BACKGROUND Care goals are often implicit, although their identification is a key element of any prescription process. This study aimed to describe the clinical goals of drug prescriptions in general practice, their determinants and the agreement between physicians and patients. METHODS This was a cross-sectional study conducted by 11 resident trainees acting as observers in 23 general practices. The residents recorded the indication and main physician's goal for all drugs prescribed during five consultation days in each practice in December 2015, and the main patient's goal for a sub-sample of consultations. We used an eight-category generic classification of prescription goals, including three specific (mortality, morbidity and cure), three non-specific (symptoms, quality of life, functioning) and two non-specified (other goal, no goal) categories. Analyses were based on a multivariable, multilevel model and on the kappa statistic applied to the sub-sample of consultations. RESULTS The sample encompassed 2141 consultations and 5036 drugs. The main physicians' goal of drug prescriptions was to relieve symptoms (43.3%). The other goals were to decrease the risk of morbidity (22.4%), to cure disease (11.7%), to improve quality of life (10.6%), to decrease the risk of mortality (8.5%) and to improve functioning (1.8%). The choice of a specific goal was more frequent in patients with the following characteristics: over 50 (OR [1.09;1.15]), of male gender (OR [1.09;1.39]), with full financial coverage for a long-term condition (OR [1.47;1.97]), known by the physician (OR [1.19;2.23]), or with a somatic health problem (OR [2.56;4.17]). Cohen's kappa for drug prescription goals between the patients and the physicians was 0.26 (0.23-0.30). CONCLUSIONS Physicians' goals are poorly shared with patients. It remains to be assessed whether it is possible to collect and discuss information on prescription goals on a daily basis.

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初级保健中的药物处方目标：一项横断面研究。

背景技术护理目标通常是隐含的，尽管它们的识别是任何处方过程的关键要素。这项研究旨在描述一般实践中药物处方的临床目标，决定因素以及医师与患者之间的协议。方法这是一项横断面研究，由11名驻地实习生作为观察员在23种常规实践中进行。居民在2015年12月的每次诊疗中的5个咨询日记录了所有处方药的适应症和主治医师的目标，以及主治医生的子样本目标。我们使用了八类处方目标的通用分类，包括三个特定目标（死亡率，发病率和治愈率），三个非特定目标（症状，生活质量，功能）和两个非特定目标（其他目标，没有目标）类别。分析是基于多变量，多层次模型以及应用于咨询子样本的kappa统计量进行的。结果样本包括2141次咨询和5036种药物。医师开处方的主要目的是缓解症状（43.3％）。其他目标是降低发病风险（22.4％），治愈疾病（11.7％），改善生活质量（10.6％），降低死亡风险（8.5％）和改善机能（1.8％） ）。具有以下特征的患者更倾向于选择特定的目标：50岁以上（OR [1.09; 1.15]），男性（OR [1.09; 1.39]），长期病情全面覆盖（ OR [1.47; 1.97]），已为医师所知（OR [1.19; 2.23]），或存在身体健康问题（OR [2.56; 4.17]）。科恩 患者和医生之间药物处方目标的κ为0.26（0.23-0.30）。结论医师与患者的目标很少。是否有可能每天收集和讨论有关处方目标的信息还有待评估。