نوع مقاله: Original Article

نویسندگان

1 استاد، گروه مدیریت خدمات بهداشتی و درمانی، دانشکده مدیریت و اطلاع رسانی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دانشیار، گروه فارماکولوژی، دانشکده داروسازی و علوم دارویی، واحد تحقیق و توسعه معاونت غذا و دارو، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 کارشناس ارشد، گروه مدیریت خدمات بهداشتی و درمانی، دانشکده مدیریت و اطلاع رسانی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

4 دانشیار، گروه مدیریت خدمات بهداشتی و درمانی، دانشکده مدیریت و اطلاع رسانی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

10.30476/smsj.2019.79281.0

چکیده

مقدمه: برگزاری دوره‌های بازآموزی و آموزش مداوم از جمله استراتژی های توصیه شده جهانی بمنظور دستیابی به تجویز منطقی داروها توسط پزشکان است. مطالعه حاضر با هدف بررسی موانع و پر کردن شکاف بین وضعیت فعلی و وضعیت مطلوب برنامه‌های بازآموزی، دیدگاه صاحبنظران را در رابطه با نقش این برنامه ها در بهبود وضعیت تجویز داروها ارزیابی نمود.
مواد و روش ها: این مطالعه به شیوه کیفی و با استفاده از مصاحبه نیمه ساختاریافته انجام گردید. مشارکت کنندگان مشتمل بر افراد باتجربه و صاحبنظر در زمینه تجویز و مصرف دارو بودند. 16 نفر با روش نمونه گیری هدفمند مورد مصاحبه قرار گرفتند. مصاحبه ها پس از پیاده سازی به روش تحلیل مضمون ارزیابی شدند.  
یافته ها: در این مطالعه دو مفهوم عمده شامل دلایل نیاز به برگزاری برنامه های آموزش مداوم و موانع برگزاری دوره های آموزش مداوم اثربخش توسط مشارکت کنندگان ارائه گردید. دلایل نیاز به برگزاری برنامه های آموزش مداوم شامل چهار موضوع اصلی و موانع برگزاری آموزش مداوم شامل شش موضوع اصلی (موانع فیزیکی، موانع مالی، موانع انگیزشی، موانع نظارتی، موانع اجرایی و موانع سیاستگذاری) و 12 زیرموضوع بودند.
بحث و نتیجه گیری:  با توجه به وجود موانع متعدد بر سر راه دستیابی به برنامه های آموزش مداوم تأثیرگذار بر وضعیت تجویز داروها و به منظور رفع این موانع و دستیابی به وضعیت مطلوب، بازنگری در محتوا و کیفیت برگزاری دوره های بازآموزی، برنامه ریزی بر اساس دستاوردهای مطلوب و ارتقای کیفیت مستمر ضرورت دارد.

عنوان مقاله [English]

Do Continuing Medical Education Programs Improve Drug Prescribing Status in Iran? A Qualitative Study

نویسندگان [English]

  • Mahmood Keyvanara 1
  • Leili Safaeian 2
  • Neda Shojaeizadeh 3
  • Saeid Karimi 4

1 Professor, Department of Health Services Management, School of Management and Medical Information, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor, Department of Pharmacology and Toxicology, School of Pharmacy and Pharmaceutical Sciences, Research and Development Office, Vice Chancellery for Food and Drug, Isfahan University of Medical Sciences, Isfahan, Iran

3 M.Sc., Department of Health Services Management, School of Management and Medical Information, Isfahan University of Medical Sciences, Isfahan, Iran

4 Associate Professor, Department of Health Services Management, School of Management and Medical Information, Isfahan University of Medical Sciences, Isfahan, Iran

چکیده [English]

Background: Holdingcontinuing medical education programs (CME) is one of the recommended global strategies for attaining rational drug prescribing by physicians. The aim of this study was to assess the barriers and fill the gap between the current situation and the favorable status of CME by evaluating experts’ viewpoints on the role of these programs in improving the status of drug prescribing.
Methods: This qualitative study was conducted using a semi-structured interview. Participants included those who were well-informed and experienced in the field of rational use and prescribing drugs. Sampling was done in a targeted way and 16 people were interviewed. The interviews were evaluated after the implementation of the theme analysis method.
Results: In this study, two major concepts including the needs for CME and barriers to effective CME were presented by the participants. The needs for CME included 4 main themes, and the barriers to effective CME included 6 themes (physical, financial, motivational, supervisional, executive, and policy making barriers) and 12 sub themes.
Conclusion: Regarding the multiple barriers to achieving the effective CME and improving the rational drug prescribing, and in order to overcome these barriers and achieve a favorable status, a review of the content and quality of CME, outcome-based planning, and continuous quality promotion are required.

کلیدواژه‌ها [English]

  • Inappropriate prescribing
  • Inappropriate use of drugs
  • Medical education

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