在使用疾病修饰性抗风湿性药物的知识和经验之间的关系. 一项针对初级保健医师的研究
1Department of Internal Medicine, University of Michigan Medical School, Ann Arbor.
JAMA
|November 17, 1989
概括
初级保健医生对类风湿性关节炎的修饰性抗风湿剂 (DMARD) 有所了解,但很少开处方. 医生的经验,而不是意识,驱动DMARD启动,导致转诊比治疗更多.
科学领域:
- 类风湿病学 类风湿病学
- 医学教育 医学教育
- 主要护理实践的初级护理实践
背景情况:
- 医疗信息的传播对于有效的患者护理至关重要.
- 风湿性关节炎 (RA) 治疗已经通过疾病修饰性抗风湿剂 (DMARD) 取得了进展.
- 了解医生采用新的RA疗法是必不可少的.
研究的目的:
- 评估初级医疗保健医生对RA的DMARDs的知识和使用情况.
- 在 RA 管理中识别DMARD处方的障碍.
- 评估关于DMARDs的医疗信息传播的有效性.
主要方法:
- 对初级保健医生关于RA治疗实践的调查.
- 在住院的RA患者中使用DMARD的分析.
- 评估医生对RA管理的临床标签的反应.
主要成果:
- 在住院的RA患者中,过去 (26.2%) 和现在 (13.9%) 的DMARD使用率较低.
- 只有12%的医生会在维涅特中启动DMARD治疗RA;大多数医生会参考.
- 医生的经验,而不是意识 (73%的意识),与DMARD启动相关;前一年只有14%的DMARD被处方.
结论:
- 医学信息关于DMARDs对RA的有效传播,但实际挑战阻碍医生启动治疗.
- 医生的经验是DMARD采用的关键因素,表明需要超越意识的加强临床支持.
- 该研究强调了DMARD知识和处方之间的差距,导致转诊增加,而不是由初级保健医生直接管理患者.
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