为酒精使用障碍处方药物:对初级保健医生决策的定性研究
Anvita Bhardwaj1,2, Jessica L Sousa1, Haiden A Huskamp3
1RAND Corporation, Santa Monica, California.
Annals of family medicine
|July 24, 2023
概括
初级保健医生发现,由于个人信仰,相互竞争的要求和社会规范,为酒精使用障碍 (AUD) 处方药物具有挑战性. 他们使用特定的患者选择规则,表明这些有效的AUD治疗方法未得到充分利用.
科学领域:
- 成 药物 药物 药物 药物
- 主要护理实践的初级护理实践
- 医疗保健服务研究 医疗服务研究
背景情况:
- 超过2900万美国人患有酒精使用障碍 (AUD).
- 有效的AUD (MAUD) 药物存在,但在初级保健机构中未得到充分利用.
- 了解处方行为对于解决AUD治疗缺口至关重要.
研究的目的:
- 探索初级保健医生 (PCP) 如何做出MAUD的处方决定.
- 确定导致MAUD在初级保健中使用不足的障碍.
主要方法:
- 进行了半结构化的采访,对处方MAUD的19名PCP进行了采访.
- 医生从一个大型的医疗专业人员在线数据库中招募医生.
- 根据计划行为理论进行的主题分析,并使用主题分析.
主要成果:
- 由于对有效性和坚持的负面信念,PCP面临着处方MAUD的挑战.
- 在初级保健中竞争的需求降低了MAUD处方的优先级.
- 关于处方MAUD的主观规范并不强烈积极,导致医生使用患者选择规则.
结论:
- 由于竞争的需求,初级保健环境为MAUD实施提供了一个具有挑战性的环境.
- 未来的研究应该专注于确定患者选择的最佳策略,以改善人口健康和公平.
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