AIM： To elucidate the preferences of gastroenterologists at our institution and compare them to those of obstetricians when making decisions in the pregnant patient, including which type of bowel preparations to use ...AIM： To elucidate the preferences of gastroenterologists at our institution and compare them to those of obstetricians when making decisions in the pregnant patient, including which type of bowel preparations to use for flexible sigmoidoscopy or colonoscopy, as well as which laxatives can be used safely.METHODS： Surveys were mailed to all attending gastroenterologists （n = 53） and obstetricians （n = 99） at our institution. Each survey consisted of the 14 most common laxative or motility agents used in pregnancy and inquired about the physician＇s prescribing habits in the past as well as their willingness to prescribe each medication in the future. The survey also listed four common bowel preparations used prior to colonoscopy and sigmoidoscopy and asked the physician to rank the order of the preferred agent in each case.RESULTS： With regard to common laxatives, both gastroenterologists and obstetricians favor the use of Metamucil, Colace, and Citrucel. Both groups appear to refrain from using Fleets Phosphosoda and Castor oil. Of note, obstetricians are less inclined to use PEG solution and Miralax, which is not the case ,with gastroenterologists. In terms of comparing bowel preparations for colonoscopy, 50% of gastroenterologists prefer to use PEG solution and 50% avoid the use of Fleets Phosphosoda. Obstetricians seem to prefer Fleets Phosphosoda （20%） and tend to avoid the use of PEG solution （26%）. With regard to bowel preparation for sigmoidoscopy, both groups prefer Fleets enema the most （51%）, while magnesium citrate is used least often （38%）.CONCLUSION： It is clear that preferences in the use of bowel cleansing preparations between the two groups exist, but there have not been many case controlled human studies in the pregnant patient that give clear cut indications for using one versus another drug. In light of the challenge of performing controlled trials in pregnant women, more extensive surveys should be undertaken to gather a larger amount of data on physicians＇ experiences and individual preferences.展开更多
目的了解当前我国妇产科医生对不同种类复方短效口服避孕药(COC)服药方案及其雌激素剂量的认识和适应症应用情况,以期为临床个体化用药决策提供参考。方法2022年8月至12月在全国20个省、自治区、直辖市的155家医院邀请妇产科医生进行问...目的了解当前我国妇产科医生对不同种类复方短效口服避孕药(COC)服药方案及其雌激素剂量的认识和适应症应用情况,以期为临床个体化用药决策提供参考。方法2022年8月至12月在全国20个省、自治区、直辖市的155家医院邀请妇产科医生进行问卷调查,了解其对国内目前五种常用COC的雌激素剂量和服药方案的认知及适应症应用情况。采用卡方检验、Bonferroni法、Crame' s V系数、雷达图等方法对数据进行统计分析及归纳总结。结果向653名妇产科医生发放调查问卷,回收有效问卷650份,回收率99.54%。妇产科医生对国内目前五种常用COC的知晓率差别较大,其中以屈螺酮炔雌醇片(Ⅱ)(20μg/片,87.69%;24/4方案,84.77%)知晓率最高,去氧孕烯炔雌醇片(20μg/片,45.69%;21/7方案,83.54%)最低。对于治疗痤疮、经前焦虑障碍、易怒、抑郁、经前综合征、多毛症和多囊卵巢综合征,28.77%~31.69%的妇产科医生选择24/4方案,37.54%~47.85%的妇产科医生选择雌激素剂量20μg/片的COC;其中对改善易怒症状(χ^(2)=9.403,P=0.009)方面,硕士及以上妇产科医生选择选择24/4方案的比例高于本科及以下学历者,差异有统计学意义。在改善月经周期规律性、治疗月经过多、经期周期控制效果方面,49.38%~50.00%的妇产科医生选择两方案效果相似,44.46%~56.31%的妇产科医生选择两剂量效果相似;其中在改善月经周期规律性(χ^(2)=8.402,P=0.015)和治疗月经过多(χ^(2)=6.451,P=0.040)方面,选择两剂量相似的副主任医师及以上的比例高于主治医师及以下者,差异均有统计学意义。妇产科医生对不同雌激素剂量和服药方案的选择呈弱相关(0.2<Cramer's V<0.3,P<0.05)。结论国内妇产科医生对不同COC的知晓率参差不齐,普遍存在对COC的作用机制认知不足。鉴于COC应用的广泛性,建议对妇产科医生加强COC药物作用机制的相关培训,了解雌孕激素剂量、种类与服药方案的关系,准确掌握适应症,以期更好地提供个体化推荐用药。展开更多
文摘AIM： To elucidate the preferences of gastroenterologists at our institution and compare them to those of obstetricians when making decisions in the pregnant patient, including which type of bowel preparations to use for flexible sigmoidoscopy or colonoscopy, as well as which laxatives can be used safely.METHODS： Surveys were mailed to all attending gastroenterologists （n = 53） and obstetricians （n = 99） at our institution. Each survey consisted of the 14 most common laxative or motility agents used in pregnancy and inquired about the physician＇s prescribing habits in the past as well as their willingness to prescribe each medication in the future. The survey also listed four common bowel preparations used prior to colonoscopy and sigmoidoscopy and asked the physician to rank the order of the preferred agent in each case.RESULTS： With regard to common laxatives, both gastroenterologists and obstetricians favor the use of Metamucil, Colace, and Citrucel. Both groups appear to refrain from using Fleets Phosphosoda and Castor oil. Of note, obstetricians are less inclined to use PEG solution and Miralax, which is not the case ,with gastroenterologists. In terms of comparing bowel preparations for colonoscopy, 50% of gastroenterologists prefer to use PEG solution and 50% avoid the use of Fleets Phosphosoda. Obstetricians seem to prefer Fleets Phosphosoda （20%） and tend to avoid the use of PEG solution （26%）. With regard to bowel preparation for sigmoidoscopy, both groups prefer Fleets enema the most （51%）, while magnesium citrate is used least often （38%）.CONCLUSION： It is clear that preferences in the use of bowel cleansing preparations between the two groups exist, but there have not been many case controlled human studies in the pregnant patient that give clear cut indications for using one versus another drug. In light of the challenge of performing controlled trials in pregnant women, more extensive surveys should be undertaken to gather a larger amount of data on physicians＇ experiences and individual preferences.
文摘目的了解当前我国妇产科医生对不同种类复方短效口服避孕药(COC)服药方案及其雌激素剂量的认识和适应症应用情况,以期为临床个体化用药决策提供参考。方法2022年8月至12月在全国20个省、自治区、直辖市的155家医院邀请妇产科医生进行问卷调查,了解其对国内目前五种常用COC的雌激素剂量和服药方案的认知及适应症应用情况。采用卡方检验、Bonferroni法、Crame' s V系数、雷达图等方法对数据进行统计分析及归纳总结。结果向653名妇产科医生发放调查问卷,回收有效问卷650份,回收率99.54%。妇产科医生对国内目前五种常用COC的知晓率差别较大,其中以屈螺酮炔雌醇片(Ⅱ)(20μg/片,87.69%;24/4方案,84.77%)知晓率最高,去氧孕烯炔雌醇片(20μg/片,45.69%;21/7方案,83.54%)最低。对于治疗痤疮、经前焦虑障碍、易怒、抑郁、经前综合征、多毛症和多囊卵巢综合征,28.77%~31.69%的妇产科医生选择24/4方案,37.54%~47.85%的妇产科医生选择雌激素剂量20μg/片的COC;其中对改善易怒症状(χ^(2)=9.403,P=0.009)方面,硕士及以上妇产科医生选择选择24/4方案的比例高于本科及以下学历者,差异有统计学意义。在改善月经周期规律性、治疗月经过多、经期周期控制效果方面,49.38%~50.00%的妇产科医生选择两方案效果相似,44.46%~56.31%的妇产科医生选择两剂量效果相似;其中在改善月经周期规律性(χ^(2)=8.402,P=0.015)和治疗月经过多(χ^(2)=6.451,P=0.040)方面,选择两剂量相似的副主任医师及以上的比例高于主治医师及以下者,差异均有统计学意义。妇产科医生对不同雌激素剂量和服药方案的选择呈弱相关(0.2<Cramer's V<0.3,P<0.05)。结论国内妇产科医生对不同COC的知晓率参差不齐,普遍存在对COC的作用机制认知不足。鉴于COC应用的广泛性,建议对妇产科医生加强COC药物作用机制的相关培训,了解雌孕激素剂量、种类与服药方案的关系,准确掌握适应症,以期更好地提供个体化推荐用药。
