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Yıl:2014; Cilt: 27; Sayı: 3>> Özet
TAM METİN
Düşünen Adam: Psikiyatri ve Nörolojik Bilimler Dergisi; 2014;27(3):242-249
İstanbul ili genelinde görev yapan aile hekimlerinin antidepresan reçetelemesini etkileyen faktörler
A Yıldırım, OG Gönüllü, N Eradamlar, M Erkıran
Bakırköy Prof. Dr. Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul
Amaç: Aile hekimliği uygulamalarında, sıklıkla karşılaşılan ruhsal bozuklukların depresyon ve anksiyete bozuklukları olduğu ve bunların sağaltımında kullanılan antidepresanların son yıllarda çok sık reçetelendiği bilinmektedir. Buradan hareketle, aile hekimlerinin antidepresan reçetelemesini etkileyen faktörlerin tespit edilmesi amaçlanmıştır. Yöntem: Çalışmamızda, İstanbul ili genelinde altı ayrı bölgede görev yapan 120 aile hekimine ulaşılarak, çalışmacılar tarafından hazırlanmış 30 sorudan oluşan anket formunun uygulanması ile veriler toplanmıştır. Bulgular: Araştırmaya katılan aile hekimlerinin %80.8’i depresyon tanısı koymak için yeterli bilgi ve deneyime sahip olduklarını bildirmiştir. Hastaların tedavisi ile ilgili bilgilerini yetersiz bulanların oranı ise %47.5 olarak belirlenmiştir. Hekimlerin %1.5 i belirtilerin tamamını tanımlayabilmiştir. Yüzde seksen dokuz nokta ikisi antidepresanların tedavide kullanımı ile ilgili düzenli eğitime ihtiyaç duyduklarını belirtmişlerdir. Hekimlerin %81.7’sinin ilk tercih ettikleri antidepresan molekülünün aynı olduğu belirlenmiştir. Aile hekimlerinin %66.7’si antidepresan olarak kullanılan ilaçların bağımlılık yapabileceklerine, %72.2’si hastaların büyük bir kısmının antidepresan tedavisiz düzeleceklerine inandıklarını belirtmişlerdir. Sonuç: İki bin on yılı sonu itibariyle ülke genelinde uygulanan aile hekimliği sistemi ile birlikte, birinci basamakta sunulan ruh sağlığı hizmetlerinde de yeni bir döneme girilmiştir. Birinci basamakta görev yapan aile hekimlerinin ruhsal bozuklukların tanısı ve sağaltımı ile ilgili yetersiz bilgi düzeyi ve olumsuz tutumlarının dikkat çekici olması, bu konuda tedbirler ve düzenlemelerin gerekliliğini göstermektedir
Factors affecting prescription of antidepressant medications by family physicians in Istanbul province
Objective: In the family physician system, depression and anxiety disorders are frequently encountered and antidepressant medications are often prescribed in recent years. Therefore, we aimed to investigate the factors affecting the prescription of antidepressants by family physicians. Methods: In our study, 120 family physicians working at six districts in Istanbul were contacted and the data were collected by administering a 30-item questionnaire prepared by the investigators. Results: Eighty point eight percent of the participating family physicians reported that they had sufficient education and practice for diagnosing depression. Fourty seven point five percent of them found their education inadequate for the treatment of patients. Only 1.5% of them were able to define all of the symptoms of depression. Eighty nine point two percent pointed out that they needed regular training about the use of antidepressants in treatment. We found that 81.7% of the physicians preferred prescribing the same antidepressant molecule as their primary option. Sixty six point seven percent stated that they believed the antidepressants could cause dependency and 72.2% believed that a large number of patients would recover without any medication. Conclusion: With the introduction of family physician practice across the country as of the end of 2010, we entered a new era in terms of the management of psychiatric disorders in primary care. We can suggest that new measures and arrangements are needed to improve the knowledge and attitudes of family physicians about the diagnosis and treatment of psychiatric disorders.

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