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门诊医疗中部分医生未报告药品不良反应的主观原因

Subjective Reasons for Non-Reporting of Adverse Drug Reactions in a Sample of Physicians in Outpatient Care.

作者信息

Gahr M, Eller J, Connemann B J, Schönfeldt-Lecuona C

机构信息

Department of Psychiatry and Psychotherapy III, University of Ulm, Leimgrubenweg, Ulm, Germany.

出版信息

Pharmacopsychiatry. 2016 Mar;49(2):57-61. doi: 10.1055/s-0035-1569291. Epub 2016 Jan 7.

Abstract

INTRODUCTION

Drug safety surveillance strongly depends on the spontaneous reporting of adverse drug reactions (ADRs). A major limiting factor of spontaneous reporting systems is underreporting (UR) which describes incorrectly low reporting rates of ADRs. Factors contributing to UR are numerous and feature country-dependent differences. Understanding causes of and factors associated with UR is necessary to facilitate targeted interventions to improve ADR reporting and pharmacovigilance.

METHODS

A cross-sectional questionnaire-based telephone survey was performed among physicians in outpatient care in a federal state of Germany.

RESULTS

From n=316 eligible physicians n=176 completed the questionnaire (response rate=55.7%). Most of the physicians (n=137/77.8%) stated that they report ADRs which they have observed to the competent authority rarely (n=59/33.5%), very rarely (n=59/33.5%) or never (n=19/10.8%); the majority (n=123/69.9%) had not reported any ADRs in 2014. Frequent subjective reasons for non-reporting of ADR were (specified response options): lack of time (n=52/29.5%), the subjective evaluation that the required process of reporting is complicated (n=47/26.7%) or requires too much time (n=25/14.2%) or the assessment that reporting of an ADR is needless (n=22/12.5%); within open answers the participants frequently stated that they do not report ADRs that are already known (n=72/40.9%) and they only report severe ADRs (n=46/26.1%).

DISCUSSION

Our results suggest a need to inform physicians about pharmacovigilance and to modify the required procedure of ADR reporting or to offer other reporting options.

摘要

引言

药物安全监测在很大程度上依赖于药品不良反应(ADR)的自发报告。自发报告系统的一个主要限制因素是报告不足(UR),即ADR的报告率被错误地低估。导致报告不足的因素众多,且存在国家差异。了解报告不足的原因及相关因素对于采取有针对性的干预措施以改善ADR报告和药物警戒至关重要。

方法

在德国一个联邦州对门诊医生进行了一项基于问卷调查的横断面电话调查。

结果

在n = 316名符合条件的医生中,n = 176名完成了问卷(回复率 = 55.7%)。大多数医生(n = 137/77.8%)表示,他们向主管当局报告所观察到的ADR的频率很低(n = 59/33.5%)、非常低(n = 59/33.5%)或从不报告(n = 19/10.8%);大多数(n = 123/69.9%)在2014年未报告任何ADR。未报告ADR的常见主观原因(特定回答选项)包括:时间不足(n = 52/29.5%)、主观认为所需的报告流程复杂(n = 47/26.7%)或耗时过长(n = 25/14.2%),或认为报告ADR没有必要(n = 22/12.5%);在开放式回答中,参与者经常表示他们不报告已知的ADR(n = 72/40.9%),只报告严重的ADR(n = 46/26.1%)。

讨论

我们的结果表明有必要向医生宣传药物警戒知识,修改ADR报告的要求流程或提供其他报告选项。

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