Lee P, Ahola S J, Grennan D, Brooks P, Buchanan W W
Br Med J. 1974 Mar 9;1(5905):424-6. doi: 10.1136/bmj.1.5905.424.
A total of 125 patients with rheumatoid arthritis were investigated about their drug therapy before referral to a specialist centre. Most referrals were from general practitioners. Only 47 of the patients had received salicylates as the first drug and 18 had never had them at all. Soluble aspirin was the preparation of salicylates most frequently prescribed (for 63 patients). Only 60 patients had been given an adequate dose and only 62 an adequate course of treatment with salicylates. In 28 patients salicylates had been stopped on account of side effects. About one-third of the patients had been prescribed oral corticosteroids.The referral letters were poor in giving details of past and present drug therapy, and there were serious omissions in reporting of previous side effects.Seventy-five general practitioners were asked to rate several currently marketed antirheumatic drugs in terms of effectiveness. Though prednisolone 15 mg daily ranked higher than aspirin 4 g daily the difference was not significant. The study shows the inadequacies of drug prescribing for rheumatoid arthritis in the Glasgow area.
共对125例类风湿性关节炎患者在转诊至专科中心之前的药物治疗情况进行了调查。大多数转诊来自全科医生。只有47例患者曾将水杨酸盐作为首选药物,18例患者从未使用过。可溶性阿司匹林是最常开具的水杨酸盐制剂(63例患者使用)。只有60例患者接受了足够剂量的水杨酸盐治疗,只有62例患者接受了足够疗程的治疗。28例患者因副作用而停用了水杨酸盐。约三分之一的患者曾被开具口服皮质类固醇药物。转诊信中关于过去和当前药物治疗的细节很少,并且在报告先前的副作用方面存在严重遗漏。75名全科医生被要求根据疗效对几种目前市场上销售的抗风湿药物进行评分。尽管每日15毫克泼尼松龙的评分高于每日4克阿司匹林,但差异并不显著。该研究表明格拉斯哥地区类风湿性关节炎药物处方存在不足之处。