Rogers Anne, Pilgrim David, Brennan Susie, Sulaiman Ilyas, Watson Gareth, Chew-Graham Carolyn
University of Manchester, UK.
Health (London). 2007 Apr;11(2):181-98. doi: 10.1177/1363459307074693.
General practitioner (GP) prescribing has been identified as an arena that has broad social and political implications, which stretch beyond individual outcomes for patients. This article revisits aspects of the controversy about prescribing benzodiazepines (or 'minor tranquillizers') through an exploration of contemporary views of GPs. In the 1980s the prescribing of these drugs was considered to be both a clinical and social problem, which brought medical decision making under public scrutiny. The legacy of this controversy for recent GPs remains a relatively under-explored topic. This article describes a qualitative study of GPs practising in the north-west of England about their views of prescribing benzodiazepines. The accounts of the respondents highlight a number of points about: blame allocation, past and present; clinical challenges about risk management; and deserving and undeserving patients. These GP views are then discussed in the wider context of psychotropic drug use. It is concluded that, while there has been a recent consensus that the benzodiazepines have been problematic, when they are placed in a longer historical context, a different picture is apparent because other psychotropic drugs have raised similar problems.
全科医生（GP）的处方行为已被视为一个具有广泛社会和政治影响的领域，其影响范围超出了对患者个体的治疗效果。本文通过探讨全科医生的当代观点，重新审视了关于开具苯二氮䓬类药物（或“轻度镇静剂”）的争议。在20世纪80年代，这些药物的处方行为被视为一个临床和社会问题，这使得医疗决策受到公众审视。对于近期的全科医生而言，这场争议的遗留影响仍是一个相对未被充分探索的话题。本文描述了一项针对在英格兰西北部执业的全科医生关于他们开具苯二氮䓬类药物观点的定性研究。受访者的叙述突出了关于以下几点的诸多问题：过去和现在的责任归咎；风险管理的临床挑战；以及应得和不应得药物治疗的患者。然后，在更广泛的精神药物使用背景下讨论了这些全科医生的观点。得出的结论是，虽然最近已达成共识，即苯二氮䓬类药物存在问题，但当将其置于更长的历史背景中时，会呈现出不同的情况，因为其他精神药物也引发了类似问题。
