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[瓦尔索的苯二氮䓬类药物消费情况。在一个早期干预已使消费量降低了38%的地区,其消费量还能进一步降低吗?]

[Benzodiazepine consumption in Hvalsø. Can it be further reduced in a region in which earlier intervention reduced consumption by 38 per cent?].

作者信息

Damsgaard J J, Schaefer K, Folke P E, Ehrich M

出版信息

Ugeskr Laeger. 1998 Mar 23;160(13):1950-3.

PMID:9540418
Abstract

Hvalsø is a country town with six general practitioners in five practices. In 1988, as a result of a campaign influencing both doctors and patients, a 38% reduction in the consumption of benzodiazepines, measured as the number of prescribed doses, was achieved. This reduction still persists. We have now attempted to reduce consumption even further by directly influencing the individual users. We gave them written information, insisted on personal attendance for each prescription renewal, and, for use at these consultations, introduced a new benzodiazepine journal for 60% of the users. Registration of the prescribed amounts of benzodiazepines was performed over two three-month periods, before and after the intervention. The final registration was made six months after the intervention period. The number of prescriptions, number of prescriptions per 1000 patients and the number of users remained unchanged. A 20% reduction in the amount of prescribed sedatives (hypnotics) and a 7% reduction in prescribed minor tranquillizers was achieved because of fewer doses per prescription. We conclude, that we did not manage to change the patients' behaviour, expressed as the number of prescriptions per 1000 patients, but the doctors were influenced to write out fewer doses per prescription. Important reductions in consumption may be achieved in primary interventions.

摘要

瓦尔索是一个乡村小镇,有五家诊所,共六名全科医生。1988年,由于一场同时影响医生和患者的运动,以处方剂量数衡量,苯二氮䓬类药物的消费量减少了38%。这种减少至今仍在持续。我们现在试图通过直接影响个体使用者来进一步减少消费量。我们给他们提供书面信息,要求每次续方时亲自到场,并为60%的使用者引入了一本新的苯二氮䓬类药物手册供会诊时使用。在干预前后的两个三个月期间对苯二氮䓬类药物的处方量进行了登记。最终登记在干预期结束六个月后进行。处方数量、每1000名患者的处方数量和使用者数量保持不变。由于每张处方的剂量减少,处方镇静剂(催眠药)的量减少了20%,处方轻度镇静剂的量减少了7%。我们得出结论,我们未能改变患者的行为,以每1000名患者的处方数量来表示,但医生受到影响,每张处方开出的剂量减少了。在初级干预中可以实现消费量的显著减少。

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