开一种新药需要多长时间？
How much time does it take to prescribe a new medication?
作者信息
Tarn Derjung M, Paterniti Debora A, Kravitz Richard L, Heritage John, Liu Honghu, Kim Sue, Wenger Neil S
机构信息
Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA.
出版信息
Patient Educ Couns. 2008 Aug;72(2):311-9. doi: 10.1016/j.pec.2008.02.019. Epub 2008 Apr 11.
OBJECTIVE
To measure the length of time spent discussing all aspects of new prescriptions and guideline-recommended aspects of counseling, and to evaluate factors associated with duration of discussion.
METHODS
We analyzed tape recordings in which 181 patients received 234 new medication prescriptions from 16 family physicians, 18 internists, and 11 cardiologists in 2 healthcare systems in Sacramento, California between January and November 1999.
RESULTS
Of the mean total visit time of 15.9min (S.D.=434s), a mean of 26s (S.D.=28s) was allocated to guideline-recommended components and a mean of 23s (S.D.=25s) was allocated to discussion of all other aspects of new prescription medications. The majority of time spent discussing individual new prescriptions was dedicated to: medication purpose or justification, directions and duration of use, and side effects. On average, more complete discussion of these components was associated with more time. More time was spent talking about guideline-recommended information if patients were in better health, if there was a third party in the room, and if the medication belonged to a psychiatric, compared to an ear, nose, throat medication class. Less time was spent discussing over-the-counter (OTC) medications and those prescribed to patients with a previous visit to the physician.
CONCLUSION
Higher quality information transmission between physicians and patients about new medications requires more time, and may be difficult to achieve in short office visits.
PRACTICE IMPLICATIONS
Time-compressed office visits may need to be redesigned to promote improved provider-patient communication about new medications.
目的
测量讨论新处方各方面及指南推荐的咨询要点所花费的时间，并评估与讨论时长相关的因素。
方法
我们分析了1999年1月至11月间在加利福尼亚州萨克拉门托市两个医疗系统中，16名家庭医生、18名内科医生和11名心脏病专家为181名患者开具234份新药物处方的录音。
结果
在平均总就诊时间15.9分钟（标准差=434秒）中，平均26秒（标准差=28秒）用于指南推荐的内容，平均23秒（标准差=25秒）用于讨论新处方药物的所有其他方面。讨论单个新处方所花费的大部分时间用于：用药目的或理由、用法用量和副作用。平均而言，对这些内容进行更全面的讨论需要更多时间。与耳部、鼻部、喉部药物类别相比，如果患者健康状况较好、就诊时有第三方在场以及药物属于精神科药物，则会花费更多时间讨论指南推荐的信息。讨论非处方药以及给之前看过医生的患者所开药物时花费的时间较少。
结论
医生与患者之间就新药物进行更高质量的信息传递需要更多时间，而在短暂的门诊就诊中可能难以实现。
实践意义
可能需要重新设计时间紧凑的门诊就诊方式，以促进医生与患者就新药物进行更好的沟通。
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