高工作相关压力的早期识别是否会影响初级保健患者的药物治疗？——一项随机对照研究中瑞典药房配药数据的分析。
Does early identification of high work related stress affect pharmacological treatment of primary care patients? - analysis of Swedish pharmacy dispensing data in a randomised control study.
机构信息
School of Health and Education, University of Skövde, PO Box 408, SE-521 28, Skövde, Sweden.
Department of Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, PO Box 454, SE-405 30, Gothenburg, Sweden, Sweden.
出版信息
BMC Fam Pract. 2020 Apr 25;21(1):70. doi: 10.1186/s12875-020-01140-x.
BACKGROUND
The study is part of a randomised controlled trial with the overall aim to evaluate if use of the Work Stress Questionnaire (WSQ), combined with feedback at consultation, can be used by healthcare professionals in primary health care to prevent sickness absence. The specific aim of the present study was to investigate whether there were differences in pharmacy dispensing of prescription medications between the intervention group and the control group.
METHODS
The study was a randomized controlled trial. Non-sick-listed employed women and men, aged 18 to 64 years, seeking care at primary health care centres (PHCCs) were eligible participants. The intervention included early identification of work-related stress by the WSQ, general practitioner (GP) training and GP feedback at consultation. Pharmacy dispensing data from the Swedish Prescription Drug Register for a period of 12 months following the intervention was used. Primary outcomes were the number of different medications used, type of medication and number of prescribing clinics. Data was analysed using Mann Whitney U tests and chi-square tests.
RESULTS
The study population included 271 individuals (132 in the intervention group and 139 in the control group). The number of different medications used per individual did not differ significantly between the control group (median 4.0) and the intervention group (median 4.0, p-value 0.076). The proportion of individuals who collected more than 10 different medications was higher in the control group than in the intervention group (15.8% versus 4.5%, p = 0.002). In addition, the proportion of individuals filling prescriptions issued from more than three different clinics was higher in the control group than in the intervention group (17.3% versus 6.8%, p = 0.007).
CONCLUSION
Systematic use of the WSQ combined with training of GPs and feedback at consultation may affect certain aspects of pharmacological treatment in primary health care patients. In this randomised control trial, analysis of pharmacy dispensing data show that patients in the intervention group had less polypharmacy and filled prescriptions issued from a smaller number of different clinics.
TRIAL REGISTRATION
ClinicalTrials.gov. Identifier: NCT02480855. Registered 20 May 2015.
背景
本研究是一项随机对照试验的一部分，其总体目标是评估在初级保健中使用工作应激问卷（WSQ）并结合咨询时的反馈，是否可以被医疗保健专业人员用于预防旷工。本研究的具体目的是调查干预组和对照组之间在药房配药方面是否存在差异。
方法
该研究是一项随机对照试验。18 至 64 岁、在初级保健中心（PHCC）就诊的非病假在职女性和男性为合格参与者。干预措施包括通过 WSQ 早期识别与工作相关的压力、全科医生（GP）培训和咨询时的 GP 反馈。使用了干预后 12 个月期间瑞典处方药物登记处的药房配药数据。主要结局指标为使用的不同药物数量、药物类型和开处方诊所数量。使用 Mann Whitney U 检验和卡方检验分析数据。
结果
研究人群包括 271 人（干预组 132 人，对照组 139 人）。个体使用的不同药物数量在对照组（中位数 4.0）和干预组（中位数 4.0，p 值 0.076）之间无显著差异。在对照组中，收集 10 种以上不同药物的个体比例高于干预组（15.8%比 4.5%，p = 0.002）。此外，在对照组中，从三个以上不同诊所开具的处方的个体比例高于干预组（17.3%比 6.8%，p = 0.007）。
结论
系统使用 WSQ 结合 GP 培训和咨询时的反馈可能会影响初级保健患者药物治疗的某些方面。在这项随机对照试验中，对药房配药数据的分析表明，干预组患者的多药治疗较少，从较少数量的不同诊所开具的处方。
试验注册
ClinicalTrials.gov。标识符：NCT02480855。2015 年 5 月 20 日注册。
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