Analysis of potential irrational drug use and training needs of family doctors in the diagnosis and treatment of patients with multiple chronic diseases
Analysis of potential irrational drug use and training needs of family doctors in the diagnosis and treatment of patients with multiple chronic diseases
Objective To investigate the potential irrational drug use among community general practitioners in patients with multimorbidity diseases,and explore improvement strategies.Methods Twenty-one field research questionnaires of community potentially inappropriate medications(PIM)project were tested in the previous study of this project group.A to-tal of 1 500 prescriptions were collected from 236 general practitioners on duty at 47 community health service centers from December 2021 to January 2022 in Pudong New Area,Shanghai using mechanical sampling method,and an online question-naire survey was conducted.Results The 21 items with the highest frequency of PIM were"Digoxin for heart failure pa-tients with normal ventricular systolic function","ankle edema dependent on clinical manifestations of non-heart failure treated with loop Diuretic",etc.The difference analysis was made on the subjective frequency of PIM items,the subjective rationality judgment of general practitioners,and the actual objective frequency in prescriptions.The rank sum test sugges-ted that there was astatistically significant difference between the subjective rationality judgment and objective occurrence frequency of 21 potentially irrational drug use items(P＜0.05);Compared with the subjective frequency judgment and sub-jective rationality judgment of 21 potential irrational drug use items,there was no significant difference between the two i-tems except for the item"Nifedipine regular release dosage form as antihypertensive drug"(P＞0.05),and the other items had significant differences(P＜0.01);Linear regression analysis was conducted using the daily occurrence frequency of 21 PIMs as the dependent variable and 5 factors such as professional title and education as independent variables.The results showed that each factor had no significant impact on the daily occurrence frequency of PIMs(P＞0.05).Conclusion Cur-rently,family doctorslack subjective understanding of the potential irrational use of medication in patients with multiple chronic diseases,and it is relatively common.Therefore,unified training and guidance should be carried out.
关键词
共存病/不合理用药/培训/需求/家庭医生
Key words
Multimorbidity/Irrational drug use/Training/Needs/Family doctor
维普
万方数据