Physicians' attitudes about prescribing and knowledge of the costs of common medications
Physicians' attitudes about prescribing and knowledge of the costs of common medications
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DOI：
10.1001/archinte.160.18.2799
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发表时间：
2000-10-09
影响因子：
--
通讯作者：
Halm, EA
中科院分区：
文献类型：
--
作者：
Reichert, S;Simon, T;Halm, EA
背景：由于患者无力支付药物费用，对药物治疗的依从性常常受到影响。医生对药品成本了解不足可能会无意中导致这一问题。 目的；旨在衡量对处方和药物费用了解的态度，并比较主治医生和住院医生之间的差异。设计/参与者：对城市医院初级保健中心的内科工作人员和全科主治医生进行书面调查。结果：189 名医生中有 134 名做出了回应（回应率为 71%）。 70% 的受访者是住院医师，30% 是主治医生。 88% 的医生认为药物成本是处方决策中的一个重要考虑因素，71% 的医生愿意牺牲一定程度的疗效，以使患者更能负担得起药物。然而，80% 的人常常感觉不知道实际成本。只有 33% 的人能够轻松获取药品成本数据，只有 13% 的人接受过有关药品成本的正式教育。关于保险范围，当患者自费时，94% 的医生会重点考虑药物费用；当患者有 Medicare 时，这一比例为 68%；当患者参加 Medicaid 或参加有处方计划的健康维护组织时，这一比例为 30%。医生对每月 33 种常用药物的供应成本的估计在 45% 的情况下是准确的，在 40% 的情况下过低，在 15% 的情况下过高。他很可能低估了名牌药物和昂贵药物的成本。与主治医生相比，住院医师的成本意识较低。结论：医生在开处方时倾向于具有成本意识，但缺乏对药物实际成本和保险范围的准确了解。需要采取干预措施来教育医生有关药品成本的知识，并为他们在现实世界的实践中提供可靠、易于获取的成本信息。
Background: Compliance with medical therapy is often compromised because patients cannot afford to pay for medications. Inadequate physician knowledge of drug costs may unwittingly contribute to this problem.Objective; To measure attitudes about prescribing and knowledge of medication costs and compare differences among attending physicians and residents.Design/Participants: Written survey of internal medicine house staff and general medicine attending physicians in an urban hospital-based primary care center.Results: One hundred thirty-four of 189 physicians responded (71% response rate). Seventy percent of respondents were house officers and 30% were attending physicians. Eighty-eight percent of physicians felt the cost of medicines was an important consideration in the prescribing decision, and 71% were willing to sacrifice some degree of efficacy to make drugs more affordable for their patients. However, 80% often felt unaware of the actual costs. Only 33% had easy access to drug cost data, and only 13% had been formally educated about drug costs. Regarding insurance coverage, 94% of physicians gave strong consideration to the cost of medications when patients were self-paying, 68% when patients had Medicare, and 30% when patients had Medicaid or were participants in a health maintenance organization with a prescription plan. Physicians' estimates of the cost of a month's supply of 33 commonly used medications were accurate in 45% of cases, too low for 40%, and too high for 15%. The costs of brand-name and expensive drugs were most likely to he underestimated. House officers were less cost-conscious than attending physicians.Conclusions: Physicians were predisposed to being cost-conscious in their prescribing habits, but lacked accurate knowledge about actual costs and insurance coverage of drugs. Interventions are needed to educate physicians about drug costs and provide them with reliable, easily accessible cost information in real-world practice.