Young Henry N, Bell Robert A, Epstein Ronald M, Feldman Mitchell D, Kravitz Richard L
Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin, Madison, WI, USA.
J Gen Intern Med. 2006 Nov;21(11):1172-7. doi: 10.1111/j.1525-1497.2006.00589.x.
Providing antidepressant information to patients may foster greater adherence to therapy.
To assess physician information-giving while prescribing antidepressants, and to identify factors that influence the provision of information.
Randomized experiment using standardized patients (SPs). Standardized patients roles were generated by crossing 2 clinical conditions (major depression or adjustment disorder) with 3 medication request types (brand-specific, general, or none).
One hundred and fifty-two general internists and family physicians recruited from solo and group practices and health maintenance organizations; cooperation rates ranged from 53% to 61%.
We assessed physician information-giving by analyzing audio-recordings of interactions between physicians and SPs, and collected physician background information by survey. Generalized estimating equations were used to examine the influence of patient and physician factors on physicians' provision of information.
One hundred and one physicians prescribed antidepressants, accounting for 131 interactions. The mean age of physicians was 46.3 years; 69% were males. Physicians mentioned an average of 5.7 specific topics of antidepressant-related information (of a possible maximum of 11). The most frequently mentioned topic was purpose (96.1%). Physicians infrequently provided information about the duration of therapy (34.9%) and costs (21.4%). Standardized patients who presented with major depression received less information than those with adjustment disorder, and older and solo/private practice physicians provided significantly less information to SPs.
Physicians provide limited information to patients while prescribing antidepressants, often omitting critical information that may promote adherence. Mechanisms are needed to ensure that patients receive pertinent antidepressant information.
向患者提供抗抑郁药相关信息可能会提高其治疗依从性。
评估医生在开具抗抑郁药时提供信息的情况，并确定影响信息提供的因素。
使用标准化患者（SPs）进行随机试验。标准化患者的角色通过将2种临床病症（重度抑郁症或适应障碍）与3种药物请求类型（特定品牌、通用或无请求）交叉产生。
从个体和团体诊所以及健康维护组织招募的152名普通内科医生和家庭医生；合作率在53%至61%之间。
我们通过分析医生与标准化患者之间互动的录音来评估医生提供信息的情况，并通过调查收集医生背景信息。使用广义估计方程来检验患者和医生因素对医生提供信息的影响。
101名医生开具了抗抑郁药，共有131次互动。医生的平均年龄为46.3岁；69%为男性。医生平均提及5.7个抗抑郁药相关信息的具体主题（可能的最大主题数为11个）。最常提及的主题是目的（96.1%）。医生很少提供关于治疗持续时间（34.9%）和费用（21.4%）的信息。患有重度抑郁症的标准化患者比患有适应障碍的患者获得的信息更少，年龄较大以及个体/私人执业的医生向标准化患者提供的信息明显更少。
医生在开具抗抑郁药时向患者提供的信息有限，常常遗漏可能促进依从性的关键信息。需要建立机制以确保患者获得相关的抗抑郁药信息。
