Adair Richard F, Holmgren Leah R
University of Minnesota, Minneapolis, Minn, USA.
Am J Med. 2005 Aug;118(8):881-4. doi: 10.1016/j.amjmed.2005.02.031.
The purpose of the study was to determine whether access to drug samples influences resident prescribing decisions.
The authors observed 390 decisions to initiate drug therapy by 29 internal medicine residents over a 6-month period in an inner-city primary care clinic. By random selection, half of the residents agreed not to use available free drug samples. Five drug class pairs were chosen for study prospectively. Highly advertised drugs were matched with drugs commonly used for the same indication that were less expensive, available over-the-counter, or available in generic formulation.
Resident physicians with access to drug samples were less likely to choose unadvertised drugs (131/202 decisions) than residents who did not have access to samples (138/188 decisions; P = .04) and less likely to choose over-the-counter drugs (51/202, 73/188; P = .003). There was a trend toward less use of inexpensive drugs.
Access to drug samples in clinic influences resident prescribing decisions. This could affect resident education and increase drug costs for patients.
本研究的目的是确定获取药物样本是否会影响住院医师的处方决策。
作者在一家市中心初级保健诊所对29名内科住院医师在6个月期间做出的390项启动药物治疗的决策进行了观察。通过随机选择,一半的住院医师同意不使用现有的免费药物样本。前瞻性地选择了五对药物类别进行研究。将大量宣传的药物与用于相同适应症的常用药物进行匹配,这些常用药物价格较低、可在柜台购买或有通用剂型。
能够获取药物样本的住院医师比无法获取样本的住院医师更不可能选择未做广告的药物(202项决策中有131项)(188项决策中有138项;P = 0.04),也更不可能选择非处方药(202项中有51项,188项中有73项;P = 0.003)。使用廉价药物的趋势有所下降。
诊所中获取药物样本会影响住院医师的处方决策。这可能会影响住院医师的教育,并增加患者的药物成本。