Conroy Elizabeth J, Kirkham Jamie J, Bellis Jennifer R, Peak Matthew, Smyth Rosalind L, Williamson Paula R, Pirmohamed Munir
Department of Biostatistics, University of Liverpool, Liverpool.
Research and Development, Alder Hey Children's NHS Foundation Trust, Liverpool.
Int J Pharm Pract. 2015 Dec;23(6):447-55. doi: 10.1111/ijpp.12197. Epub 2015 May 29.
Causality assessment of adverse drug reactions (ADRs) by healthcare professionals is often informal which can lead to inconsistencies in practice. The Liverpool Causality Assessment Tool (LCAT) offers a systematic approach. An interactive, web-based, e-learning package, the Liverpool ADR Causality Assessment e-learning Package (LACAeP), was designed to improve causality assessment using the LCAT. This study aimed to (1) get feedback on usability and usefulness on the LACAeP, identify areas for improvement and development, and generate data on effect size to inform a larger scale study; and (2) test the usability and usefulness of the LCAT.
A pilot, single-blind, parallel-group, randomised controlled trial hosted by the University of Liverpool was undertaken. Participants were paediatric medical trainees at specialty training level 1+ within the Mersey and North-West England Deaneries. Participants were randomised (1 : 1) access to the LACAeP or no training. The primary efficacy outcome was score by correct classification, predefined by a multidisciplinary panel of experts. Following participation, feedback on both the LCAT and the LACAeP was obtained, via a built in survey, from participants.
Of 57 randomised, 35 completed the study. Feedback was mainly positive although areas for improvement were identified. Seventy-four per cent of participants found the LCAT easy to use and 78% found the LACAeP training useful. Sixty-one per cent would be unlikely to recommend the training. Scores ranged from 4 to 13 out of 20. The LACAeP increased scores by 1.3, but this was not significant.
Improving the LACAeP before testing it in an appropriately powered trial, informed by the differences observed, is required. Rigorous evaluation will enable a quality resource that will be of value in healthcare professional training.
医疗保健专业人员对药物不良反应(ADR)的因果关系评估往往不规范,这可能导致实践中的不一致。利物浦因果关系评估工具(LCAT)提供了一种系统的方法。利物浦药物不良反应因果关系评估电子学习包(LACAeP)是一个交互式的基于网络的电子学习包,旨在使用LCAT改进因果关系评估。本研究旨在:(1)获取关于LACAeP可用性和实用性的反馈,确定改进和发展的领域,并生成效应量数据以为更大规模的研究提供信息;(2)测试LCAT的可用性和实用性。
在利物浦大学进行了一项试点、单盲、平行组随机对照试验。参与者是默西和英格兰西北部地区1+级专科培训水平的儿科医学实习生。参与者被随机(1∶1)分配接受LACAeP培训或不接受培训。主要疗效结果是由多学科专家小组预先定义的正确分类得分。参与后,通过内置调查从参与者那里获得了关于LCAT和LACAeP的反馈。
57名随机分组的参与者中,35名完成了研究。反馈主要是积极的,不过也确定了需要改进的领域。74%的参与者认为LCAT易于使用,78%的参与者认为LACAeP培训有用。61%的人不太可能推荐该培训。得分范围为20分中的4至13分。LACAeP使得分提高了1.3分,但不显著。
根据观察到的差异,在以适当规模进行试验之前改进LACAeP是必要的。严格的评估将产生一种高质量的资源,这对医疗保健专业人员培训将具有价值。