我国中西部三省(自治区)贫困边远地区农村基层医疗机构处方医生对基本药物制度的知信行调查

An investigation of the knowledge,attitude,and practice of the doctors who prescribe on essential medicine policy in rural primary medical institutions in poor or remote areas of three provinces(autonomous regions) in central and western China

目的 :了解我国中西部贫困边远地区农村基层医疗机构处方医生对基本药物制度的知识、态度、行为以及基本药物标识的态度。方法 :采用自编的基本药物制度认知知识-态度-行为问卷,经信效度分析,信度系数α=0.907,效度KMO=0.854,问卷的信效度良好。采用典型抽样法,按乡镇卫生院1∶3、村卫生室1∶30的比例,在湖北、广西、江西抽取73家有代表性的农村基层医疗机构(26家乡镇卫生院、47家村卫生室)。调查处方医生400人,有效问卷370份,有效率92.5%。采用基本药物使用率和添加基本药物标识率等指标进行分析。采用SAS 8.0进行描述性分析,包括均数、标准差和率等。结果 :86.5%的人对基本药物制度有较高认知,约80%的人对基本药物制度持积极态度,92.2%的人开处方时首选基本药物,70.8%的人希望增加基本药物的标识。结论 :贫困边远地区农村基层医疗机构的处方医生对基本药物制度的认知中高,虽普遍支持基本药物制度,但缺乏系统、合理的认知渠道。因此,加强基本药物制度的宣传、增加基本药物的标识对提高处方医生的基本药物制度认知度、促进合理用药有重要意义。

Objective To understand the knowledge,attitude,and practice（KAP） of the doctors who prescribe on essential medicine policy and their attitude towards essential medicine identification in rural primary medical institutions in poor or remote areas of central and western China. Methods：The self-made KAP questionnaire was used to conduct essential medicine policy knowledge survey. The reliability coefficient α was 0.907 and the validity of KMO was 0.854. The questionnaire was of good reliability and validity. Typical sampling method was used,and 73 representative rural primary medical institutions was selected（26 township health centers,47 village clinics） in Hubei,Guangxi and Jiangxi. The number of township health centers selected were determined as 1/3 of total,and village clinics as 1/30 of total. A total of 400 doctors who prescribe medicine were investigated,and 370 valid questionnaires were collected with a valid rate of 92.5%. Indicators included essential medicine using rate and essential medicine identification using rate. SAS 8.0 was used to analyze mean,standard deviation and rate. Results：A total of 86.5% of doctors who prescribe medicine had good knowledge of essential medicine policy,about 80% supported the policy,92.2% preferred to use essential medicines,and 70.8% hoped to increase essential medicine identification. Conclusion：Doctors who prescribe medicine in poor or remote areas have a medium or high knowledge of essential medicine policy,and generally support it. But they lack a systematic and reasonable access to the knowledge of essential medicine policy. Therefore,strengthening the publicity of essential medicine policy and increasing essential medicine identification are of great significance to improve the medical staff’s knowledge of the policy and promote rational drug use.