Saastamoinen Leena, Enlund Hannes, Klaukka Timo
The Social Insurance Institution, P.O. Box 450, 00101 Helsinki, Finland.
Pharm World Sci. 2008 Oct;30(5):605-9. doi: 10.1007/s11096-008-9224-5. Epub 2008 May 29.
There is limited knowledge on repeat prescribing of different drug groups in cases where the physician does not see the patient. This study aimed to investigate the frequency of repeat prescribing of different drug groups both with and without consultation.
The study was a nationwide prescription database study performed in Finnish primary care in 2001. Each physician in a sample of 400 physicians was asked to report all patient contacts over a specified period of five consecutive working days once over a period of six months, and another sample of 400 physicians did the same for the next six months. Copies of physicians' prescriptions were collected and data on the drugs and type of prescriptions were recorded. Repeat prescriptions issued with and without a consultation were included.
About 19% of all prescriptions were issued without direct contact between the physician and the patient. In the different drug groups, the range was from 2% of antibiotics to 57% of antipsychotics. Psychotropics including hypnotics and tranquillizers, cardiovascular drugs and drugs for elderly patients were most often issued without consultation.
Repeat prescribing without consultation is common especially for elderly patients and users of psychotropics and cardiovascular drugs, and this may contribute to suboptimal therapy.
在医生未见到患者的情况下，对于不同药物组重复开药的了解有限。本研究旨在调查有无会诊情况下不同药物组重复开药的频率。
该研究是一项2001年在芬兰初级医疗保健机构进行的全国性处方数据库研究。在400名医生样本中，要求每位医生在六个月内报告一次连续五个工作日特定时间段内的所有患者接触情况，另外400名医生样本在接下来的六个月内也进行同样的操作。收集医生处方副本，并记录药物和处方类型的数据。纳入有无会诊情况下开具的重复处方。
所有处方中约19%是在医生与患者没有直接接触的情况下开具的。在不同药物组中，范围从抗生素的2%到抗精神病药物的57%。包括催眠药和镇静剂在内的精神药物、心血管药物以及老年患者用药最常是在没有会诊的情况下开具的。
无会诊情况下的重复开药很常见，尤其是对于老年患者以及精神药物和心血管药物使用者，这可能导致治疗效果欠佳。
