Phueanpinit Pacharaporn, Pongwecharak Juraporn, Sumanont Sermsak, Krska Janet, Jarernsiripornkul Narumol
Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand.
Faculty of Pharmacy, Thammasat University, Rangsit, Thailand.
J Eval Clin Pract. 2017 Dec;23(6):1387-1394. doi: 10.1111/jep.12806. Epub 2017 Aug 15.
RATIONALE, AIMS, AND OBJECTIVES: Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently prescribed for orthopaedic conditions, therefore this study aimed to explore orthopaedic physicians' perceptions of their role in NSAID-risk communication, their attitudes towards the necessity of informing patients about adverse drug reactions (ADR), and factors associated with these.
Self-administered questionnaires were mailed to all 206 orthopaedic physicians working at hospitals in Northeastern Thailand. Attitudes were assessed using 17 statements and total scores classed as poor, moderate and good attitude.
Sixty-six questionnaires were returned (32.04%). The responses showed that 75% of physicians claimed to communicate NSAID ADR information, more frequently about gastrointestinal (GI) complications, than about renal and cardiovascular (CVS) complications. ADR management (36%) and monitoring (30%) were not frequently communicated. The time spent with patients was associated with provision of ADR and monitoring advice. Renal function was the risk factor of greatest concern for prescribing any NSAID, followed by history of GI complications, and allergy for non-selective NSAIDs, and history of CVS diseases and age for selective COX-2 NSAIDs. Most physicians (41) had moderate attitude towards providing information and 24 good attitude. Fewer physicians working in tertiary hospitals than general and community hospital physicians considered that time limitations prevented counseling and that patient information leaflets offered easily accessible information. Additionally, more physicians who did not inform patients about ADRs agreed that ADR communication can lead to anxiety and discontinuing treatment.
The study indicates that, although orthopaedic physicians had positive attitudes towards providing ADR information to patients, improvement is needed in communicating NSAID risk information.
原理、目的和目标：非甾体抗炎药（NSAIDs）常用于治疗骨科疾病，因此本研究旨在探讨骨科医生对其在NSAIDs风险沟通中作用的看法、他们对告知患者药物不良反应（ADR）必要性的态度以及与之相关的因素。
自行填写的问卷被邮寄给泰国东北部医院工作的所有206名骨科医生。使用17项陈述评估态度，并将总分分为态度差、态度中等和态度好。
共收回66份问卷（32.04%）。调查结果显示，75%的医生声称会沟通NSAIDs的ADR信息，关于胃肠道（GI）并发症的沟通频率高于肾脏和心血管（CVS）并发症。ADR管理（36%）和监测（30%）的沟通并不频繁。与患者相处的时间与提供ADR和监测建议有关。肾功能是开具任何NSAIDs时最受关注的风险因素，其次是GI并发症史、非选择性NSAIDs的过敏史、选择性COX-2 NSAIDs的CVS疾病史和年龄。大多数医生（41名）对提供信息持中等态度，24名持积极态度。与综合医院和社区医院的医生相比，在三级医院工作的医生中，较少有人认为时间限制妨碍了咨询，并且患者信息手册提供了易于获取的信息。此外，更多未告知患者ADR的医生认为，ADR沟通可能导致焦虑和停药。
该研究表明，尽管骨科医生对向患者提供ADR信息持积极态度，但在沟通NSAIDs风险信息方面仍需改进。
