Crowe Sarah, Tully Mary P, Cantrill Judith A
Division of Primary Care, School of Community Health Sciences, University of Nottingham, University Park, Nottingham NG7 2RD, UK.
Fam Pract. 2009 Aug;26(4):301-8. doi: 10.1093/fampra/cmp030. Epub 2009 Jun 8.
As Governments worldwide strive to integrate efficient health care delivery across the primary-secondary care divide, particular significance has been placed on the need to understand GPs' prescribing of specialist drugs.
To explore the factors which influence GPs' decision-making process when requested to prescribe specialist drugs.
A qualitative approach was used to explore the perspectives of a wide range of practice-, primary care trust-, strategic health authority-level staff and other relevant stakeholders in the North-West of England. All semi-structured interviews (n = 47) were analysed comprehensively using the five-stage 'framework' approach.
Six diverse factors were identified as having a crucial bearing on how GPs evaluate initial requests and subsequently decide whether or not to prescribe. These include GPs' lack of knowledge and expertise in using specialist drugs, the shared care arrangement, the influence of a locally agreed advisory list, financial and resource considerations, patient convenience and understanding and GPs' specific areas of interest.
This exploration of GPs' decision-making process is needed to support future integrated health care delivery.
随着世界各国政府努力整合跨越初级和二级医疗保健界限的高效医疗服务，了解全科医生对专科药物的处方开具情况变得尤为重要。
探讨在被要求开具专科药物时，影响全科医生决策过程的因素。
采用定性研究方法，探究英格兰西北部广泛的诊所、初级医疗保健信托、战略健康管理局层面的工作人员以及其他相关利益攸关方的观点。所有半结构化访谈（n = 47）均采用五阶段“框架”方法进行全面分析。
确定了六个不同因素，这些因素对全科医生如何评估初始请求以及随后决定是否开具处方具有关键影响。这些因素包括全科医生在使用专科药物方面缺乏知识和专业技能、共享护理安排、当地商定的咨询清单的影响、财务和资源考量、患者便利性和理解度以及全科医生的特定兴趣领域。
需要对全科医生的决策过程进行此探索，以支持未来的综合医疗服务提供。
