Secondary care doctors' perception of appropriate prescribing
Secondary care doctors' perception of appropriate prescribing
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DOI：
10.1111/j.1365-2753.2008.00963.x
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发表时间：
2009-02-01
影响因子：
2.4
通讯作者：
Tully, Mary
中科院分区：
文献类型：
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作者：
Ljungberg, Christina;Lindblad, Asa Kettis;Tully, Mary
由于众所周知，二级保健中的药物处方会影响初级保健中的处方，并且了解处方者的推理对于评估处方适当性至关重要，因此本研究的目的是通过定性个人访谈来调查二级保健医生对适当处方的看法。对 15 名在不同医学专业工作的医院医生进行了定性、半结构化个人访谈。这些采访涵盖了医生对“适当”处方含义的看法，并从解释主义的角度进行了录音和分析。在分析医生如何看待适当处方时，确定了三个不同的主题：“治疗个体化”、“成本”和“时间”。最重要的是，治疗应根据个体患者进行调整，尽管费用也应合理。应进行持续的药物审查，以适应患者相关因素随时间的变化。医院医生提出持续审查是适当处方的必要组成部分。因此，从处方者的角度来看，除了治疗的个体化和成本考虑之外，这一时间观点还应明确纳入适当处方的定义中。
As the prescribing of drugs in secondary care is known to influence prescribing in primary care and because an understanding of prescribers' reasoning is essential for evaluating prescribing appropriateness, the aim of this study was to investigate secondary care doctors' views of appropriate prescribing, using qualitative individual interviews.Qualitative, semi-structured individual interviews were conducted with 15 hospital doctors working in different medical specialities. The interviews, covering the doctors' views of the meaning of 'appropriate' prescribing, were audiotaped and analysed from an interpretivist perspective.Three different main themes were identified in the analysis of how the doctors perceived appropriate prescribing: 'individualization of treatment', 'cost' and 'time'. Most importantly, treatment should be adjusted to the individual patient, although cost should also be justified. Ongoing medication reviews should be carried out, to adjust to changes in patient-related factors over time.The hospital doctors brought up continuous review as a necessary part of appropriate prescribing. Thus, from the prescribers' point of view, this time perspective should be explicitly incorporated in definitions of appropriate prescribing, in addition to individualization of treatment and cost considerations.