Types of information physicians provide when prescribing antidepressants.
Types of information physicians provide when prescribing antidepressants.
复制标题
医生在开抗抑郁药处方时提供的信息类型。
DOI：
10.1111/j.1525-1497.2006.00589.x
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发表时间：
2006
影响因子：
5.7
通讯作者：
Kravitz,RichardL
中科院分区：
文献类型：
--
作者：
Young,HenryN;Bell,RobertA;Epstein,RonaldM;Feldman,MitchellD;Kravitz,RichardL
背景：向患者提供抗抑郁药信息可能会提高患者对治疗的依从性。目的：评估医生在开抗抑郁药的同时提供信息的情况，并确定影响信息提供的因素。设计：使用标准化患者的随机试验(SPS)。标准化患者角色是通过将2种临床情况(重度抑郁症或适应障碍)与3种用药请求类型(品牌特定、一般或无)交叉而产生的。伙伴：从个人和团体诊所和健康维护组织招募的152名普通内科医生和家庭医生，合作率从53%到61%不等。测量：我们通过分析医生与SP之间互动的录音来评估医生信息的提供，并通过调查收集医生背景信息。结果：101名医生开出了抗抑郁药，共131次交互作用。医生的平均年龄为46.3岁：69%是男性。医生们平均提到了5.7个与抗抑郁药相关的特定主题(可能最多11个)。最常被提及的话题是目的(96.1%)。医生很少提供有关疗程(34.9%)和费用(21.4%)的信息。与有适应障碍的患者相比，患有重度抑郁症的标准化患者获得的信息更少，年长的和单独/私人执业的医生向SP提供的信息明显更少。结论：医生在开抗抑郁药时向患者提供的信息有限，经常省略可能促进依从性的关键信息。需要建立机制来确保患者获得相关的抗抑郁药物信息。
BACKGROUND:Providing antidepressant information to patients may foster greater adherence to therapy.OBJECTIVE:To assess physician information-giving while prescribing antidepressants, and to identify factors that influence the provision of information.DESIGN:Randomized experiment using standardized patients (SPs). Standardized patients roles were generated by crossing 2 clinical conditions (major depression or adjustment disorder) with 3 medication request types (brand-specific, general, or none).PARTICIPANTS:One hundred and fifty-two general internists and family physicians recruited from solo and group practices and health maintenance organizations; cooperation rates ranged from 53% to 61%.MEASUREMENTS:We assessed physician information-giving by analyzing audio-recordings of interactions between physicians and SPs, and collected physician background information by survey. Generalized estimating equations were used to examine the influence of patient and physician factors on physicians’ provision of information.RESULTS:One hundred and one physicians prescribed antidepressants, accounting for 131 interactions. The mean age of physicians was 46.3 years: 69% were males. Physicians mentioned an average of 5.7 specific topics of anti-depressant-related information (of a possible maximum of 11). The most frequently mentioned topic was purpose (96.1%). Physicians infrequently provided information about the duration of therapy (34.9%) and costs (21.4%). Standardized patients who presented with major depression received less information than those with adjustment disorder, and older and solo/private practice physicians provided significantly less information to SPs.CONCLUSIONS:Physicians provide limited information to patients while prescribing antidepressants, often omitting critical information that may promote adherence. Mechanisms are needed to ensure that patients receive pertinent antidepressant information.