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中国一家综合医院中用于改善药品不良反应自发报告的多方面干预措施。

Multifaceted interventions for improving spontaneous reporting of adverse drug reactions in a general hospital in China.

作者信息

Fang Huan, Lin Xiaowen, Zhang Jun, Hong Zhen, Sugiyama Kenji, Nozaki Takao, Sameshima Tetsuro, Kobayashi Susumu, Namba Hiroki, Asakawa Tetsuya

机构信息

Department of Pharmacy, Jinshan Hospital of Fudan University, No. 1508 Longhang Road, Shanghai, 201508, People's Republic of China.

Department of Pharmacy, Jinshan Central Hospital, No 147 Jiankang Road, Shanghai, 201500, People's Republic of China.

出版信息

BMC Pharmacol Toxicol. 2017 Jun 26;18(1):49. doi: 10.1186/s40360-017-0159-0.

Abstract

BACKGROUND

The present study investigates changes in spontaneous reporting (SR) compliance and ADR patterns following adoption of a new hospital SR system, and multiple interventions designed for its improvement use under modified drug administration guidelines.

METHODS

In total, 1389 ADR cases were reviewed. Cases were divided into two groups, cases from period 1 (n = 557, from January 2006 to June 2011) under the old SR system and cases in period 2 (n = 832, from July 2011 to December 2016) under the new SR system with multiple interventions to improve physician SR compliance. General information, drug information, and clinical manifestations were investigated and compared between periods.

RESULTS

Interventions for improved clinician training, education on knowledge, attitudes, and practices (KAP), and economic incentives substantially improved SR adherence. We also found that changing drug usage patterns (based on the new drug administration guidelines) greatly influenced ADR occurrence and type.

CONCLUSIONS

We found the SR compliance can be improved by multifaceted interventions. Drug usage patterns also influence ADR occurrence, so programs tailored for rational use are essential. These results could lead to further improvements in the SR system for ADRs in China, and provide guidance for establishing better methods of pharmacovigilance.

摘要

背景

本研究调查了采用新的医院自发报告(SR)系统后SR依从性的变化以及药品不良反应(ADR)模式,以及为在修改后的药物管理指南下改进其使用而设计的多种干预措施。

方法

共审查了1389例ADR病例。病例分为两组,第一阶段(n = 557,2006年1月至2011年6月)旧SR系统下的病例和第二阶段(n = 832,2011年7月至2016年12月)新SR系统下采用多种干预措施以提高医生SR依从性的病例。对两个阶段的一般信息、药物信息和临床表现进行了调查和比较。

结果

改善临床医生培训、知识、态度和实践(KAP)教育以及经济激励等干预措施显著提高了SR依从性。我们还发现,改变药物使用模式(基于新的药物管理指南)对ADR的发生和类型有很大影响。

结论

我们发现通过多方面干预可以提高SR依从性。药物使用模式也会影响ADR的发生,因此针对合理用药量身定制的方案至关重要。这些结果可能会进一步改善中国ADR的SR系统,并为建立更好的药物警戒方法提供指导。

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