Department of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Sweden.
BMC Fam Pract. 2013 Aug 12;14:115. doi: 10.1186/1471-2296-14-115.
Psychotropic drug prescribing is problematic and knowledge of factors affecting the initiation and maintenance of such prescribing is incomplete. Such knowledge could provide a basis for the design of interventions to change prescribing patterns for psychotropics. The aim of this study was to explore the views of general practitioners (GPs), GP interns, and heads of primary care units on factors affecting the prescribing of psychotropic drugs in primary care.
We performed four focus group discussions in Gothenburg, Sweden, with a total of 21 participants (GPs, GP interns, and heads of primary care units). The focus group discussions were transcribed verbatim and analyzed using manifest content analysis.
Three different themes emerged from the focus group discussions. The first theme Seeking care for symptoms, reflects the participants' understanding of why patients approach primary care and comprised categories such as knowledge, attitudes, and society and the media. The second theme, Lacking a framework, resources, and treatment alternatives, which reflects the conditions for the physician-patient interaction, comprised categories such as economy and resources, technology, and organizational aspects. The third theme, Restricting or maintaining prescriptions, with the subthemes Individual factors and External influences, reflects the physicians' internal decision making and comprised categories such as emotions, knowledge, and pharmaceutical industry.
The results of the present study indicate that a variety of factors may affect the prescribing of psychotropic medications in primary care. Many factors were related to characteristics of the patient, the physician or their interaction, rather than the patients' medical needs per se. The results may be useful for interventions to improve psychotropic prescribing in primary care.
精神药物的处方存在问题，而影响此类处方启动和维持的因素的知识并不完整。这种知识可以为改变精神药物处方模式的干预措施提供基础。本研究的目的是探讨全科医生（GP）、GP 实习生和基层医疗单位负责人对影响基层医疗中精神药物处方的因素的看法。
我们在瑞典哥德堡进行了四次焦点小组讨论，共有 21 名参与者（全科医生、GP 实习生和基层医疗单位负责人）参加。焦点小组讨论的文字记录被逐字转录，并使用明显的内容分析进行分析。
从焦点小组讨论中出现了三个不同的主题。第一个主题是寻求治疗症状的护理，反映了参与者对患者为何寻求基层医疗的理解，包括知识、态度和社会与媒体等类别。第二个主题是缺乏框架、资源和治疗替代方案，反映了医患互动的条件，包括经济和资源、技术和组织方面等类别。第三个主题是限制或维持处方，包括个体因素和外部影响两个子主题，反映了医生的内部决策，包括情绪、知识和制药行业等类别。
本研究的结果表明，各种因素可能会影响基层医疗中精神药物的处方。许多因素与患者、医生或他们的互动的特征有关，而不是与患者的医疗需求本身有关。这些结果可能对改善基层医疗中的精神药物处方干预措施有用。
