Understanding US addiction physicians' low rate of naltrexone prescription
Understanding US addiction physicians' low rate of naltrexone prescription
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DOI：
10.1016/s0376-8716(03)00134-0
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发表时间：
2003-09-10
影响因子：
4.2
通讯作者：
Song, X
中科院分区：
文献类型：
--
作者：
Mark, TL;Kranzler, HR;Song, X
纳曲酮于1994年12月获得美国食品和药物管理局（FDA）批准。虽然纳曲酮是美国批准的两种酒精康复药物之一，但它并不经常被开处方。本文探讨了限制医生使用纳曲酮的因素。数据是通过对两个成瘾医学专业协会的美国医生成员的调查收集的。以纳曲酮处方为因变量进行Logistic回归分析。自变量包括医生执业特征、医生对纳曲酮属性（如疗效）的评分、医生的患者特征和医生对纳曲酮信息的接触。平均而言，治疗成瘾的医生会给13%的酗酒患者开纳曲酮。医生不给更多患者开药的两个主要自我报告原因是患者拒绝服药或遵守处方制度（23%），以及患者负担不起药费（21%）。多变量结果表明，医生对纳曲酮有效性和安全性的认知与处方有显著相关性。对产品有更多了解的医生（例如，通过阅读更多关于纳曲酮的期刊文章）更有可能开这种药。综上所述，多种因素导致纳曲酮处方率相对较低。2003爱思唯尔爱尔兰有限公司版权所有。
Naltrexone was approved by the US Food and Drug Administration (FDA) in December 1994. Although it is one of only two medications for alcohol rehabilitation approved in the US, naltrexone is not frequently prescribed. This paper examines the factors limiting physicians' use of naltrexone. Data were collected through a survey of US physician members of two addiction medicine professional associations. Logistic regression analysis was conducted with the dependent variable being any prescription of naltrexone. Independent variables consisted of physician practice characteristics, physician ratings of naltrexone's attributes (e.g. efficacy), physicians' patient characteristics, and physicians' exposure to information about naltrexone. On average, addiction medicine physicians prescribed naltrexone to 13% of their alcoholism patients. The two main self-reported reasons why physicians did not prescribe the medication to more patients were that patients refused to take the medication or comply with prescribing regimes (23%), and that patients could not afford the medication (21%). Multivariate results indicated that physician perceptions of naltrexone's effectiveness and safety were significantly associated with prescribing. Physicians who had more exposure to information about the product (e.g. by reading more journal articles about naltrexone) were more likely to prescribe it. In summary, multiple factors are contributing to the relatively low naltexone prescription rate. (C) 2003 Elsevier Ireland Ltd. All rights reserved.