医生对注意力缺陷多动障碍（ADHD）态度的差异及其与处方行为的关联。
Variations in Physician Attitudes Regarding ADHD and Their Association With Prescribing Practices.
作者信息
Sheldrick R Christopher, Leslie Laurel K, Rodday Angie Mae, Parsons Susan K, Saunders Tully S, Wong John B
机构信息
Tufts University School of Medicine, Boston, MA, USA Tufts Medical Center, Boston, MA, USA
Tufts University School of Medicine, Boston, MA, USA Tufts Medical Center, Boston, MA, USA.
出版信息
J Atten Disord. 2015 Jul;19(7):569-77. doi: 10.1177/1087054712461689. Epub 2012 Nov 9.
OBJECTIVE
The objective of this study was to test whether physicians' attitudes regarding the impact of ADHD on health-related quality of life (HRQL) explain differences in practices for prescribing psychostimulants in children.
METHOD
In a cross-sectional survey, U.S.-based pediatricians and psychiatrists ("physicians") used the Paper-Standard Gamble--a widely used preference-based assessment of HRQL--to rate four vignettes describing ADHD health states of varying severity. Associations between standard gamble scores and questions about prescribing practices were analyzed using ordinal logistic regression.
RESULTS
Surveys were mailed to 291 physicians; 127 (44%) returned complete forms. Lower standard gamble scores were associated with more emphasis on children's ADHD symptoms (p = .03) and less emphasis on parents' concerns about stimulant side effects (p = .03) when prescribing psychostimulants.
CONCLUSION
Differences in physician perceptions of the severity of ADHD symptoms and in their emphasis on parental concerns about side effects may help explain variations in ADHD psychostimulant prescription patterns.
目的
本研究旨在测试医生对于注意缺陷多动障碍（ADHD）对健康相关生活质量（HRQL）影响的态度，是否能解释儿童精神兴奋剂处方行为的差异。
方法
在一项横断面调查中，美国的儿科医生和精神科医生（“医生”）使用纸质标准博弈法（一种广泛应用的基于偏好的HRQL评估方法）对描述不同严重程度ADHD健康状态的四个 vignette进行评分。使用有序逻辑回归分析标准博弈得分与处方行为相关问题之间的关联。
结果
向291名医生邮寄了调查问卷；127名（44%）返回了完整的表格。在开具精神兴奋剂时，较低的标准博弈得分与更强调儿童的ADHD症状（p = 0.03）以及较少强调家长对兴奋剂副作用的担忧（p = 0.03）相关。
结论
医生对ADHD症状严重程度的认知差异以及他们对家长对副作用担忧的重视程度差异，可能有助于解释ADHD精神兴奋剂处方模式的差异。
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