A qualitative study to identify factors influencing COXIB prescribed by family physicians for musculoskeletal disorders
A qualitative study to identify factors influencing COXIB prescribed by family physicians for musculoskeletal disorders
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DOI：
10.1093/fampra/cml048
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发表时间：
2006-12-01
期刊：
影响因子：
2.2
通讯作者：
Cave, A.
中科院分区：
文献类型：
--
作者：
Klein, D.;MacDonald, A.;Cave, A.
导论.在过去的5年里，环氧化酶-2抑制（COXIB）抗炎药一直是加拿大大量肌肉骨骼（MSK）疾病病例的处方药。阿尔伯塔MSK疾病改善（AIMS）计划旨在通过资助几项研究来更好地了解COXIB处方情况。本定性研究的目的是确定潜在的因素，初级保健医生的药物处方行为在办公室访问的MSK障碍，特别强调处方的COXIBs. Methods。目标受访者是阿尔伯塔初级保健医生从分层随机抽样中选择，以满足广泛的特点。个人，半结构化访谈被用来评估决策途径在四个真实的情况下选择的医生。共进行了19次访谈，并使用分析归纳法进行分析。被判定为与COXIB处方治疗MSK疾病相关的决策途径重要的因素包括安全性、患者特征、患者负担能力、样本可用性、制药公司营销实践、习惯形成、时间约束、医生和/或患者使用某些药物的既往临床经验以及医生对绝对与相对风险的感知。大多数医生在复杂的、多因素的、但基本上以患者为中心的决策过程之后优先处方COXIB。
Introduction. Cyclo-oxygenase-2 inhibiting (COXIB) anti-inflammatories have been the drug class prescribed for a large number of cases of musculoskeletal (MSK) disorders in Canada over the past 5 years. The Alberta Improvements for MSK Disorders (AIMS) initiative sought to better understand the COXIB prescribing situation by funding several studies. The objective of this qualitative study was to determine the factors underlying primary care physicians' medication prescribing behaviour during an office visit for an MSK disorder, with particular emphasis on the prescribing of COXIBs.Methods. The target respondents were Alberta primary care physicians chosen from a stratified random sample to meet a wide range of characteristics. Individual, semi-structured interviews were used to assess decision pathways in four real cases chosen by the physician. A total of 19 interviews were conducted and analysed using an analytic inductive approach.Results. Factors judged as being important to decision pathways in relation to COXIB prescribing for MSK disease included safety, patient characteristics, affordability to patients, availability of samples, drug company marketing practices, habit formation, time contstraints, previous clinical experience of doctors and/or patient with certain drugs and doctors' perception of absolute versus relative risk.Interpretation. Most physicians preferentially prescribed COXIBs subsequent to a complicated, multifactorial, but essentially patient-centred, decision-making process.