Fletcher J, Fahey T, McWilliam J
Department of Health Policy and Public Health, Oxfordshire Health Authority, Oxford.
Br J Gen Pract. 1995 Sep;45(398):467-9.
The provision of counselling in general practice is increasing, despite uncertainty concerning its effectiveness. Furthermore, the relationship between counselling and prescribing of antidepressants, hypnotics and anxiolytics in general practice is not known.
This study set out to assess the relationship between provision of counselling and prescribing of antidepressants, hypnotics and anxiolytics in general practice.
An observational, cross-sectional study of general practices in Oxfordshire Family Health Services Authority was undertaken. Practices were surveyed on the availability of counselling services. The quantity and cost of prescribing of psychotropic drugs over one year (April 1992 to March 1993) were compared for practices with different levels of counselling provision.
Of the 82 (96%) respondents, 74 (90%) referred patients for counselling; of these 74 practices, the highest levels of prescribing, in terms of number of items and net ingredient cost, were seen in those practices that employed a counsellor working on the premises. The lowest levels of prescribing were seen in those practices that referred their patients to a counsellor not working on the practice premises.
The relationship between the provision of counselling and the level of prescribing of antidepressants, hypnotics and anxiolytics is complex. In this study lower levels of prescribing of these drugs in practices with higher provision of counselling were not observed.
尽管心理咨询的有效性存在不确定性，但在全科医疗中提供心理咨询的情况正在增加。此外，在全科医疗中，心理咨询与抗抑郁药、催眠药和抗焦虑药处方之间的关系尚不清楚。
本研究旨在评估全科医疗中提供心理咨询与抗抑郁药、催眠药和抗焦虑药处方之间的关系。
对牛津郡家庭健康服务管理局的全科医疗进行了一项观察性横断面研究。对各医疗机构的心理咨询服务可及性进行了调查。比较了不同心理咨询服务水平的医疗机构在一年时间（1992年4月至1993年3月）内精神药物的处方量和成本。
在82名（96%）受访者中，74名（90%）将患者转介进行心理咨询；在这74家医疗机构中，就处方项目数量和净成分成本而言，处方量最高的是那些聘请了驻场咨询师的机构。处方量最低的是那些将患者转介给非驻场咨询师的机构。
心理咨询的提供与抗抑郁药、催眠药和抗焦虑药的处方水平之间的关系很复杂。在本研究中，未观察到心理咨询服务提供较多的机构中这些药物的处方量较低。
