Olumsuz İlaç Reaksiyonları Konusunda Asistan Hekimlerin Bilgi ve Tutumları

Abstract

Amaç: DSÖ, evrensel mesajında tüm sağlık hizmeti sağlayıcılarına, ADR'ler rapor edilerek binlerce hastanın hayatının kurtarılabileceğini bildirmiştir. Bu çalışmada, üniversite hastanemizdeki asistan hekimlerin ADR ve farmakovijilans konusundaki bilgi düzeylerini ve tutumlarını değerlendirmeyi amaçladık.

Yöntem: Bu prospektif çalışma, Harran Üniversitesi Hastanesi'nde çalışmaya katılmayı kabul eden 88 asistan hekim üzerinde 14 sorudan oluşan bir anket formuyla gerçekleştirildi. Çalışmaya Harran Üniversitesi Tıp Fakültesi Etik Kurulu onayının alınmasından sonra başlandı. Anketin sonuçları SPSS 18.0 paket programı kullanılarak frekans ve yüzde testleri ile değerlendirildi.

Bulgular: ADR'lerin kesin tanımı doktorların %51,1'i tarafından doğru bir şekilde işaretlenmiştir. Hekimlerin çoğu (%69,3) hiçbir zaman ADR raporlaması yapmadığını belirtmiştir. ADR raporlaması yapmanın sağlık profesyonellerinin sorumluluğu olmadığını düşünen katılımcıların oranı %9,1'dir. Hekimlerin sadece %6,8'inin ADR raporlaması hakkında mesleki bilgi veya eğitim aldığı gözlemlenmiştir. Hekimlerin %72,7'si Türkiye'de ADR'nin ciddi bir sorun olduğunu düşünmektedir.

Sonuç: Bu çalışma hastanemizde çalışan asistanların ADR raporlaması konusundaki bilgi ve tutum düzeylerinin yeterli olmadığını göstermiştir. ADR'lerin raporlanması konusunda sağlık uzmanları arasında farkındalığın artırılmasının önemli olduğuna ve durumun etkili ve periyodik eğitim yöntemleriyle iyileştirilebileceğine inanıyoruz.

Keywords

• Olumsuz ilaç reaksiyonu
• tutum
• bilgi
• hekim

Knowledge and Attitudes of Resident Physicians About Adverse Drug Reactions

Abstract

Objective: WHO reported to all healthcare providers in its universal message that thousands of patients lives could be saved by reporting ADRs. In this study, we aimed to evaluate the knowledge levels and attitudes of the resident physicians about ADR and pharmacovigilance in our university hospital

Method: This prospective study is performed by a questionnaire form consisted of 14 questions on 88 resident physicians who accepted to participate the study in Harran University Hospital. The study was started after gaining the approval of Harran University Faculty of Medicine Ethics Committee. The results of the questionnaire were evaluated by using SPSS 18.0 package program by frequency and percentage tests.

Results: The exact definition of ADRs is correctly marked by 51.1% of doctors. Most of the physicians (69.3%) stated that they had never do ADR reporting. The rate of the participants who think that it is not the responsibility of the healthcare professionals to make ADR reporting is 9.1%. It was observed that only 6.8% of the physicians received professional information or training on ADR reporting. 72.7% of physicians think that, ADR is a serious problem in Turkey.

Conclusion: This study showed that the level of knowledge and attitude of resident physicians working in our hospital about ADR reporting was not sufficient. We believe that it is important to raise awareness among the healthcare professionals about the ADRs reporting and the status can be improved by effective and periodical training methods.

Keywords

• Adverse drug reaction
• attitude
• knowledge
• physician

References

1. 1. Farcas A, Bojita M. Adverse drug reactions in clinical practice: a causality assessment of a case of drug-induced pancreatitis. J Gastrointestin Liver Dis. 2009;18(3):353-8.
2. 2. World Health Organization. Quality A, Safety of Medicines T. Safety of medicines : a guide to detecting and reporting adverse drug reactions : why health professionals need to take action. Geneva: World Health Organization; 2002.
3. 3. Passarelli MCG, Jacob-Filho W, Figueras A. Adverse drug reactions in an elderly hospitalised population. Drugs & aging. 2005;22(9):767-77.
4. 4. Leape LL. Error in medicine. Jama. 1994;272(23):1851-7.
5. 5. Aykaç E, editor Farmakovijilansa Bakış ve Türkiye Farmakovijilans Merkezinin Çalışmaları. 12 Ulusal Aile Hekimliği Kongresi; 15-19 May 2013; Kuşadası- Aydin.
6. 6. Brewer T, Colditz GA. Postmarketing surveillance and adverse drug reactions: current perspectives and future needs. Jama. 1999;281(9):824-9.
7. 7. Pirmohamed M, James S, Meakin S, Green C, Scott AK, Walley TJ, et al. Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients. Bmj. 2004;329(7456):15-9.
8. 8. Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. Jama. 1998;279(15):1200-5.

9. 9. Ozcan G, Aykac E, Kasap Y, Nemutlu NT, Sen E, Aydinkarahaliloglu ND. Adverse drug reaction reporting pattern in Turkey: analysis of the national database in the context of the first pharmacovigilance legislation. Drugs-real world outcomes. 2016;3(1):33-43.
10. 10. Dormann H, Muth-Selbach U, Krebs S, Criegee-Rieck M, Tegeder I, Schneider HT, et al. Incidence and costs of adverse drug reactions during hospitalisation. Drug safety. 2000;22(2):161-8.
11. 11. Türkiye İlaç ve Tıbbi Cihaz Kurumu TÜFAM. İyi Farmakovijilans Uygulamaları (İFU) Kılavuzu Modül I – Advers ilaç reaksiyonlarının yönetimi ve bildirimi. 2014 [cited 2020 June 20]. Available from: https://www.titck.gov.tr/Dosyalar/Ilac/Farmakovijilans/%C4%B0FU%20Mod%C3%BCl%20I.pdf.
12. 12. Waller PC. Making the most of spontaneous adverse drug reaction reporting. Basic & clinical pharmacology & toxicology. 2006;98(3):320-3.
13. 13. Dhikav V, Singh S, Anand K. Adverse drug reaction monitoring in India. J Indian Acad Clin Med. 2004;5(1):27-33.
14. 14. Şencan N, Altınkaynak M, Ferah I, Özyıldırım A, Ceylan EM, Clark PM. The knowledge and attitudes of physicians and nurses towards adverse event reporting and the effect of pharmacovigilance training: A hospital experience. Hacettepe Üniversitesi Eczacılık Fakültesi Dergisi. 2010(1):25-40.
15. 15. Ergün Y, Ergün TB, Toker E, Ünal E, Akben M. Knowledge attitude and practice of Turkish health professionals towards pharmacovigilance in a university hospital. International health. 2019;11(3):177-84.
16. 16. Güner MD, Ekmekci PE. Healthcare professionals’ pharmacovigilance knowledge and adverse drug reaction reporting behavior and factors determining the reporting rates. Journal of drug assessment. 2019;8(1):13-20.
17. 17. Paveliu MS, Bengea-Luculescu S, Mihai T, Paveliu SF. Perception on adverse drug reaction reporting by physicians working in southern Romania. Maedica. 2013;8(1):17.
18. 18. Singh J, Singh H, Rohilla R, Kumar R, Gautam C. Lack of awareness of pharmacovigilance among young health-care professionals in India: An issue requiring urgent intervention. International Journal of Applied and Basic Medical Research. 2018;8(3):158.
19. 19. Stoynova V, Getov IN, Naseva EK, Lebanova HV, Grigorov EE. Physicians' knowledge and attitude towards adverse event reporting system and result to intervention--randomized nested trial among Bulgarian physicians. Medicinski Glasnik. 2013;10(2).
20. 20. Altıntaş Aykan D, Nazik H, Ergün Y. Advers İlaç Reaksiyonları Spontan Bildirimlerinin Değerlendirilmesi: Klinik Farmakoloji Deneyimimiz. Kocaeli Tıp Dergisi. 2019;8(2):230-9.
21. 21. Palaian S, Ibrahim MI, Mishra P. Health professionals' knowledge, attitude and practices towards pharmacovigilance in Nepal. Pharmacy practice. 2011;9(4):228.
22. 22. Khan SA, Goyal C, Chandel N, Rafi M. Knowledge, attitudes, and practice of doctors to adverse drug reaction reporting in a teaching hospital in India: An observational study. Journal of natural science, biology, and medicine. 2013;4(1):191.
23. 23. Oshikoya KA, Awobusuyi JO. Perceptions of doctors to adverse drug reaction reporting in a teaching hospital in Lagos, Nigeria. BMC clinical pharmacology. 2009;9(1):14.
24. 24. Fincham J. A statewide program to stimulate reporting of adverse drug reactions. Journal of pharmacy practice. 1989;2(4):239-44.
25. 25. McGettigan P, Golden J, Conroy R, Arthur N, Feely J. Reporting of adverse drug reactions by hospital doctors and the response to intervention. British journal of clinical pharmacology. 1997;44(1):98-100.
26. 26. Figueiras A, Herdeiro MT, Polónia J, Gestal-Otero JJ. An educational intervention to improve physician reporting of adverse drug reactions: a cluster-randomized controlled trial. Jama. 2006;296(9):1086-93.
27. 27. Necho W, Worku A. Assessment of knowledge, attitude and practice of health professionals towards adverse drug reaction reporting and factors associated with reporting. J Pharmacovigilance. 2014;2(4):135.
28. 28. Asseray N, Ballereau F, Trombert-Paviot B, Bouget J, Foucher N, Renaud B, et al. Frequency and severity of adverse drug reactions due to self-medication: a cross-sectional multicentre survey in emergency departments. Drug safety. 2013;36(12):1159-68.
29. 29. Schmiedl S, Rottenkolber M, Hasford J, Rottenkolber D, Farker K, Drewelow B, et al. Self-medication with over-the-counter and prescribed drugs causing adverse-drug-reaction-related hospital admissions: results of a prospective, long-term multi-centre study. Drug safety. 2014;37(4):225-35.