瑞士初级保健中的处方决定:全科医生和老年人之间的一致性较低
Kristie Rebecca Weir1,2, Renata Vidonscky Lüthold3,4, Zsofia Rozsnyai3
1Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland. Kristie.weir@sydney.edu.au.
Journal of general internal medicine
|January 14, 2026
概括
一般医生 (GPs) 和患者对处方抑郁药物表现出类似的兴趣,但很少就哪些药物停止同意. 关于药物必要性和患者偏好的公开沟通是成功为老年人处方抑郁症的关键.
科学领域:
- 老年医学 老年医学
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 停止处方对于减少老年人与药物相关的伤害至关重要.
- 了解患者和提供者的观点对于有效的脱处方实施至关重要.
- 有限的研究比较了患者和全科医生 (GP) 在抑郁症的偏好.
研究的目的:
- 为了比较医生和患者对抑郁症药物的偏好.
- 调查影响抑郁症描述偏好一致性的因素.
- 分析患者与医疗服务提供者之间的信任关系和下药偏好之间的关系.
主要方法:
- 在瑞士初级保健机构进行的横截面调查.
- 65名患者 (≥65岁,≥5种药物) 和他们的10名全科医生填写了问卷.
- 使用通用估计方程评估描述偏好并分析一致性和信任关联.
主要成果:
- 类似比例的患者 (38%) 和全科医生 (35%) 希望不再开至少一种药物.
- 观察到的一致性较低:只有8个二合一同意减缓处方,其中1个二合一选择相同的药物.
- 患者经常确定心血管药物 (43%) 为抑郁症,而全科医生专注于食补充剂 (26%).
- 一般医生将患者继续治疗的愿望 (83%) 列为障碍;患者认为医生只开必需药物 (38%).
结论:
- 尽管有共同的兴趣,但GP和患者选择抑郁症之间存在显著的分歧.
- 药物必要性和患者偏好的差异阻碍了抑郁症的处方.
- 关于药物必要性和个人偏好的加强沟通可以改善抑郁症的处方结果.
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