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首页> 外文期刊>Pharmacoepidemiology and drug safety >Variations in antidepressant prescribing practice: clinical need or market influences?
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Variations in antidepressant prescribing practice: clinical need or market influences?

机译：抗抑郁药处方实践的变化：临床需求还是市场影响？

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OBJECTIVE: To assess the antidepressant prescribing patterns of community psychiatrists, and the prescriptions issued by general practitioners and private physicians during 1999 in order to analyse and discuss the intensity and sources of variations between doctors. METHODS: All reimbursed prescriptions for antidepressants written in 1999 by community psychiatrists and general practitioners working for the Canary Islands Health Service at Santa Cruz de Tenerife were collected from official sources. Prescriptions were available individualized for each psychiatrist but were collected globally for the others. Drugs were classified according to the Anatomic Therapeutic Chemical (ATC-1999 edition) System and use was quantified in terms of defined daily doses (DDDs). As an indicator of the quality of drug prescribing, the DU90% was used. RESULTS: The total use of antidepressant in Tenerife was 21.4 DDD/1000 inhabitants/day. The most frequently prescribed substances were fluoxetine, paroxetine and sertraline,which accounted for 58% of all prescriptions. Each psychiatrist used between 10 and 20 different substances and between 15 and 26 different trade names. Prescribing by general practitioners mirrored that of psychiatrist, and private doctors (mainly psychiatrist) were found to have a different pattern of prescribing with higher use of new and uncommon antidepressants. Psychiatrists acknowledge the pressures of promotion by the pharmaceutical industry and half of them recognize a personal relationship with some 'company representatives'. CONCLUSION: There is a remarkable degree of variation in antidepressant prescribing by psychiatrists and general practitioners, this is due to economic and social factors as much as to morbidity differences.
机译：目的：评估社区精神科医生的抗抑郁药处方模式，以及全科医生和私人医生在1999年间发布的处方，以分析和讨论医生之间差异的强度和来源。方法：1999年，圣塔克鲁兹德特内里费岛加那利群岛卫生服务局的社区精神科医生和全科医生为抗抑郁药开出的所有报销处方均从官方渠道收集。每种精神病医生都有个性化的处方，但其他人则在全球范围内收集。根据《解剖治疗化学》（ATC-1999版）系统对药物进行分类，并根据确定的日剂量（DDDs）对使用进行量化。作为药物处方质量的指标，使用了DU90％。结果：特内里费岛抗抑郁药的总使用量为21.4 DDD / 1000居民/天。处方最频繁的物质是氟西汀，帕罗西汀和舍曲林，占所有处方的58％。每位精神科医生使用10至20种不同的物质以及15至26种不同的商品名。全科医生的处方与精神科医生的处方相仿，而私人医生（主要是精神科医生）被发现有不同的处方方式，更多地使用新的和不常见的抗抑郁药。精神科医生承认制药业的提升压力，其中一半认识到与某些“公司代表”的私人关系。结论：精神科医生和全科医生的抗抑郁药处方差异很大，这是由于经济和社会因素以及发病率差异所致。

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