Siguín R, Almodóvar M J, Saiz L C, Izquierdo-Palomares J M, Estévez J C, Malillos D
Servicio de Farmacia de Atención Primaria, Servicio Madrileño de Salud, Madrid, España.
Rev Calid Asist. 2012 May-Jun;27(3):146-54. doi: 10.1016/j.cali.2011.09.006. Epub 2011 Dec 1.
To determine the percentage of new Specialist Healthcare prescriptions received and modified by Primary Healthcare physicians.
Descriptive, cross-sectional and multi-centre study with the participation of Primary Healthcare physicians from one Madrid Health Area during 2 months. A method was established for registering the origin of the new prescriptions in the Computerised Medical Record System. In order to register new prescriptions without any change from Specialist Healthcare, the «second level» option was marked when the prescription was issued. A protocol was prepared and was available on the Computerized Medical Record System, so for those cases where there was a new Specialist Healthcare prescription, the Primary Healthcare physician would not issue any prescription or issue a prescription with changes as regards the original one.
A total of 69 Primary Healthcare physicians from 15 Primary Healthcare centres registered 46,512 new prescriptions, 3,893 (8.4%) from Specialist Healthcare. From this number, 3,544 prescriptions (91.0% 95% CI: 90.1-91.9) were issued without changes, and 298 prescriptions were modified (7.7% 95% CI: 7.0-8.7). In 46 cases (1.2% 95% CI: 0.8-1.5) no prescription was issued. Some prescriptions were changed by 51% of Primary Healthcare physicians, and the median of prescriptions changed or not issued was 3. The main reason for the modification was replacement with generics.
A high percentage of new Specialist Healthcare prescriptions are issued without any changes being made by Primary Healthcare physicians. Modifications are concentrated in half of the participating physicians. Therefore, these data suggest that this practice is not generally adopted by the professionals.
确定初级医疗保健医生接收并修改的专科医疗保健新处方的百分比。
描述性、横断面多中心研究，有来自马德里一个健康区域的初级医疗保健医生参与，为期2个月。建立了一种在计算机化病历系统中记录新处方来源的方法。为了记录未经专科医疗保健更改的新处方，在开具处方时标记“二级”选项。编写了一份方案并在计算机化病历系统上可用，因此对于有新的专科医疗保健处方的情况，初级医疗保健医生不会开具任何处方或开具与原处方有变化的处方。
来自15个初级医疗保健中心的69名初级医疗保健医生共记录了46512份新处方，其中3893份（8.4%）来自专科医疗保健。在这些处方中，3544份（91.0%，95%可信区间：90.1 - 91.9）未经更改开具，298份处方被修改（7.7%，95%可信区间：7.0 - 8.7）。在46例（1.2%，95%可信区间：0.8 - 1.5）中未开具处方。51%的初级医疗保健医生对一些处方进行了更改，更改或未开具处方的中位数为3。修改的主要原因是替换为通用名药物。
初级医疗保健医生开具的专科医疗保健新处方中有很大比例未作任何更改。修改集中在一半的参与医生中。因此，这些数据表明这种做法并未被专业人员普遍采用。
