武汉市医院医务人员对药品不良反应报告认知度调查

Study on the knowledge and attitude to adverse drug reactions reporting among healthcare professionals in Wuhan city

目的 调查医务人员(医生、护士、管理人员)对药品不良反应报告工作的认知度,找出药品不良反应报告率低的原因。方法 采取分层随机抽样方法,选取武汉市16家医院并抽取15％医务人员作为样本,进行问卷调查。结果 问卷的应答率为85％,有效问卷为1653份。医务人员对药品不良反应定义的答对率为2.7％,89.2％的医务人员曾经遇到不良反应,94％的医务人员认为应该报告所见不良反应。仅有28.5％的医生、22.8％的护士、29.7％的管理人员曾经报告过药品不良反应,主要报告的机构为医院药房和其他医院部门、药厂。62.1％的医务人员遇到过药品不良反应而没有报告,没有报告的主要原因有:不知药品不良反应监测中心的联系方式(67.9％)、找不到药品不良反应报告表(60.4％)、无机构无人管理(52.2％)、不知道报告程序(71.4％)和认为所见药品不良反应是众所周知(44.1％)。对医务人员的教育和培训,增强管理人员对药品不良反应的认识是提高药品不良反应的主要方法。结论 医务人员缺乏药品不良反应的基本知识,对自发报告体系不了解。这一点也是目前漏报率高的主要原因。药品不良反应专业机构管理跟不上,应加强管理,加强医务人员的教育和培训。

Objective To investigate the knowledge and attitudes of healthcare professionals (doctors,nurses and administrators)to adverse drug reactions (ADR) in Wuhan city and to identify the reasons for under-reporting. Methods Structured interviews were carried out in Wuhan,Hubei province. Questionnaire survey to approximately 15% of the medical practitioners selected from 16 hospitals, was conducted during the period from February to March 2003. Results Only 2.7% of the interviewees knew the definition of adverse drug reactions. 61.7% of the doctors, 62.7% of the nurses and 61.1% of the administrators had ever encountered an ADR during their practices, but did not report to the national monitoring center or other centers. The major reasons for not reporting included: ignorant about the requirement and the reporting process of ADR(71.4%); address of the reporting agency and Forms unavailable (67.9%,60.4%); unaware of the existence of a national ADR reporting system (52.2%); needless to report as the ADR being too well known(44.1%). They mainly reported an ADR to the hospital pharmacy or other departments, or to the pharmaceutical administration. Education, training and developing new institutions were ways to improve the reporting system. Conclusions Our results showed that healthcare professionals had little knowledge on the basic ADR knowledge. The main reasons for underreporting were related to factors on reporting process, address of related centers and unavailable of the Forms. Education and training to doctors and nurses to enhance the awareness of administrators were the ways to improve the reporting system.