病変性抗レウマティック剤の使用に関する知識と経験の関係. 初等医療従事者に関する研究
1Department of Internal Medicine, University of Michigan Medical School, Ann Arbor.
JAMA
|November 17, 1989
まとめ
プライマリケア医は,関節リウマチに対する疾患修正抗レウマティック剤 (DMARD) について知っていますが,めったに処方しません. 意識ではなく,医師の経験がDMARDの開始を促し,治療よりも多くの紹介につながります.
科学分野:
- リーマトロジーの病理学
- 医療教育 医療教育について
- プライマリーケア・プラクティス
背景:
- 医療情報の普及は,効果的な患者ケアに不可欠です.
- リウマチ性関節炎 (RA) の治療は,病気を改変する抗レウマティック剤 (DMARDs) で進歩しました.
- 新しいRA治療法の医師の採用を理解することは不可欠です.
研究 の 目的:
- プライマリケア医師の知識と,RAに対するDMARDの利用を評価する.
- RA管理におけるDMARDの処方に対する障壁を特定する.
- DMARDsに関する医療情報の普及の有効性を評価する.
主な方法:
- RA治療の実践に関する初等保健医療従事者の調査.
- 入院したRA患者のDMARD使用の分析.
- RA管理に関する臨床ヴィニエットに対する医師の反応の評価.
主要な成果:
- 過去 (26.2%) および現在の (13.9%) DMARDの使用率は,入院したRA患者で低い.
- ヴィニエットでRAに対するDMARD治療を開始する医師の割合はわずか12%で,ほとんどの医師はリファレンスします.
- 医者の経験は意識ではなく (73%が意識している) DMARDの開始と相関しており,前年にDMARDを処方したのは14%のみでした.
結論:
- RAに対するDMARDsに関する医療情報は効果的に拡散されていますが,実践的な課題が医師の治療開始を妨げています.
- 医者の経験は,DMARDの採用の重要な要因であり,意識を超えて臨床サポートの強化の必要性を示唆しています.
- この研究は,DMARDの知識と処方箋の間のギャップを強調し,プライマリケア医師による直接的な患者管理ではなく,紹介の増加につながっています.
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