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药物与老年驾驶员交通事故:西班牙初级卫生保健医生了解多少?

Medications and traffic accidents involving older drivers: do Spanish primary healthcare physicians know enough?

机构信息

Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Avenida de la Investigación 11, Edificio A, 8ª planta, Granada, 18016, Spain.

Centros de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.

出版信息

BMC Geriatr. 2023 Oct 17;23(1):669. doi: 10.1186/s12877-023-04316-z.

Abstract

BACKGROUND

Our aim was to evaluate Spanish family doctors' knowledge about medications that increase the risk of traffic accidents involving older drivers, and to obtain data about the involvement of family doctors in accident prevention activities and the associations between these factors and their demographic and workplace characteristics.

METHODS

A cross-sectional study of 1888 family doctors throughout Spain was carried out from 2016 to 2018. Participants completed a previously validated self-administered questionnaire that explored whether family doctors distinguished between medications associated with a high or low risk of involvement in a traffic accident, investigated the appropriateness of advice given to older patients, and physicians' involvement in preventive activities. Multiple regression models were used to estimate the adjusted association of these variables with each other and with characteristics of family doctors in the sample.

RESULTS

On a scale of 1 (never or hardly ever) to 4 (always), the indexes constructed to evaluate how often family doctors believed they should oversee the use of high-risk and low-risk medications yielded values of 3.38 for the former and 2.61 for the latter (p < 0.001). Only 24% responded correctly to all three items that inquired about the appropriateness of the advice they gave to older patients. On a scale of 1 to 4, the frequency at which family doctors gave older patients advice about preventive measures was 2.85, and only 43% reported allocating time during appointments to provide this advice. These latter two variables were directly associated with appropriate values for the index used to evaluate physicians' oversight of medications associated with a high risk. The perception of risk associated with medications and involvement in preventive activities were both greater among female participants.

CONCLUSIONS

Family doctors correctly identified medications according to their risk of playing a role in traffic accidents, although the recommendations they gave to their patients were not always appropriate. These findings, along with physicians' infrequent involvement in preventive activities, suggest a need to improve family doctors' competencies and increase the resources available to them so that they can provide their older patients with advice on ways to prevent involvement in traffic accidents.

摘要

背景

我们的目的是评估西班牙家庭医生对可能增加老年驾驶员发生交通事故风险的药物的了解,并获取家庭医生参与事故预防活动的数据,以及这些因素与他们的人口统计学和工作场所特征之间的关联。

方法

这是一项 2016 年至 2018 年在西班牙各地进行的 1888 名家庭医生的横断面研究。参与者填写了一份先前经过验证的自我管理问卷,该问卷调查了家庭医生是否能够区分与交通事故高风险或低风险相关的药物,调查了他们对老年患者的建议是否合适,以及医生是否参与预防活动。使用多回归模型来估计这些变量彼此之间以及与样本中家庭医生特征之间的调整关联。

结果

在一个从 1(从不或几乎从不)到 4(总是)的评分尺度上,为评估家庭医生认为他们应该监督使用高风险和低风险药物的频率而构建的指标,前者得分为 3.38,后者得分为 2.61(p<0.001)。只有 24%的人正确回答了询问他们对老年患者建议是否合适的三个问题。在一个从 1 到 4 的评分尺度上,家庭医生为老年患者提供预防措施建议的频率为 2.85,只有 43%的人报告在预约期间分配时间提供该建议。这两个变量都与用于评估医生对与高风险相关药物的监督的指标的适当值直接相关。女性参与者对药物相关风险的感知和参与预防活动的程度都更高。

结论

家庭医生根据药物在交通事故中发挥作用的风险正确识别药物,尽管他们给患者的建议并不总是合适的。这些发现以及医生很少参与预防活动表明,需要提高家庭医生的能力,并增加他们可用的资源,以便他们能够为老年患者提供预防交通事故的建议。

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