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首页> 外文期刊>BMC Family Practice >Attitudes and behaviour towards psychotropic drug prescribing in Swedish primary care: a questionnaire study
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Attitudes and behaviour towards psychotropic drug prescribing in Swedish primary care: a questionnaire study

机译：瑞典初级保健中对精神药物处方的态度和行为：一项问卷调查研究

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The prescribing of psychotropic drugs, i.e. antidepressants, sedatives (anxiolytics, hypnotics), and antipsychotics is considerable and a large proportion is prescribed by general practitioners (GPs). There are concerns about dependency and medicalisation, and treatment decisions in psychiatry may appear arbitrary. Increased knowledge of GPs’ opinions on the prescribing of psychotropics may lead to more rational use of these drugs. We aimed to quantify GPs’ attitudes, beliefs and behaviour towards various aspects of psychotropic drug prescribing. A questionnaire was distributed to physicians in all 199 GP practices in Region V?stra G?taland, Sweden. The questions concerned determinants of psychotropic drug prescribing that had been identified in a previous, qualitative study. Questionnaires from 516 physicians (64% of whom were specialists in family medicine, 21% interns in family medicine, 15% others) at 152 GP practices (59% of which were state owned, 72% in an urban area, with a median of 7808 registered patients) were returned (estimated response rate: 48%). A majority – 62% – of GPs found it easier to start prescribing psychotropic drugs than to stop (95% confidence interval, 57%, 66%) vs. 8% (6%, 10%). Most GPs considered psychotherapy more suitable than psychotropic drugs in cases of mild psychiatric disease: 81% (77%, 84%) vs. 4% (3%, 6%). The problems treated with psychotropic drugs were considered to be mostly socioeconomic, or mostly medical, by similar proportions of physicians: 38% (34%, 42%) vs. 40% (36%, 45%). GPs were on average satisfied with their levels of antidepressant and sedative prescribing in relation to medical needs. More GPs regarded their prescribing of antipsychotics as being too low rather than too high: 33% (28%, 39%) vs. 7% (4%, 10%). This study illustrates the complexities of psychiatric drug treatment in primary care and identifies potential drivers of increased prescribing of psychotropics. The manifold factors, medical and non-medical, that affect prescribing decisions may explain a sense of arbitrariness surrounding psychotropic drug treatment. This notwithstanding, GPs seem mostly content with their prescribing.
机译：精神药物，即抗抑郁药，镇静药（抗焦虑药，催眠药）和抗精神病药的处方是相当多的，全科医师（GPs）开出了很大的比例。有关依赖性和医疗的问题令人担忧，精神病学方面的治疗决定可能显得武断。对全科医生对精神药物开处方的看法的了解增加，可能会导致更合理地使用这些药物。我们旨在量化全科医生对精神药物处方各个方面的态度，信念和行为。在瑞典V？stra G？taland地区，向所有199名GP执业医师分发了一份调查问卷。这些问题涉及在先前的定性研究中确定的精神药物开处方的决定因素。来自152名GP执业医师的516名医生（其中64％是家庭医学专家，21％是家庭医学实习生，其他15％是其他人）的问卷（其中59％为国有，城市地区为72％，中位数为返回了7808名注册患者（估计缓解率：48％）。绝大多数（62％）的全科医生发现开始开精神药物比停止（72％置信区间，57％，66％）相对于8％（6％，10％）更容易。大多数GP认为轻度精神病患者的心理治疗比精神药物更合适：81％（77％，84％）对4％（3％，6％）。相似比例的医生认为，使用精神药物治疗的问题大部分是社会经济问题，或者大部分是医学问题：38％（34％，42％）对40％（36％，45％）。全科医生对他们的抗抑郁和镇静处方水平与医疗需求有关的平均满意度。越来越多的全科医生认为他们对抗精神病药物的处方过低而不是过高：33％（28％，39％）对7％（4％，10％）。这项研究说明了精神药物治疗在初级保健中的复杂性，并确定了增加精神药物处方的潜在驱动因素。影响处方决定的多种因素（医学和非医学因素）可以解释围绕精神药物治疗的随意性。尽管如此，GP似乎大多对他们的处方感到满意。

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