Mant A, de Burgh S, Mattick R P, Donnelly N, Hall W
Royal Australian College of General Practitioners.
Aust Fam Physician. 1996 Jan;Suppl 1:S15-8.
To assess whether an educational visit to GPs providing information about the non-drug and drug management of anxiety and insomnia can reduce subsequent rates of benzodiazepine prescription.
A randomised controlled trial of 286 NSW general practitioners conducted during 1991 and 1992.
The educational visit was statistically significant in reducing the number of new prescriptions recorded by general practitioners for new diagnoses of insomnia. However, the majority of benzodiazepine prescriptions were for patients continuing treatment for insomnia or anxiety/depression. Overall, benzodiazepines were the sole management of insomnia recorded by the surveyed GPs in most cases (93.5%). In comparison, non-drug management for anxiety and depression was offered to more than a third of patients with anxiety and depression. (Benzodiazepines were the only management of anxiety and depression in just over 50% of cases.)
This study shows general practitioners can change their management of insomnia and that change is most likely to occur when the problem is new, rather than old. The decreased emphasis on drug treatment in the general practice management of anxiety and depression may reflect the change in psychiatric teaching for these conditions. Further, most of the publicity about benzodiazepines has been in relation to their use for anxiety disorders. Doctors were interested in learning about advances in the understanding of sleep disorders and their non-drug management.
评估对全科医生进行关于焦虑和失眠的非药物及药物管理信息的教育访问，是否能降低随后苯二氮䓬类药物的处方率。
1991年至1992年期间对286名新南威尔士州全科医生进行的一项随机对照试验。
教育访问在减少全科医生对新诊断失眠症记录的新处方数量方面具有统计学意义。然而，大多数苯二氮䓬类药物处方是针对持续治疗失眠或焦虑/抑郁的患者。总体而言，在大多数情况下（93.5%），苯二氮䓬类药物是被调查全科医生记录的失眠症的唯一治疗方法。相比之下，超过三分之一的焦虑和抑郁患者接受了焦虑和抑郁的非药物治疗。（在略多于50%的病例中，苯二氮䓬类药物是焦虑和抑郁的唯一治疗方法。）
本研究表明全科医生可以改变他们对失眠症的治疗方法，而且这种改变最有可能在问题是新出现而非旧有的情况下发生。在全科医疗中对焦虑和抑郁治疗中药物治疗的重视程度降低，可能反映了针对这些病症的精神病学教学的变化。此外，关于苯二氮䓬类药物的大部分宣传都与它们用于焦虑症有关。医生们有兴趣了解睡眠障碍及其非药物管理方面的进展。
