Characteristics of primary health care units with focus on drug information from the pharmaceutical industry and adherence to prescribing objectives: a cross-sectional study.
Daniel Carlzon, Lena Gustafsson, Anna L Eriksson, Karin Rignér, Anders Sundström, Susanna M Wallerstedt
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引用次数: 8
Abstract
Background: Adherence to prescribing guidelines varies between primary health care units. The aim of the present study was to investigate correlations between characteristics of primary health care units and adherence to prescribing objectives for rational drug use with focus on drug information from the pharmaceutical industry.
Methods: A cross-sectional study was performed in all 25 primary health care units in Göteborg, Sweden. A questionnaire on characteristics of practice settings [(i) size of unit, (ii) profession of head, (iii) use of temporary physicians, (iv) drug information from the pharmaceutical industry, (v) producer-independent drug information, and (vi) education on prescribing for newly employed physicians] was sent to the heads of the units. A national sales register for prescribed drugs (Xplain) was used for evaluation of adherence to the six regional prescribing objectives concerning proton pump inhibitors (PPIs), angiotensin converting enzyme inhibitors (ACEIs), statins and antidepressants.
Results: Twenty-two out of 25 primary health care units responded to the questionnaire (response rate 88%). A physician as head and presence of producer-independent drug information was positively correlated with adherence to the prescribing objectives (median number of prescribing objectives adhered to (25th - 75th percentile): 2.5 (1-3.25) vs 1 (0-2), P = 0.013; 2 (1-3) vs 0, P = 0.043, respectively. Presence of drug information from the pharmaceutical industry and education on prescribing for newly employed physicians was negatively associated with adherence to the prescribing objectives: 1 (0-2) vs 3.5 (2.25-4.75), P = 0.005; 1 (0-2) vs 3 (1.5-4), P = 0.034, respectively.
Conclusion: Several characteristics of the primary health care units correlated with adherence to prescribing objectives for rational drug use. Further research on this topic is needed and would constitute valuable information for health care decision makers.
背景:各初级卫生保健单位对处方指南的依从性各不相同。本研究的目的是调查初级卫生保健单位的特征与遵守合理用药的处方目标之间的相关性，重点关注制药行业的药物信息。方法:在瑞典Göteborg的所有25个初级卫生保健单位进行横断面研究。一份关于执业环境特征的调查问卷[(i)单位规模，(ii)负责人的职业，(iii)临时医生的使用，(iv)来自制药行业的药物信息，(v)独立于生产商的药物信息，以及(vi)对新入职医生的处方教育]被发送给单位负责人。国家处方药销售登记(Xplain)用于评估关于质子泵抑制剂(PPIs)、血管紧张素转换酶抑制剂(ACEIs)、他汀类药物和抗抑郁药的六个区域处方目标的依从性。结果:25个初级卫生保健单位中有22个答复了问卷(回复率88%)。医师作为负责人和是否存在与生产者无关的药物信息与遵守处方目标呈正相关(遵守处方目标的中位数(25 - 75百分位数):2.5 (1-3.25)vs 1 (0-2)， P = 0.013;2 (1-3) vs 0, P = 0.043。来自制药行业的药物信息和新入职医生的处方教育与处方目标的依从性呈负相关:1 (0-2)vs 3.5 (2.25-4.75)， P = 0.005;1 (0-2) vs 3 (1.5-4)， P = 0.034。结论:基层卫生保健单位的几个特点与坚持合理用药的处方目标相关。需要对这一主题进行进一步研究，这将为卫生保健决策者提供有价值的信息。
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