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Yıl:2005; Cilt: 15; Sayı: 1>> Özet
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Klinik Psikofarmakoloji Bülteni; 2005;15(1):5-13
Psikiyatri ve psikiyatridışı hekimlerin benzodiazepin reçetesi yazma örüntülerinin incelenmesi
O Karamustafalıoğlu, M Yılmaz, B Özçelik, B Bakım, M Güveli
Şişli Etfal Eğitim ve Araştırma Hastanesi Psikiyatri Kliniği, İstanbul
Amaç: Psikiyatri ve psikiyatridışı (iç hastalıkları ve nöroloji) hekimlerin benzodiazepin grubu ilaçlarla ilgili düşüncelerini ve tedavide bu ilaçlarla reçete yazma örüntülerini değerlendirmektir. Yöntem: Örneklem, ülkenin çeşitli büyük şehir ve şehir/ilçelerinde (kırsal) çalışan, yurt içi bilimsel bir toplantıya katılmakta olan 169 gönüllü asistan ve uzman hekimden oluştu. Hekimlere demografik ve mesleki özellikleri, benzodiazepinlerin farmakodinamik ve farmakokinetik özellikleri hakkında açık ve kapalı uçlu sorular içeren anket formu uygulandı. Bulgular: Anksiyete bozuklukları %89 oranıyla en sık benzodiazepin reçetesi düzenlenen endikasyondu. Somatizasyon psikiyatridışı hekimlerin %25.8’inde, psikiyatri hekimlerinin %5’inde benzodiazepin reçetesi yazma endikasyonu olarak ifade edildi (p<0.001). Benzodiazepin reçetesi yazma endikasyonları bakımından psikiyatri asistan ve uzmanları arasında istatistiksel olarak anlamlı bir fark saptanmadı. Depresyon ve anksiyete, daha sık kırsal bölgede (p=0.009, p=0.03), deliryum tremens ve EPS daha sık büyük şehirde (p=0.04, p=0.001) belirtilen endikasyonlardı. Benzodiazepinlerin öforizan yan etkileri, sıklıkla diğer psikoaktif maddeleri kullanmayanlar tarafından kötüye kullanıldıkları, alkol kötüye kullanımı olanlarda bilhassa reçete etmekten kaçınılması gerektiği gibi hususlarda bilgili olma düzeyinin orta ve düşük seviyede (%11-50) olduğu saptandı. Sonuç: Benzodiazepin reçetesi yazma örüntüsü, hekimin asistan ya da uzman olması, branşı, büyük şehir ve şehir/ilçede çalışmak gibi özellikler bakımından farklılıklar göstermektedir.(
Benzodiazepine prescription patterns of psychiatry and non-psychiatry residents and specialists
Objective: The aim of this study was to evaluate the thoughts about using benzodiazepines in the treatment and the prescription patterns of psychiatry and non-psychiatry residents and specialists in Turkey. Method: Total number of 169 residents and specialists from both rural (city/town) and urban (metropolis) regions, who have been attending a national congress, were assigned to the study. A questionnaire form including items about sociodemographic and occupational properties of the physicians, pharmacodynamics and pharmacokinetics of benzodiazepines, with open and closed-end questions were completed by the volunteering physicians. Results: Anxiety disorders were found to be the most frequent (89%) indication for benzodiazepine prescription. Twenty five percent of physicians other than psychiatrists used benzodiazepines for patients with a clinical presentation of somatization (p<0.001). The usage for indications of depression and anxiety were found to be more frequent in rural areas (p=0.009, p=0.03), delirium tremens and EPS, in urban areas, respectively (p=0.04, p=0.001). 11-50% of physicians were knowledgeable about features such as euphorizan side effects, being abused by the patients who do not abuse other psychoactive substances, and need to avoid benzodiazepines to the patients abusing alcohol. There were significant differences about those items among psychiatrists at the urban and rural regions at the level of p<0.05. Conclusion: The pattern of benzodiazepine prescription seems to be closely related with some characteristic features of the physician, geographical and regional differences. It is noteworthy to say that psychiatry residents and -to some extent- specialists do not have enough knowledge about pharmacodynamics and pharmacokinetics of benzodiazepines. Physicians other than psychiatrists seemed to have confusion about management of somatization disorder.(

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