Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Westchester Medical Center, Valhalla, NY, USA.
Acad Psychiatry. 2018 Apr;42(2):297-303. doi: 10.1007/s40596-017-0750-0. Epub 2017 Jul 6.
Benzodiazepines are widely prescribed for a variety of symptoms and illnesses. There has been limited investigation on the training psychiatry residents receive regarding benzodiazepine prescribing. This study surveyed US psychiatric trainees about their didactic and clinical experience with benzodiazepines, investigating how experience with benzodiazepines may shape trainees' opinions and likelihood to prescribe.
The 14-question online survey was distributed to residents and fellows at US training programs through an invitation from their training directors.
Of 466 programs contacted, with an estimated 1345 trainees, a total of 97 programs (20.8%) and 424 trainees (31.5%) responded. The analyses focused only on the 342 general psychiatry trainees who responded. Most trainees reported having formal didactics on benzodiazepines, and earlier training was correlated with higher trainee quality of instruction assessments (p < 0.01). Most trainees rated their instructors as Above or Well Above Average. Trainees cited the observation and opinion of supervisors as the two most important factors affecting likelihood of future benzodiazepine prescribing. Trainees commonly reported pressure from patients to prescribe benzodiazepines but were split on perceived pressure from supervisors about prescribing and whether a bias exists against prescribing at their program or in general.
The survey indicated that psychiatry trainees generally feel adequately trained through didactic and clinical experience with benzodiazepines. Trainees perceived pressure by patients to prescribe benzodiazepines, but generally felt comfortable in managing benzodiazepine usage. Psychiatry attendings' opinions on benzodiazepines most impacted trainees. Influences on trainees' prescribing patterns are important variables that can impact future benzodiazepine prescribing.
苯二氮䓬类药物被广泛用于治疗各种症状和疾病。关于精神科住院医师在苯二氮䓬类药物处方方面的培训，研究有限。本研究调查了美国精神科住院医师在苯二氮䓬类药物处方方面的教学和临床经验，探讨了他们的经验如何影响他们的看法和处方倾向。
通过培训主任的邀请，将这份 14 个问题的在线调查分发给美国培训项目的住院医师和研究员。
在联系的 466 个项目中，估计有 1345 名受训者，共有 97 个项目（20.8%）和 424 名受训者（31.5%）做出了回应。分析仅关注了 342 名回应的普通精神病学住院医师。大多数住院医师报告有关于苯二氮䓬类药物的正式教学，早期培训与住院医师对教学质量的评估更高相关（p<0.01）。大多数住院医师将其导师评为高于或远高于平均水平。住院医师将观察和主管的意见列为影响未来苯二氮䓬类药物处方的两个最重要因素。住院医师经常报告患者要求开苯二氮䓬类药物的压力，但对主管关于处方的压力以及在其所在项目或总体上是否存在处方偏见存在分歧。
该调查表明，精神病学住院医师普遍通过苯二氮䓬类药物的教学和临床经验得到充分培训。住院医师认为患者有开苯二氮䓬类药物的压力，但通常对管理苯二氮䓬类药物的使用感到舒适。精神病学主治医生对苯二氮䓬类药物的看法对住院医师影响最大。对住院医师处方模式的影响是重要的变量，可能会影响未来的苯二氮䓬类药物处方。
