一般医生的决策过程,为腰部疼痛开处方止痛药:一个定性研究
Giovanni E Ferreira1,2, Joshua Zadro3,2, Caitlin Jones3,2
1Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia giovanni.ferreira@sydney.edu.au.
BMJ open
|October 29, 2023
概括
一般医生 (GPs) 经常为腰部疼痛 (LBP) 开处方止痛药,但他们的决定是基于个人经验而不是指导方针. 诸如患者诊断和对药物使用的担忧等因素影响了对LBP的处方.
科学领域:
- 初级保健研究研究初级保健研究
- 疼痛管理 疼痛管理
- 医疗保健服务研究 医疗服务研究
背景情况:
- 一般医生 (GPs) 经常为腰部疼痛 (LBP) 处方止痛药.
- 了解影响这些处方决定的因素对于优化LBP管理至关重要.
研究的目的:
- 调查在为腰部疼痛开处方时对全科医生的决定的影响.
- 为了确定关键的驱动因素和障碍在疼痛药物处方LBP.
主要方法:
- 一项定性研究涉及对25名澳大利亚全科医生进行深入采访,他们有经验管理LBP.
- 总医生讨论了他们对三种常见的LBP细节的管理 (慢性LBP的急性恶化,亚急性坐骨髓炎,慢性LBP).
- 用内容和框架分析来分析处方选择和决策因素.
主要成果:
- 医生通常为LBP处方阿片类止痛药,抗药和抗抑郁药.
- 处方决定主要基于全科医生的个人经验和患者病理解剖学诊断,而不是指南.
- 对寻找药物的行为,不良影响,耻辱和监管压力的担忧影响了选择,有时导致多药.
结论:
- 医生对LBP疼痛药物处方的决策是复杂的,受个人经验和外部因素的影响.
- 结果突出了改善低背部疼痛药物的使用质量的领域.
- 未来的实施策略可以利用这些见解来加强LBP管理.
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