影响全科医生在治疗药物组中选择药物的因素。一项定性研究。
Factors influencing GPs' choice between drugs in a therapeutic drug group. A qualitative study.
作者信息
Buusman Allan, Andersen Morten, Merrild Camilla, Elverdam Beth
机构信息
Research Unit for General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
出版信息
Scand J Prim Health Care. 2007 Dec;25(4):208-13. doi: 10.1080/02813430701652036.
OBJECTIVE
To explore how GPs choose between drugs in a therapeutic drug group.
DESIGN
A qualitative study based on semi-structured ethnographic interviews.
SETTING AND SUBJECTS
General practitioners from the counties of both Funen and West Zealand in Denmark. A total of 15 general practitioners (GPs) were selected with reference to variation in organizational structure, age, and gender.
MAIN OUTCOME MEASURES
GPs' description of drug choice in relation to specific patient encounters involving a prescription.
RESULTS
All informants appeared to consider drug price important as it was a recurring theme during all interviews. External factors outside the GP's control such as governmental regulation on prescribing and the pharmaceutical industry influenced most GPs. Internal factors related to the actual consultation included characteristics of the GP and the patient, drug characteristics, and repeat prescriptions. These factors interact in a non-linear and unpredictable way similar to complex adaptive systems.
CONCLUSION
GPs balance both internal and external factors when choosing between analogues. Drug choice is a regulated process in the realm of complex prescribing behaviour with drug costs as a major factor.
目的
探讨全科医生在治疗药物组中如何选择药物。
设计
基于半结构化人种学访谈的定性研究。
背景与研究对象
丹麦富恩岛和西兰岛西部的全科医生。根据组织结构、年龄和性别的差异，共选取了15名全科医生。
主要观察指标
全科医生对涉及处方开具的特定患者诊疗过程中药物选择的描述。
结果
所有受访者似乎都认为药价很重要，因为这是所有访谈中反复出现的主题。政府对处方开具的监管以及制药行业等全科医生无法控制的外部因素影响了大多数全科医生。与实际诊疗相关的内部因素包括全科医生和患者的特征、药物特性以及重复处方。这些因素以类似于复杂适应系统的非线性且不可预测的方式相互作用。
结论
全科医生在选择同类药物时会平衡内部和外部因素。在复杂的处方行为领域，药物选择是一个受规范的过程，药物成本是一个主要因素。
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