System struggles and substitutes: A qualitative study of general practitioner and psychiatrist experiences of prescribing antipsychotics to children and adolescents
System struggles and substitutes: A qualitative study of general practitioner and psychiatrist experiences of prescribing antipsychotics to children and adolescents
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系统斗争和替代：对全科医生和精神科医生向儿童和青少年开抗精神病药物的经验的定性研究
DOI：
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发表时间：
2015
影响因子：
1.8
通讯作者：
J. Hughes
中科院分区：
文献类型：
--
作者：
A. Murphy;D. Gardner;S. Kisely;C. Cooke;S. Kutcher;J. Hughes
关于儿童和青少年中抗精神病药物处方趋势的上升存在重大争议。许多药物流行病学趋势研究已经发表，对这些数据的解释有助于解释处方实践中发生的事情，但不能解释这些模式存在的原因。这方面缺乏定性数据，对儿童和青少年开具抗精神病药物的经验也没有进行充分的研究。我们进行了一项定性研究，使用解释现象学分析医生的经验，抗精神病药物处方的儿童和青少年。开处方者参加了个人访谈和焦点小组。我们使用分阶段的方法对转录进行数据分析。包括精神科医生和全科医生在内的11名医生参与了我们的研究。我们确定了与上下文、角色和身份、决策和过滤相关的主题。与卫生系统差距的斗争是重大的，导致使用抗精神病药物作为其他治疗的替代品。医生给年轻人开抗精神病药的适应症范围和显著关注的不良反应。我们的结果提供了有关儿童和青少年抗精神病药物处方经验的知识。卫生系统内部存在重大差距，为开始使用和继续使用这些药物创造了机会。
There are significant controversies regarding rising antipsychotic prescription trends in children and adolescents. Many pharmacoepidemiology trend studies have been published, and interpretations of these data are helpful in explaining what is happening in prescribing practices, but not why these patterns exist. There is a lack of qualitative data in this area, and the experience of prescribing antipsychotics to children and adolescents has not been adequately researched. We conducted a qualitative study using an interpretive phenomenological analysis of physicians’ experiences of antipsychotic prescribing to children and adolescents. Prescribers participated in individual interviews and a focus group. We used a staged approach for data analysis of transcriptions. In all, 11 physicians including psychiatrists and general practitioners participated in our study. We identified themes related to context, role and identity, and decision-making and filtering. Struggles with health system gaps were significant leading to the use of antipsychotics as substitutes for other treatments. Physicians prescribed antipsychotics to youth for a range of indications and had significant concerns regarding adverse effects. Our results provide knowledge regarding the prescribers’ experience of antipsychotics for children and adolescents. Important gaps exist within the health system that are creating opportunities for the initiation and continued use of these agents.
使用管理数据来识别医疗补助人群中第二代抗精神病药物的标签外使用。
DOI：
10.1176/appi.ps.005482012
发表时间：
2013
期刊：
Psychiatric services (Washington, D.C.)
影响因子：
--
作者：
Hartung,DanielM;Middleton,Luke;McFarland,BentsonH;Haxby,DeanG;McDonagh,MarianS;McConnell,KJohn
通讯作者：
McConnell,KJohn
DOI：
10.1001/jama.2012.211266
发表时间：
2013-02-06
期刊：
JAMA
影响因子：
--
作者：
Briesacher BA;Tjia J;Field T;Peterson D;Gurwitz JH
通讯作者：
Gurwitz JH
马里兰州为拥有医疗补助保险的青少年开出的精神药物方面存在种族差异。
DOI：
10.1097/00004583-199802000-00010
发表时间：
1998
期刊：
Journal of the American Academy of Child and Adolescent Psychiatry.
影响因子：
--
作者：
Zito,JM;Safer,DJ;dosReis,S;Riddle,MA
通讯作者：
Riddle,MA