外科医生对同行比较和基于指南的反对术后阿片类药物处方的看法:定性调查
Meghan Martinez1, Allison Kirkegaard2, Kathryn Bouskill2
1Palo Alto Medical Foundation Research Institute and Center for Health Systems Research, Sutter Health, Palo Alto, California, USA.
行为推动通过提高外科医生对指导方针的认识,有效地减少了术后阿片类药物处方. 外科医生很开心,将反纳入处方决策中,强调了准则意识的重要性.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗信息学 医疗信息学
- 外科手术实践 在外科手术实践中
背景情况:
- 手术后过度处方阿片类药物有助于长期使用和转移.
- 一个集群随机对照试验调查了行为"推动"以减少阿片类药物数量.
- 这项研究探讨了外科医生为处方行为变化背后的推理,以应对干预.
研究的目的:
- 了解外科医生改变或维持在行为推动干预后阿片类药物处方习惯的理由.
- 评估电子邮件推对术后阿片类药物处方实践的影响.
主要方法:
- 与36名外科医生进行了半结构面试,涉及三个专业 (骨科,产科/妇科,整体外科).
- 采访探讨了外科医生对推动的反应,它们对处方的影响以及其他影响因素.
- 面试成绩单被研究小组编码和分析.
主要成果:
- nudges有效地减少了跨专业和干预部门的术后阿片类药物处方.
- 外科医生报告说,意识和意向增加,导致释放的阿片类药物处方减少.
- 大多数外科医生不知道现有的阿片类药物处方指南;一些人对nudge准确性和感知到的监督表示保留.
结论:
- 外科医生对准则和同行对处方行为的反持开放态度.
- 对临床指南的认识对于制术后阿片类药物过度处方至关重要.
- 将基于指南的反与临床经验相结合,为处方决策提供了信息.
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