中国医师非维生素K拮抗剂口服抗凝药知识掌握程度的调查分析

Knowledge mastery of non-vitamin K antagonist oral anticoagulants in Chinese doctors:an analysis and survey

目的了解中国医师对于非维生素K拮抗剂口服抗凝药(NOAC)知识的掌握情况,为医学继续教育提供依据。方法通过现场问卷调查收集2019年第三十届长城心脏病学会议参会医师信息,包括人口学资料、临床工作特点10道题目和NOAC知识20道题目。NOAC知识题目正确作答比例≥80%定义为知晓良好。结果收集有效问卷578份。被调查医师中,华北地区医师数量最多(39.4%),男性占50.9%。NOAC知识知晓良好率为39.1%。知晓率较低问题包括:患者服药过量的处理措施(10.0%)、单次漏服药物危害(31.1%)、减低服药期间副作用发生率的方法(38.1%)。多因素Logistic回归分析提示具有博士学位[优势比(OR)=3.70,95%置信区间(CI):1.49~9.17,P<0.01]、执业于三级甲等医疗机构(OR=1.51,95%CI:1.07~2.13,P<0.05)更倾向于知晓良好。执业地点位于西部地区更倾向于知晓不良(OR=0.42,95%CI:0.27~0.66,P<0.01)。结论中国医师所掌握的NOAC知识匮乏,尤其不了解过量服用时的处理措施、漏服危害及降低副作用发生率的方法。未来可针对特定人群开展NOAC相关知识继续教育。

Objective To investigate the knowledge mastery of non-vitamin K antagonist oral anticoagulants(NOAC)in Chinese doctors,and to provide evidence for continuing medical education.Methods The information was collected through on-site questionnaire survey from the doctors attended 2019 the 30th Great Wall International Congress of Cardiology,including 10 questions regarding demographic data and clinical practice features and 20 questions about NOAC knowledge.Correct rate≥80%in answering questions of NOAC knowledge was defined as well knowledge mastery.Results A total of 578 valid questionnaires were collected.The most common respondents were from northern China(39.4%).Males accounted for 50.9%.The rate of well knowledge mastery was 39.1%.The questions with poor accuracy were how to treat overdose(10.0%),hazard of one does missing(31.1%)and how to reduce adverse side effects(38.1%).The results of multi-factor Logistic analysis showed that respondents with doctor degree(OR=3.70,95%CI:1.49~9.17,P<0.01),and practiced in grade III-A hospitals(OR=1.51,95%CI:1.07~2.13,P<0.05)were likely to have well knowledge mastery.The respondents based in western China(OR=0.42,95%CI:0.27~0.66,P<0.01)were likely to have poor knowledge mastery.Conclusion The majority of Chinese doctors have poor knowledge mastery of NOAC,particularly in how to treat overdose,the understanding of the hazard of one does missing and how to reduce adverse side effects.Continuing medical education associated with NOAC should be emphasized for specific doctor group to improve their job ability.