Drug testing of adolescents in general medical clinics, in school and at home: physician attitudes and practices.
Drug testing of adolescents in general medical clinics, in school and at home: physician attitudes and practices.
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在普通医疗诊所、学校和家里对青少年进行药物检测：医生的态度和做法。
DOI：
10.1016/j.jadohealth.2005.11.023
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
Knight,JohnR
中科院分区：
文献类型：
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作者：
Levy,Sharon;Harris,SionK;Sherritt,Lon;Angulo,Michelle;Knight,JohnR
确定(1)医生是否同意家庭和学校药物筛查的建议，(2)在什么情况下医生建议青少年进行尿药检测，以及(3)医生如何处理青少年患者的阳性结果。关于青少年尿液药物检测的临床实践指南很少，也不知道医生何时推荐这种程序，以及他们如何管理阳性结果。方法2004年4月至7月对具有全国代表性的医生样本进行了多模式调查。我们计算了简单频率，并使用反向选择逻辑回归来确定不同专业(儿科、家庭医学、青少年医学)或人口统计学因素(医生年龄、性别、执业类型或地点)的医生在同意或执业方面是否存在差异。结果共有359名医生(剔除不合格者后占43%)完成了调查。38%的人会建议在被要求重返学校的情况下进行药物测试，41%的人会根据父母的担忧，46%的人会根据病史(没有父母的关心)建议进行药物测试。48%的医生会与父母分享阳性的药检结果。大多数人(83%)不同意高中药物测试计划。结论医生对普通医疗诊所药物测试的适应症几乎没有达成共识。然而，大多数人不同意学校的药物测试计划。当尿液药检呈阳性时，医生之间对如何进行治疗几乎没有一致性。专业组织应该考虑发布临床实践指南，以帮助医生有效地使用这一程序。
PURPOSETo determine (1) whether physicians agree with recommendations for home and school drug screening, (2) under what circumstances physicians recommend urine drug tests for adolescents, and (3) how physicians manage adolescent patients with positive results. Few clinical practice guidelines have been published on urine drug testing of adolescents, and it is not known when physicians recommend this procedure or how they manage positive results.METHODSMulti-modal survey of a nationally representative sample of physicians conducted April–July 2004. We computed simple frequencies and used backwards selection logistical regression to determine if there were differences in agreement or practices among physicians from different specialties (pediatrics, family medicine, adolescent medicine) or by demographic factors (physician age, gender, practice type or location).RESULTSA total of 359 physicians (43% after eliminating ineligibles) completed the survey. Thirty-eight percent would recommend a drug test if were required to return to school, 41% if a parent was concerned, and 46% based on history (without a parent’s concern). Forty-eight percent of physicians would share a positive drug test result with parents. A large majority (83%) disagreed with high school drug testing programs.CONCLUSIONSThere is little consensus among physicians regarding the indications for drug testing in the general medical clinic. However, most disagree with school drug testing programs. There is little consistency among physicians in how to proceed when a urine drug test is positive. Professional organizations should consider publishing clinical practice guidelines in order to assist physicians in using this procedure effectively.