样,与适当的精神活性药物处方相关的科学知识应加以修订,更加重视临床实践中的实际情况。

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