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Drug prescription goals in primary care: a cross-sectional study
- Source :
- BMC Health Services Research, Vol 20, Iss 1, Pp 1-10 (2020), BMC Health Services Research
- Publication Year :
- 2020
- Publisher :
- BMC, 2020.
-
Abstract
- Background Care goals are often implicit, although their identification is a key element of any prescription process. This study aimed to describe the clinical goals of drug prescriptions in general practice, their determinants and the agreement between physicians and patients. Methods This was a cross-sectional study conducted by 11 resident trainees acting as observers in 23 general practices. The residents recorded the indication and main physician’s goal for all drugs prescribed during five consultation days in each practice in December 2015, and the main patient’s goal for a sub-sample of consultations. We used an eight-category generic classification of prescription goals, including three specific (mortality, morbidity and cure), three non-specific (symptoms, quality of life, functioning) and two non-specified (other goal, no goal) categories. Analyses were based on a multivariable, multilevel model and on the kappa statistic applied to the sub-sample of consultations. Results The sample encompassed 2141 consultations and 5036 drugs. The main physicians’ goal of drug prescriptions was to relieve symptoms (43.3%). The other goals were to decrease the risk of morbidity (22.4%), to cure disease (11.7%), to improve quality of life (10.6%), to decrease the risk of mortality (8.5%) and to improve functioning (1.8%). The choice of a specific goal was more frequent in patients with the following characteristics: over 50 (OR [1.09;1.15]), of male gender (OR [1.09;1.39]), with full financial coverage for a long-term condition (OR [1.47;1.97]), known by the physician (OR [1.19;2.23]), or with a somatic health problem (OR [2.56;4.17]). Cohen’s kappa for drug prescription goals between the patients and the physicians was 0.26 (0.23–0.30). Conclusions Physicians’ goals are poorly shared with patients. It remains to be assessed whether it is possible to collect and discuss information on prescription goals on a daily basis.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Cross-sectional study
Drug prescription
030204 cardiovascular system & hematology
Drug Prescriptions
Health administration
03 medical and health sciences
Young Adult
0302 clinical medicine
Quality of life (healthcare)
General Practitioners
Observational study
medicine
Risk of mortality
Humans
030212 general & internal medicine
Medical prescription
Practice Patterns, Physicians'
Aged
Aged, 80 and over
Physician-Patient Relations
Primary Health Care
business.industry
Health Policy
Nursing research
Public health
lcsh:Public aspects of medicine
lcsh:RA1-1270
Middle Aged
Primary care
Cross-Sectional Studies
Family medicine
Female
France
business
General practice
Goals
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14726963
- Volume :
- 20
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Health Services Research
- Accession number :
- edsair.doi.dedup.....3046c4fb5b0378bd2bb62412dadfb5ef