Recognition and reporting of suspected adverse drug reactions by surveyed healthcare professionals in Uganda: key determinants
Recognition and reporting of suspected adverse drug reactions by surveyed healthcare professionals in Uganda: key determinants
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DOI：
10.1136/bmjopen-2014-005869
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发表时间：
2014-01-01
期刊：
影响因子：
2.9
通讯作者：
Bird, Sheila M.
中科院分区：
文献类型：
--
作者：
Kiguba, Ronald;Karamagi, Charles;Bird, Sheila M.
目的：评估乌干达卫生保健专业人员（HCPs）过去一个月对疑似药物不良反应（ADR）和过去一年ADR报告的识别程度和决定因素。环境：地理位置不同的卫生设施（公共、私营营利、私营非营利）。参与者：共发放问卷2000份，完成问卷1345份，回收率67%。主要和次要结局指标：在过去一个月内怀疑发生不良反应的医务人员的百分比；报告的不良反应。结果：护士占多数（59%,792/1345）。只有一半的受访者听说过药物警戒：39%的护士（295/763；95% CI 35%至42%），70%的护士（383/547；95% CI 66%至74%）没有听说过药物警戒。1 / 5（268/1289或21%，95% CI 19% ~ 23%）的患者在前4周怀疑发生不良反应，其中111名为护士；15%（190/1296）在过去一年中报告了疑似不良反应，其中103人是护士。非护士（OR=1.7, 95% CI 1.16至2.40）和医学研究参与者（OR=1.5, 95% CI 1.05至2.15）更有可能怀疑过去一个月的ADR，但过去一个月收到的患者ADR投诉占主导地位（OR=19, 95% CI 14至28）。医院工作人员报告过去一年不良反应的比例较高（OR=1.9, 95% CI 1.18 ~ 3.10），特别是在医学领域（OR=2.3, 95% CI 1.08 ~ 4.73）；但私营营利性医疗机构（OR=0.5, 95% CI 0.28 - 0.77）和老年工作人员（OR=0.6, 95% CI 0.43 - 0.91）的比例较低；曾经遇到过致命性ADR （OR=2.9, 95% CI 1.94 ~ 4.25）、知道向谁报告（OR=1.7, 95% CI 1.18 ~ 2.46）或建议如何改善ADR报告（OR=1.6, 95% CI 1.04 ~ 2.49）的HCPs更有可能出现这种情况。两个态度因素很重要：缺乏自信和无精打采。结论：五分之一的HCPs在过去一个月怀疑发生了不良反应，七分之一的HCPs在过去一年中报告了不良反应。赋予患者权力可以加强非洲的不良反应发现和报告。
Objective: To assess extent and determinants of past-month recognition of suspected adverse drug reactions (ADR) and past-year ADR reporting among healthcare professionals (HCPs) in Uganda.Setting: Geographically diverse health facilities (public, private for-profit, private not-for-profit).Participants: Of 2000 questionnaires distributed, 1345 were completed: return rate of 67%.Primary and secondary outcome measures: Per cent HCPs who suspected ADR in the past month; reported ADR in the past year.Results: Nurses were the majority (59%, 792/1345). Only half the respondents had heard about pharmacovigilance: 39% of nurses (295/763; 95% CI 35% to 42%), 70% otherwise (383/547; 95% CI 66% to 74%). One fifth (268/1289 or 21%; 95% CI 19% to 23%) had suspected an ADR in the previous 4 weeks, 111 of them were nurses; 15% (190/1296) had reported a suspected ADR in the past year, 103 of them were nurses. Past-month ADR suspicion was more likely by non-nurses (OR=1.7, 95% CI 1.16 to 2.40) and with medical research involvement (OR=1.5, 95% CI 1.05 to 2.15) but past-month receipt of patient ADR-complaint predominated (OR=19, 95% CI 14 to 28). Past-year ADR reporting was higher by hospital staff (OR=1.9, 95% CI 1.18 to 3.10), especially in medicine (OR=2.3, 95% CI 1.08 to 4.73); but lower from private for-profit health facilities (OR=0.5, 95% CI 0.28 to 0.77) and by older staff (OR=0.6, 95% CI 0.43 to 0.91); more likely by HCPs who had ever encountered a fatal ADR (OR=2.9, 95% CI 1.94 to 4.25), knew to whom to report (OR=1.7, 95% CI 1.18 to 2.46), or suggested how to improve ADR reporting (OR=1.6, 95% CI 1.04 to 2.49). Two attitudinal factors were important: diffidence and lethargy.Conclusions: One in five HCPs suspected an ADR in the past-month and one in seven reported ADR in the previous year. Empowering patients could strengthen ADR detection and reporting in Africa.