Furtado Cláudia, Pereira João A
Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal.
Acta Med Port. 2006 Jul-Aug;19(4):301-8. Epub 2007 Jan 23.
Quality in prescribing and rational use of drugs requires that physicians are kept up to date with developments in the medical literature and have knowledge of newly available drugs. This study aimed to examine, quantitatively, the sources of drug information that are used by physicians and to verify if there are differences according to work setting, namely health centers and hospitals.
Cross-sectional descriptive analysis based on the application of a self-administered anonymous questionnaire developed specifically for the study. The 71 physician respondents were drawn from one public hospital (60.9%) and three public health centers (39.1%) in the Lisbon region. Respondents were asked to rate information sources in terms of their importance for prescribing and to report their use of these sources both in their general drug adoption procedures, in the adoption of one of a number of target 'new' drugs and in the evaluation of the therapeutic, pharmacological and economic value of drugs.
Commercial sources were cited more frequently than professional or official sources of information in the process of adopting new drugs for prescribing. In evaluating the therapeutic and economic value of a new drug, doctors used primarily studies disseminated by the pharmaceutical industry. Official sources of information were only used widely in case of uncertainties in the dose and dose regime of drugs. The use of sources of information varied with physician's characteristics and with the place of work, with primary care doctors revealing more frequent use of commercial sources.
Doctors working in hospitals and health centers use commercial sources above all others. There are, however, some differences according to work setting. In combining scientific information with interpersonal communication, the pharmaceutical industry appears to have a more effective strategy for communicating information to doctors. Health authorities should take this knowledge on board when drawing up strategies for improving the quality of prescribing, thereby assuring that the best quality information is used in clinical practice.
药物处方的质量和合理用药要求医生及时了解医学文献的进展，并掌握新上市药物的相关知识。本研究旨在定量考察医生使用的药物信息来源，并验证根据工作环境（即健康中心和医院）是否存在差异。
基于专门为本研究设计的自填式匿名问卷进行横断面描述性分析。71名医生受访者来自里斯本地区的一家公立医院（60.9%）和三家公共健康中心（39.1%）。受访者被要求就信息来源对处方的重要性进行评分，并报告他们在一般药物采用程序、采用多种目标“新”药物之一以及评估药物的治疗、药理和经济价值时对这些来源的使用情况。
在采用新药用于处方的过程中，商业来源的信息比专业或官方来源的信息被引用得更频繁。在评估新药的治疗和经济价值时，医生主要使用制药行业传播的研究。官方信息来源仅在药物剂量和给药方案存在不确定性的情况下被广泛使用。信息来源的使用因医生的特征和工作地点而异，基层医疗医生更频繁地使用商业来源。
在医院和健康中心工作的医生主要使用商业来源的信息。然而，根据工作环境存在一些差异。在将科学信息与人际沟通相结合方面，制药行业似乎有更有效的向医生传播信息的策略。卫生当局在制定提高处方质量的策略时应考虑到这一点，从而确保在临床实践中使用最佳质量的信息。
