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首页> 外文期刊>Journal of psychiatric practice. >The impact of evidence-based education on prescribing in a psychiatry residency.
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The impact of evidence-based education on prescribing in a psychiatry residency.

机译：循证教育对精神科住院医师处方的影响。

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OBJECTIVE: Recent clinical trials comparing the effectiveness of antipsychotics have found no advantage for second-generation antipsychotics over older first-generation agents. However, the former are much more commonly used despite their significantly higher cost and potential for contributing to the metabolic syndrome. To date, educational interventions have been unsuccessful in influencing this pattern. The Duke University Medical Center Department of Psy chiatry began a program based on principles of academic detailing designed to educate psychiatry residents about generic psychotropics. To encourage residents to gain experience with these medications, samples of selected generic drugs were provided. To assess the initiative's impact, the authors measured the prescribing patterns of residents. METHODS: We measured the amount of generic drug use 6 months after the program began and compared it with data from a 6-month control period. The data were analyzed based on overall psychotropic use, class of medication, site, and diagnosis. RESULTS: We found a consistent increase in generic use across analyses. There was an increase in overall generic prescribing from 55.8% to 58.6% [X=10.37, odds ratio (OR)=1.12, P=0.0013] and a particularly large increase in prescribing of generic antipsychotic medications from 39.5% to 47.7% [X=36.12, OR=1.39, P<0.0001]. Conclusion. The implementation of this educational program was correlated with increasing use of generic medications and brought antipsychotic prescribing into concordance with the new evidence. This is the first such study in a psychiatry residency program and has implications for promoting cost-effective care while preserving patient choice in the mental health system. The findings from this study also suggest potential techniques for expanding residents' prescribing skills across specialties.
机译：目的：比较抗精神病药有效性的最新临床试验发现，与较老的第一代药物相比，第二代抗精神病药没有优势。然而，尽管前者成本高得多并且有可能导致代谢综合征，但前者却更为常用。迄今为止，教育干预还没有成功地影响这一模式。杜克大学医学中心精神病学系开始了一项基于学术细节原则的计划，旨在教育精神病学居民有关一般精神药物的知识。为了鼓励居民获得使用这些药物的经验，提供了一些非专利药物的样本。为了评估该计划的影响，作者测量了居民的处方方式。方法：我们测量了该计划开始后6个月的仿制药使用量，并将其与6个月对照期的数据进行了比较。根据总体精神药物使用情况，用药类别，部位和诊断分析数据。结果：我们发现各种分析中通用药物的使用量持续增加。总体非处方药处方从55.8％增加到58.6％[X = 10.37，优势比（OR）= 1.12，P = 0.0013]，非处方抗精神病药物处方从39.5％增加到47.7％[X = 36.12，OR = 1.39，P <0.0001]。结论。这项教育计划的实施与越来越多的非专利药物的使用相关，并使抗精神病药的处方与新证据一致。这是精神科住院医师计划中的首项此类研究，对促进具有成本效益的护理同时保留精神卫生系统中患者的选择具有重要意义。这项研究的发现还提出了扩展居民跨学科专业处方技能的潜在技术。

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