Patient race and psychotropic prescribing during medical encounters
Patient race and psychotropic prescribing during medical encounters
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DOI：
10.1016/s0738-3991(98)00030-5
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发表时间：
1998-07-01
影响因子：
3.5
通讯作者：
Roter, D
中科院分区：
文献类型：
--
作者：
Sleath, B;Svarstad, B;Roter, D
本文探讨了患者种族、身体和情绪健康的评分、身体、情绪和社会问题症状的表达，以及医生对患者身体健康、情绪健康和社会问题的看法如何影响慢性疾病患者的精神药物处方。数据收集于美国和加拿大的11个地理区域。对患者的就诊进行录音，研究助理在每位患者就诊后对其进行访谈。医生在每次访问后都要完成一份自我管理的问卷。白人获得精神药物处方的可能性明显高于非白人（P < 0.05）。20%的白人和13.5%的黑人患者接受了一种或多种精神药物的处方。采用Logistic回归技术分别预测白人和非白人患者的精神药物处方。患者情绪症状的表达和医生对患者情绪健康的感知显著影响白人患者的精神药物处方，而只有患者情绪症状的表达显著影响非白人患者的精神药物处方。患者对身体和社会问题症状的表达以及医生对患者身体健康和社会问题的看法对白人或非白人患者的精神药物处方没有影响。本文强调培训初级保健医生的重要性，以探讨和提供病人一个机会，讨论他们的情绪症状。(C) 1998爱思唯尔科学爱尔兰有限公司
This paper examines how patient race, rating of physical and emotional health, expression of physical, emotional, and social problem symptoms, and physician perceptions of patients' physical health, emotional health, and social problems influence psychotropic prescribing in patients with chronic illness. Data were collected at 11 geographic areas in the United States and Canada. Patient visits were audio-tape recorded and research assistants interviewed each patient after their medical visit. Physicians completed self-administered questionnaires after each visit with a participating patient. Whites were significantly more likely to receive psychotropic prescriptions than non-whites (P < 0.05). Twenty percent of white and 13.5% of black patients received prescriptions for one or more psychotropic medications. Logistic regression techniques were used to predict psychotropic prescribing to white and non-white patients respectively. Patient expression of emotional symptoms and physician perceptions of patient emotional health significantly influenced psychotropic prescribing to white patients, whereas only patient expression of emotional symptoms significantly influenced psychotropic prescribing to non-white patients. Patient expression of physical and social problem symptoms and physician perceptions of patient physical health and social problems did not influence psychotropic prescribing to white or non-white patients. The paper emphasizes the importance of training primary care physicians to probe and to provide patients with an opportunity to discuss their emotional symptoms. (C) 1998 Elsevier Science Ireland Ltd.