Provider attributes associated with hormone therapy prescribing frequency.
Provider attributes associated with hormone therapy prescribing frequency.
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DOI：
10.1097/gme.0b013e318198e2fd
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发表时间：
2009-07
期刊：
影响因子：
--
通讯作者：
Newton KM
中科院分区：
文献类型：
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作者：
Spangler L;Reed SD;Nekhyludov L;Grothaus LC;LaCroix AZ;Newton KM
确定与激素治疗处方相关的提供者特征。横截面。2005年12月，我们向位于美国西北部和东北部的两个综合医疗保健提供系统的提供者邮寄了调查问卷; 379人（74%）做出了回应，249人（占总数的49%）获准访问他们的自动数据。数据包括提供者的人口统计学，实践特点，以及对激素治疗的看法。提供者特定的年度激素治疗处方频率计算为：激素治疗供应天数除以就诊次数（45-80岁女性）。使用双变量和多变量分析确定了与较高的激素治疗处方率相关的因素。我们报告的结果分别为初级保健提供者（内科医生和家庭医生）和产科医生/妇科医生，因为显着的相关性在这两组不同。在多变量分析中，对于初级保健提供者和产科医生/妇科医生，激素治疗处方因研究中心（P ≤ 0.002）和医疗保健机构的年数（P≤ 0.01）而异。仅对于初级保健提供者，较高的激素治疗处方与激素治疗试验的专家知识相关（P=<0.001）。对于产科医生/妇科医生来说，更高的激素治疗处方与为建议女性接受激素治疗做好充分准备有关（P=<0.007），认为雌激素和孕激素的风险被夸大了（P=0.04），并且看到年轻患者（p= 0.03）。在WHI研究结果发布并在类似的临床指南下实践后，激素治疗处方与提供者的信心，实践地点和医疗机构的时间相关。
To identify provider characteristics associated with hormone therapy prescribing. Cross-sectional. In December 2005 we mailed surveys to providers practicing in two integrated health care delivery systems located in North Western and North Eastern United States; 379 responded (74%) and 249 (49% of total) granted access to their automated data. Data included provider demographics, practice characteristics, and perceptions about hormone therapy. Provider-specific annual hormone therapy prescribing frequency was calculated as: days supply of hormone therapy filled divided by the number of visits (among women age 45-80). Factors associated with higher rates of hormone therapy prescribing were identified using bivariate and multivariate analyses. We report results separately for primary care providers (internists and family practitioners) and obstetrician/gynecologists since significant correlates differed in these two groups. For both primary care providers and obstetrician/gynecologists, in multivariate analyses, hormone therapy prescribing varied by site (P ≤ 0.002) and years at the health care organization (P≤ 0.01). For primary care providers only, higher hormone therapy prescribing was associated with reported expert knowledge of the hormone therapy trials (P=<0.001). For obstetrician/gynecologists, higher hormone therapy prescription was related to feeling well prepared to counsel women on hormone therapy (P=<0.007), believing that the risks of estrogen with progestogen had been exaggerated (P=0.04), and seeing younger aged patients (p=.03). After the release of the WHI findings and practicing under similar clinical guidelines, hormone therapy prescribing is associated with providers’ confidence, practice location, and time with a healthcare organization.