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药品通用名替代与患者态度、信念和体验的关联。

Associations between generic substitution and patients' attitudes, beliefs and experiences.

机构信息

Institute of Public Health, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark,

出版信息

Eur J Clin Pharmacol. 2013 Oct;69(10):1827-36. doi: 10.1007/s00228-013-1539-z. Epub 2013 Jun 14.

Abstract

BACKGROUND

Generic substitution has been implemented in many countries, but knowledge about patients' attitudes, beliefs and experiences is still sparse.

AIM

To assess associations between generic switching and patients' attitudes, beliefs and experiences with previous generic switching.

DESIGN AND SETTING

A cross-sectional study comprising questionnaire responses from 2,476 randomly selected patients aged 20 years or older and living in the Region of Southern Denmark, who had redeemed substitutable drugs.

METHODS

The questionnaire included items on beliefs about medicine, views on generic medicine and confidence in the healthcare system. Only prescriptions issued by the general practitioners were included. For each patient, we focused on one purchase of a generically substitutable drug (index drug). Patients were identified by means of a dispensing database.

RESULTS

Earlier generic switches within the index ATC code were statistically significantly associated with experience of a generic switch (adjusted OR 5.93; 95 % CI 4.70-7.49). Having had more than five earlier switches within other ATC codes and having negative views on generic medicines reduced the odds of experiencing a generic switch. No associations were found between generic substitution and gender, drug group, number of different drugs used by the patient, confidence in the health care system and beliefs about medicine in general.

CONCLUSION

Patients who had once experienced a generic switch were more likely to accept a future generic switch within the same ATC code. Negative views on generic medicines were negatively associated with switching, while beliefs about medicine and confidence in the healthcare system had no influence.

摘要

背景

许多国家已经实施了仿制药替代,但关于患者的态度、信念和体验的知识仍然很少。

目的

评估与之前仿制药替代相关的患者态度、信念和体验与仿制药转换之间的关联。

设计和设置

一项横断面研究,包括来自丹麦南部地区 2476 名随机选择的 20 岁或以上年龄、使用可替代药物的患者的问卷调查回复。

方法

问卷包括对药物的信念、对仿制药的看法和对医疗保健系统的信心等项目。仅包括全科医生开具的处方。对于每位患者,我们关注一次可替代药物(索引药物)的购买。通过配药数据库识别患者。

结果

索引 ATC 代码内之前的仿制药替代与仿制药替代体验具有统计学显著相关性(调整后的比值比 5.93;95%置信区间 4.70-7.49)。在其他 ATC 代码中有超过五次的早期转换,对仿制药有负面看法,会降低经历仿制药替代的可能性。在仿制药替代与性别、药物类别、患者使用的不同药物数量、对医疗保健系统的信心和对一般药物的信念之间未发现关联。

结论

曾经经历过仿制药替代的患者更有可能接受同一 ATC 代码内的未来仿制药替代。对仿制药的负面看法与转换呈负相关,而对药物的信念和对医疗保健系统的信心则没有影响。

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