Erwin J, Britten N, Jones R
Department of General Practice, United Medical School, London.
Br J Gen Pract. 1997 Feb;47(415):99-102.
In recent years there has been a trend towards increasing the number of drugs that are available over the counter (OTC) without prescription. Simultaneously, community pharmacists have been encouraged to develop and extend their role. General practitioners (GPs) have been shown to have some reservations about these developments. A group of drugs widely used in general practice, the H2-antagonists, have recently become available OTC.
To examine GPs' attitudes towards community pharmacists dispensing H2-antagonists over the counter (OTC) without prescription.
Postal questionnaire to a sample of GPs from inner and outer London, Surrey, Kent, Hampshire, Northumberland, Newcastle upon Tyne and Leicestershire.
Of 850 questionnaires sent, 515 were returned, an overall response rate of 60.5%. Fifty four per cent of respondents agreed that cimetidine should be available over the counter for dyspepsia in adults under 45 years not responsive to antacids. Ninety per cent of respondents were aware that H2-antagonists had been deregulated. Most general practitioners learned about the deregulation from professional journals. Very few GPs stated they had changed their prescribing practice since H2-antagonists became available OTC. The high cost to the patient of the OTC product was the most frequently mentioned reason why respondents did not encourage their patients to switch from prescription to OTC H2-antagonists. Worries and concerns regarding the OTC availability of H2-antagonists included masking serious conditions, missed diagnosis, loss of control by the GP and the potential for inappropriate use by patients.
Since 1990, there has been a large increase in GPs support for the OTC availability of cimetidine. However, according to their stated behaviour, the reclassification of H2-antagonists does not seem to have changed GPs' prescribing practice, and few appear to be recommending that their patients buy them over the counter.
近年来，无需处方即可购买的非处方药（OTC）数量呈增加趋势。与此同时，社区药剂师被鼓励拓展其职责范围。有证据表明，全科医生（GP）对这些变化有所保留。一类在全科医疗中广泛使用的药物——H2拮抗剂，最近已成为非处方药。
调查全科医生对社区药剂师无需处方即可配发H2拮抗剂作为非处方药的态度。
向来自伦敦市区及郊区、萨里郡、肯特郡、汉普郡、诺森伯兰郡、泰恩河畔纽卡斯尔和莱斯特郡的全科医生样本发放邮政问卷。
共发放850份问卷，回收515份，总体回复率为60.5%。54%的受访者同意，对于45岁以下对抗酸剂无反应的消化不良成人患者，西咪替丁应可作为非处方药购买。90%的受访者知晓H2拮抗剂已放宽管制。大多数全科医生是从专业期刊上了解到这一放宽管制情况的。自H2拮抗剂成为非处方药以来，很少有全科医生表示他们改变了处方习惯。OTC产品对患者的高成本是受访者不鼓励患者从处方H2拮抗剂改用非处方H2拮抗剂的最常提及原因。对H2拮抗剂作为非处方药供应的担忧包括掩盖严重病情、漏诊、全科医生失去控制权以及患者可能不当使用。
自1990年以来，全科医生对西咪替丁作为非处方药供应的支持大幅增加。然而，根据他们所述的行为，H2拮抗剂的重新分类似乎并未改变全科医生的处方习惯，而且似乎很少有人建议他们的患者非处方购买这些药物。
