一般医生对给老年人处方成性催眠药的思考:一个定性研究
Holgeir Skjeie1, Mette Brekke2, Trygve Skonnord2
1General Practice Research Unit, Institute of Health and Society, University of Oslo, Oslo, Norway holgeir.skjeie@medisin.uio.no.
BJGP open
|July 19, 2024
概括
挪威的全科医生经常给老年患者开上性催眠药,偏离欧洲的指导方针. 这种务实的方法平衡了患者的需求和有限的替代方案,表明零愿景政策是不现实的.
科学领域:
- 老年医学 老年医学
- 一般实践 一般实践
- 药理学 药理学是指药理学的学科.
背景情况:
- 欧洲指导方针建议在不眠症中使用有限的,短期的成性催眠药.
- 挪威的实际实践包括对老年患者频繁,定期处方这些药物.
- 这种做法与既有治疗建议相矛盾.
研究的目的:
- 调查经验丰富的挪威全科医生 (GP) 关于定期处方成性催眠药的观点.
- 专注于70岁以上独立生活的患者.
主要方法:
- 进行了深入的个人访谈,对挪威南部的专业全科医生进行了有目的的采样.
- 在2022年6月至2023年1月期间,使用了半结构面试指南.
- 用反射主题跨案例分析分析了数据.
主要成果:
- 大多数接受采访的全科医生 (11) 每天给超过10名老年患者定期开处方催眠药 (主要是z-催眠药),并间歇地给类似的患者开处方.
- 一般医生承认这种做法与指导方针相矛盾,但表示安慰,优先避免新的依赖.
- 他们将这些患者视为严重失眠的少数群体,很少有替代方案,耐受性很好,这反映了以患者为中心的,共同的决策方法,尽管有资源挑战.
结论:
- 在一般实践中,严格的"零视觉"政策对老年人处方成性催眠药被认为是不切实际的,可能是不明智的.
- 这些发现突出了指导方针建议与失眠的老年人临床现实之间的差距.
- 实用性,以患者为中心的方法被一般医生所使用,他们面临着有限的治疗选择.
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