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印度一家三级护理教学医院本科医学生的药品不良反应报告:与医生报告相比的内容及质量分析

Adverse drug reactions reporting by undergraduate medical students in a tertiary care teaching hospital of India: Content and quality analysis in comparison to physician reporting.

作者信息

Patel Parvati B, Patel Tejas K, Anturlikar Snehal, Khatun Sahila, Bhabhor Prakash, Saurabh Manoj Kumar

机构信息

Department of Pharmacology, GMERS Medical College, Gotri, Vadodara, Gujarat, India.

Department of Pharmacology, Parul Institute of Medical Sciences and Research, Vadodara, Gujarat, India.

出版信息

Perspect Clin Res. 2017 Jul-Sep;8(3):137-144. doi: 10.4103/2229-3485.210453.

Abstract

BACKGROUND

An important challenge to spontaneous reporting system is underreporting. The sensitization and involvement of undergraduate medical students can reduce underreporting in pharmacovigilance program.

OBJECTIVE

To analyze the clinical characteristics and reporting quality of adverse drug reactions (ADRs) by undergraduate medical students in comparison with physicians' reporting.

METHODS

We sensitized the second professional year undergraduate medical students about pharmacovigilance and asked them to submit reports of ADR observed during their clinical posting from January to December 2015. We compared students' reports with those sent by physicians (Department of Medicine and Allied Branches, Paediatric, Obstetrics and Gynaecology) of our institute during the same time period. We included ADRs of "certain," "probable," or "possible" categories as per the World Health Organization causality definitions in analysis of both groups. We excluded "unlikely," "unclassified," and "unclassifiable" causality ADRs from the analysis due to questionable association of reactions with suspected drugs. We collected data of demographics, pattern of ADRs, causative drugs, seriousness, other clinical characteristics, and quality of reporting.

RESULTS

We analyzed a total number of 176 students' reports having 269 ADRs and 143 physicians' reports covering 180 ADRs. The students predominantly reported ADRs of single drug suspect (84.09% vs. 43.35%), "probable" causality (63.94% vs. 21.11), and augmented type reactions (67.29% vs. 55%) than physicians. Both groups did not differ in reporting of serious reactions (6.25% vs. 9.09%). Students most frequently suspected gastrointestinal disorders (35.68%), whereas physicians most frequently reported skin and appendages disorders (41.11%). Students and physicians more commonly suspected ADRs due to systemic anti-infective (33.64%) and nervous system (42.07%) class of drugs, respectively. The quality analysis suggested no substantial difference in most domains of ADR reporting among both groups.

CONCLUSION

Students' reported valuable and clinically relevant ADRs. Medical students should be exposed to ADR reporting during their clinical teaching posting and should be actively involved in pharmacovigilance program to improve detection rate.

摘要

背景

自发报告系统面临的一个重要挑战是报告不足。本科医学生的宣传和参与可以减少药物警戒计划中的报告不足。

目的

与医生的报告相比,分析本科医学生报告的药品不良反应(ADR)的临床特征和报告质量。

方法

我们对本科二年级医学生进行了药物警戒方面的宣传,并要求他们提交2015年1月至12月临床实习期间观察到的ADR报告。我们将学生的报告与同一时期我院医生(内科及相关科室、儿科、妇产科)提交的报告进行了比较。在两组分析中,我们根据世界卫生组织因果关系定义纳入了“肯定”、“很可能”或“可能”类别的ADR。由于反应与可疑药物的关联存疑,我们在分析中排除了“不太可能”、“未分类”和“无法分类”因果关系的ADR。我们收集了人口统计学数据、ADR模式、致病药物、严重程度、其他临床特征和报告质量。

结果

我们共分析了176名学生的报告,其中有269例ADR,以及143名医生的报告,涵盖180例ADR。与医生相比,学生主要报告单一可疑药物的ADR(84.09%对43.35%)、“很可能”因果关系的ADR(63.94%对21.11%)和加重型反应(67.29%对55%)。两组在严重反应报告方面无差异(6.25%对9.09%)。学生最常怀疑的是胃肠道疾病(35.68%),而医生最常报告的是皮肤和附属器疾病(41.11%)。学生和医生分别更常怀疑全身性抗感染药物(33.64%)和神经系统药物(42.07%)导致的ADR。质量分析表明,两组在ADR报告的大多数领域没有实质性差异。

结论

学生报告了有价值且与临床相关的ADR。医学生在临床教学实习期间应接触ADR报告,并应积极参与药物警戒计划以提高发现率。

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本文引用的文献

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An update on the Pharmacovigilance Programme of India.印度药物警戒计划的最新情况。
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