临床医生对一线抗结核药物及治疗支持的知信行研究  

Knowledge, attitude, and practice of clinicians on first-line antitubercular agents and treatment support

作　　者：皮殷欢 谭隽怡 李天驹 石小枫[1] 向明确[2,3] PI Yin-huan;TAN Jun-yi;LI Tian-ju;SHI Xiao-feng;XIANG Ming-que(Infection Department,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China;Infection Department,Chongqing Ninth People′s Hospital,Chongqing 400799,China;the Second Clinical College,Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第二医院感染科,重庆400010 [2]重庆市第九人民医院感染科,重庆400799 [3]重庆医科大学第二临床学院,重庆400016

出　　处：《临床肺科杂志》2023年第6期863-868,873,共7页Journal of Clinical Pulmonary Medicine

基　　金：重庆市自然科学基金项目(No.csts2021jcyj-msmxmX1219);重庆市第九人民医院科技计划项目(No.2021YJXM01)。

摘　　要：目的了解临床医生对一线抗结核药物及治疗支持的知信行现状。方法随机抽取重庆各级卫生机构诊治成人肺结核的医生,调查其对一线抗结核药物及治疗支持的知信行。结果知识得分中位数16(14,18)分,知道治疗支持提供者推荐顺序的医生占19.2%。15.4%的参与者认为复方制剂效果优于单一制剂,72.1%的人认为复方制剂不便于调整用药,27.9%的医生倾向开复方制剂处方,这些情况在感染专业、三级医院医生中更为显著(P<0.05)。认为门诊医生进行健康教育效果更好的占85.6%。大多数医生选择剂型时考虑的主要因素为疗效(76.0%),没有医生选择患者要求和价格。受访医生所接诊患者的治疗支持主要由家庭成员提供(50.0%),其次是医务人员(34.6%),健康教育由门诊医生进行的占70.2%。结论重庆地区不同类型临床医生对一线抗结核药物的知信行存在较大差异,治疗支持知识不全面,感染专业及三级医院医生更偏好单一制剂。Objective To understand the situation of knowledge,attitude,and practice of clinicians on first-line antitubercular agents and treatment support.Methods It recruited doctors from all levels of health institutions and different specialties who were conducting the diagnosis and treatment of adult pulmonary tuberculosis to conduct an online survey on the knowledge,attitude and practice of first-line antitubercular agents and treatment support through a self-designed questionnaire.Results The knowledge questionnaire had a total score of 20,with a median score of 16(14,18),and 31.7%scored≥18.The order of recommendation of treatment support providers was known by 19.2%.15.4%of the participants felt that fixed-dose compound tablets were better than separate drug formulations,and 72.1%felt that fixed-dose compound tablets were not easy to change prescription.27.9%of clinicians preferred combination preparation when prescribing,among physicians in infection specialist and tertiary hospitals(P<0.05).85.6%felt that outpatients′health education was better.The main factor considered by most doctors when choosing the dosage form was efficacy(76.0%),and no doctor chose patient requirements and price.The treatment support of patients received by the doctors interviewed was mainly provided by family members(50.0%),followed by medical personnel(34.6%),and 70.2%of health education was carried out by outpatient physicians.Conclusion The knowledge,attitudes,and practices of first-line antitubercular agents vary widely among different types of clinicians in Chongqing.In general,they lack a thorough knowledge of treatment support.Separate drug formulations are preferred by physicians in infectious specialties and tertiary hospitals.

关 键 词：肺结核 抗结核药物 临床医生 知识 态度 实践 合理用药 

分 类 号：R521[医药卫生—内科学]