Tigretti T, Berthoud S, Dayer P, Fabre J
Schweiz Med Wochenschr. 1982 May 15;112(20):706-13.
The medical prescriptions of 18 house officers working at the Policlinique Universitaire de Médecine in Geneva were analyzed for a period of 17 working days and provide insight into drug therapy chosen for 2194 outpatients at 2694 consultations. These patients were prescribed an average of 1.39 drugs each or 1.13 per call. Of the 298 different drugs thus prescribed, the following were chosen most frequently (in decreasing order): Digoxin, Hygroton, Lexotanil, Metamucil, Voltaren, Aspirin, different insulins and Aldomet. Antimicrobial agents accounted for only 2.5% of all prescriptions, while vitamins and "fortifiers" represent an even lower percentage. It would be possible to limit the number of drugs, since half of the prescriptions cover 23 drugs and 90% of all prescriptions cover 119 drugs. Prescription patterns vary markedly from one subspecialty of internal medicine to another, but also between physicians working in the same field. House officers in charge of given sectors of the city (internists not working in a subspecialty) may thus prescribe between 1,83 and 2.9 drugs per patient, whereas the number of drugs chosen may vary between 81 and 134. Some quaint individual preferences for drugs were also noted and the trend is analyzed. The data is compared with results of the few existing similar studies and offers food for thought on prescription habits, directed ultimately towards a more rational approach to drug therapy for outpatients.
对在日内瓦大学医学门诊部工作的18名住院医生在17个工作日内开具的医疗处方进行了分析,这些处方涉及2694次会诊中的2194名门诊患者,从中可以了解到所选用的药物治疗情况。这些患者平均每人开具1.39种药物,每次会诊开具1.13种药物。在总共开具的298种不同药物中,以下几种药物的选用频率最高(按降序排列):地高辛、氢氯噻嗪、氯氮卓、欧车前亲水胶、双氯芬酸、阿司匹林、不同种类的胰岛素和甲基多巴。抗菌药物仅占所有处方的2.5%,而维生素和“强化剂”的占比更低。有可能减少药物数量,因为一半的处方涉及23种药物,90%的处方涉及119种药物。内科各亚专业之间的处方模式差异显著,同一领域的医生之间也存在差异。负责城市特定区域的住院医生(非亚专业内科医生)每位患者可能开具1.83至2.9种药物,而选用的药物数量可能在81至134种之间。还注意到了一些奇特的个人用药偏好并进行了趋势分析。将这些数据与现有的少数类似研究结果进行了比较,为处方习惯提供了思考方向,最终目标是使门诊患者的药物治疗更具合理性。