在全科医生的处方决定中评估决策疲劳,使用澳大利亚BEACH数据集
Mona Maier1, Daniel Powell1, Christopher Harrison2
1Health Psychology, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
概括
随着工作日的进展,全科医生 (GPs) 显示抗生素处方增加,而他类药物/骨质疏松症药物处方减少,与决策疲劳一致. 这突显了决策疲劳作为优化处方行为的目标.
科学领域:
- 医疗决策的制定 医疗决策的制定
- 临床药房 临床药房
- 医疗保健服务研究 医疗服务研究
背景情况:
- 一般医生 (GPs) 面临着许多日常决策,可能导致决策疲劳.
- 决策疲劳会导致人们转向对认知要求较低的选择.
- 这项研究调查了GP的处方模式是否反映了决策疲劳.
研究的目的:
- 检查一般医生的处方决定是否会在工作日内因决策疲劳而改变.
- 测试假设,随着工作日的进展,处方过度使用的药物增加,而过度使用的药物减少.
主要方法:
- 来自澳大利亚的全国代表性初级保健数据的分析 (改善健康评估和护理计划).
- 利用通用线性混合模型来评估处方决策与遭遇顺序之间的关联.
- 根据患者,提供者和遭遇特征进行调整.
主要成果:
- 处方抗生素增加了8.7%,与15个额外的患者接触 (OR=1.087).
- 类药物的处方减少了21.9% (OR=0.791) 和骨质疏松症药物的处方减少了25.0% (OR=0.750) 与15个额外的遭遇.
- 对阿片类药物没有观察到显著影响;对二胺类药物有不同的结果.
结论:
- 医生处方模式与决策疲劳一致,在工作日晚些时候增加了抗生素和减少了他类药物/骨质疏松症药物处方.
- 决策疲劳似乎影响了某些药物类别的处方.
- 研究结果表明,决策疲劳是改善符合指导方针的处方的可修改因素.
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