Hem Erlend, Stokke Guro, Tyssen Reidar, Grønvold Nina T, Vaglum Per, Ekeberg Øivind
Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, University of Oslo, PO Box 1111 Blindern, NO-0317 Oslo, Norway.
BMC Med. 2005 Oct 21;3:16. doi: 10.1186/1741-7015-3-16.
Self-prescribing among doctors is common, but no longitudinal studies have documented this issue. We studied the self-prescribing behaviour among young Norwegian physicians and the predictors of self-prescribing.
We conducted a nationwide, prospective and longitudinal study following young Norwegian physicians from internship through the subsequent nine years using three postal questionnaires. Chi-square tests and logistic regression models were applied.
About 54% of the physicians in their fourth and ninth postgraduate years had self-prescribed medication at least once during the previous year. Among those who had used prescription medication during the previous year, about 90% had self-prescribed. Self-prescribing behaviour did not differ significantly between men and women, or according to the type of work at any time. The most frequently self-prescribed medications were antibiotics (71%-81%), contraceptives (24%-25%), analgesics (18%-21%), and hypnotics (9%-12%). Those who had needed treatment for mental problems had self-prescribed hypnotics and sedatives to a greater extent than the others. Being male, having self-prescribed during internship, somatic complaints, mental distress, subjective health complaints, and not having sought help from a general practitioner, were significant adjusted predictors of self-prescribing in the ninth postgraduate year.
The level of self-prescribing among young Norwegian physicians is relatively high, and this behaviour is established early in their professional lives. Although self-prescribing is acceptable in some situations, physicians should seek professional help for illness. Efforts to inculcate more rational help-seeking behaviour should probably start in medical schools.
医生自我开药方的现象很常见,但尚无纵向研究记录过这一问题。我们研究了挪威年轻医生的自我开药方行为及其预测因素。
我们开展了一项全国性的前瞻性纵向研究,通过三份邮寄问卷对挪威年轻医生从实习开始到随后九年进行跟踪调查。应用卡方检验和逻辑回归模型。
在研究生四年级和九年级的医生中,约54%在前一年至少有过一次自我开药方的情况。在前一年使用过处方药的人中,约90%有过自我开药方的行为。自我开药方行为在男性和女性之间,以及在任何时候根据工作类型来看,均无显著差异。最常自我开的药物是抗生素(71%-81%)、避孕药(24%-25%)、镇痛药(18%-21%)和催眠药(9%-12%)。那些有心理问题需要治疗的人,自我开催眠药和镇静剂的程度比其他人更高。男性、在实习期间有过自我开药方行为、有躯体不适、精神困扰、主观健康问题,以及未向全科医生寻求帮助,是研究生九年级自我开药方的显著校正预测因素。
挪威年轻医生的自我开药方水平相对较高,且这种行为在他们职业生涯早期就已形成。虽然在某些情况下自我开药方是可以接受的,但医生患病时应寻求专业帮助。培养更理性的求助行为的努力或许应在医学院就开始。