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运用计划行为理论考察药师向 FDA 报告严重药物不良事件(ADEs)的意愿。

Examination of pharmacists' intention to report serious adverse drug events (ADEs) to the FDA using the theory of planned behavior.

机构信息

Department of Pharmaceutical, Social and Administrative Sciences, Appalachian College of Pharmacy, 1060 Dragon Road, Oakwood, VA 24631, USA.

出版信息

Res Social Adm Pharm. 2011 Dec;7(4):369-82. doi: 10.1016/j.sapharm.2010.09.001. Epub 2010 Nov 5.

Abstract

BACKGROUND

Adverse drug event (ADE) reporting by pharmacists is an indispensable part of the drug safety system. U.S. pharmacists may submit reports of serious ADEs that they encounter to the Food and Drug Administration (FDA) through MedWatch. However, underreporting of serious ADEs is a common problem. Little is known about pharmacists' decision making with respect to ADE reporting.

OBJECTIVES

This study explored the utility of the theory of planned behavior (TPB) model in predicting Texas pharmacists' intention to report serious ADEs to the FDA.

METHODS

Data were collected from practicing Texas pharmacists using a mail questionnaire. A total of 1500 surveys were mailed, and 377 usable responses were obtained for a response rate of 26.4%.

RESULTS

A majority (70.2%) of the 377 respondents were white/Caucasian, and 52.9% were male. Overall, pharmacists intended to report serious ADEs (mean=15.87±4.22; possible range: 3-21), had a positive attitude toward reporting (mean=4.62±4.92; possible range: -15 to +15), perceived that important others wanted them to report (subjective norm [SN] score=5.65±2.99; possible range: -9 to +9), and believed that they had control over their reporting behavior (perceived behavioral control [PBC] score=3.54±2.69; possible/actual range: -6 to +6). Attitude (β=0.221, P<.001) and SN (β=0.438, P<.001) significantly predicted intent; however, PBC (β=0.028, P>.05) did not. Attitude, SN, and PBC together accounted for 34.0% of the variance in intention to report serious ADEs (P<.001). The addition of past reporting behavior (P=.021) and perceived moral obligation (P<.001) significantly increased the variance in intention explained by the TPB model.

CONCLUSIONS

Pharmacists showed a strong positive intent to report serious ADEs to the FDA. Strategies to increase pharmacists' intentions to report serious ADEs should focus on helping them see the value of reporting and altering their perception of social pressure toward reporting. The TPB may have utility in predicting ADE-reporting behavior.

摘要

背景

药师报告药物不良反应(ADE)是药物安全系统不可或缺的一部分。美国药师可以通过 MedWatch 向美国食品药品监督管理局(FDA)报告他们遇到的严重 ADE 报告。然而,严重 ADE 报告的漏报是一个常见的问题。对于药师的 ADE 报告决策知之甚少。

目的

本研究探讨了计划行为理论(TPB)模型在预测德克萨斯州药师向 FDA 报告严重 ADE 意愿中的效用。

方法

使用邮寄问卷从执业德克萨斯州药师那里收集数据。共邮寄了 1500 份调查问卷,获得了 377 份可用回复,回复率为 26.4%。

结果

70.2%(377 名受访者中的 377 名)为白人/高加索人,52.9%为男性。总体而言,药师打算报告严重 ADE(平均 15.87±4.22;可能范围:3-21),对报告持积极态度(平均 4.62±4.92;可能范围:-15 至+15),认为重要他人希望他们报告(主观规范[SN]评分=5.65±2.99;可能范围:-9 至+9),并认为他们对报告行为有控制能力(感知行为控制[PBC]评分=3.54±2.69;可能/实际范围:-6 至+6)。态度(β=0.221,P<.001)和 SN(β=0.438,P<.001)显著预测意图;然而,PBC(β=0.028,P>.05)并没有。态度、SN 和 PBC 共同解释了报告严重 ADE 意图的 34.0%(P<.001)。过去报告行为(P=.021)和感知道德义务(P<.001)的增加显着增加了 TPB 模型解释意图的方差。

结论

药师对向 FDA 报告严重 ADE 表现出强烈的积极意图。增加药师报告严重 ADE 意愿的策略应侧重于帮助他们看到报告的价值,并改变他们对报告的社会压力的看法。TPB 可能对预测 ADE 报告行为具有效用。

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