Winther Rolf B, Bramness Jørgen G
Fylkesmannen i BuskerudPostboks 16043007 Drammen.
Tidsskr Nor Laegeforen. 2009 Mar 12;129(6):517-20. doi: 10.4045/tidsskr.09.34414.
A Regular General Practitioner Scheme was introduced in Norway in 2001. One aim was to restrict patients from "shopping" doctors and prescription drugs.
Data from The Norwegian Prescription Database (NorPD) for 2004 were used to assess the following: number of physicians each patient had used to obtain prescriptions for a drug, the relationship between number of physicians used and amount of drugs prescribed, and concomitant prescription of opioids and benzodiazepines during the same period to the same patients. The drugs studied were the prescription drugs with potential for abuse; diazepam, carisoprodol and codeine combinations. The information retrieved was compared to that for the supposedly non-addictive drugs esomeprazole, metformine and salbutamol.
More than 96 % (96.3 - 98.9) of the patients used one or two physicians for prescriptions of the same drug, and fewer than 0.5 % (0.01 - 0.26) used five or more physicians. However, the proportion of patients who used five or more physicians for the addictive drugs was 9.5 times higher than that for a comparable proportion of patients using the non-addictive drugs. The amount of dispensed drug increased considerably more with the number of physicians used for addictive drugs than for non-addictive drugs, as did the amount of concomitantly dispensed opioids and benzodiazepines.
The occurrence of prescription drug shopping in the Norwegian population was limited. Among the few patients who used many physicians for prescription of drugs, the phenomenon was much more frequent for users of addictive drugs than for users of the non-addictive drugs. The study suggests that prescription drug shopping may be an indicator of a drug abuse potential.
2001年挪威引入了一项普通全科医生计划。其目的之一是限制患者“挑选”医生和处方药。
使用挪威处方数据库（NorPD）2004年的数据进行以下评估：每位患者为获取某种药物处方所使用的医生数量、使用医生数量与所开药物量之间的关系，以及同期向同一患者同时开具阿片类药物和苯二氮卓类药物的情况。所研究的药物为有滥用潜力的处方药；地西泮、卡立普多和可待因组合制剂。将检索到的信息与被认为无成瘾性的药物埃索美拉唑、二甲双胍和沙丁胺醇的信息进行比较。
超过96%（96.3 - 98.9）的患者为同一种药物处方使用一或两名医生，少于0.5%（0.01 - 0.26）的患者使用五名或更多医生。然而，为成瘾性药物处方使用五名或更多医生的患者比例比使用无成瘾性药物的类似患者比例高9.5倍。与无成瘾性药物相比，随着用于成瘾性药物的医生数量增加，配药量增加得更多，同时开具的阿片类药物和苯二氮卓类药物量也是如此。
挪威人群中存在的处方药购买行为有限。在少数为处方使用多名医生的患者中，成瘾性药物使用者的这种现象比无成瘾性药物使用者更为频繁。该研究表明，处方药购买行为可能是药物滥用潜力的一个指标。
