In order to assess the prevalence and knowledge of diuretic prescription, 203 consecutive admissions to three general medical wards were interviewed. Additional information was collected on forms sent to general practitioners and hospital doctors responsible for each patient. 2. Prevalence of diuretic use was 31% (63 patients); other drugs only, 60% (121 patients); no drugs, 9% (19 patients). Patients gave an incorrect indication for 31% of diuretics prescribed, but for only 16% of other drugs (P < 0.005). 3. Compared with patients not taking diuretics, diuretic-users were older (mean +/- s.d., 70 years +/- 14 vs 54 +/- 20, P < 0.001), had lower abbreviated mental test scores (AMT scores seven or less, 21% vs 9%, chi 2 = 3.48, P = 0.06) and were prescribed more drugs (5.0 +/- 2.4 vs 3.2 +/- 2.0, P < 0.001). Increasing age and decreasing AMT score were associated with poorer knowledge of drug indication, but these factors could not explain fully the poor understanding of diuretic prescription. 4. Accurate recall of dose was the same for diuretics and for other agents. Knowledge about medication was not different if the general practitioner or hospital initiated treatment.
摘要
为评估利尿剂处方的使用情况及相关知识,我们对三个普通内科病房连续收治的203名患者进行了访谈。此外,还通过向负责每位患者的全科医生和医院医生发放表格收集了更多信息。2. 利尿剂的使用率为31%(63例患者);仅使用其他药物的患者占60%(121例患者);未使用药物的患者占9%(19例患者)。患者对31%的利尿剂处方给出了错误的用药指征,但对其他药物仅为16%(P<0.005)。3. 与未服用利尿剂的患者相比,服用利尿剂的患者年龄更大(平均±标准差,70岁±14岁 vs 54±20岁,P<0.001),简易精神状态检查得分更低(得分7分及以下者,分别为21%和9%,χ² = 3.48,P = 0.06),且开具的药物更多(5.0±2.4种 vs 3.2±2.0种,P<0.001)。年龄增长和简易精神状态检查得分降低与药物指征知识较差有关,但这些因素不能完全解释对利尿剂处方理解不足的情况。4. 利尿剂和其他药物的剂量准确回忆情况相同。无论治疗由全科医生还是医院发起,药物知识并无差异。