约旦医院药剂师对儿科患者超说明书用药配药的认知与态度研究
Perceptions and attitudes towards off-label dispensing for pediatric patients, a study of hospital based pharmacists in Jordan.
作者信息
Mukattash Tareq L, Alzoubi Karem H, Abuirjie Amani M, Jarab Anan S, Abu Farha Rana K, Nusair Mohammad B, McElnay James C
机构信息
Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan.
Department of Therapeutics and Clinical Pharmacy, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan.
出版信息
Saudi Pharm J. 2018 Jan;26(1):20-24. doi: 10.1016/j.jsps.2017.11.004. Epub 2017 Nov 13.
BACKGROUND
With growing responsibility of the pharmacists in ensuring public health and safe medicine use, an understanding of the issues surrounding off-label prescribing is crucial to allow pharmacists to make informed decisions about such practice. The aim of this study is to assess the perceptions and attitudes of hospital based pharmacists toward off-label medicine dispensing to children.
METHODS
After obtaining the required approvals, a validated questionnaire about off-label dispensing to pediatric patients was administered to 250 randomly selected hospital pharmacists.
RESULTS
One hundred and fifty (150) completed questionnaires were returned. Less than half of the respondents (44%, n = 66) admitted to being familiar with the concept of off-label dispensing, claiming to have obtained this knowledge basically through their dispensing experience rather than education. A minority of respondents (36%, n = 54) reported dispensing off-label medicines within their practice knowingly. The majority of respondents had concerns regarding the efficacy (82%, n = 123) and safety (98%, n = 147) of off-label medicines. The most common reasons given by respondents for a dispensed prescription being off label were younger age than recommended (88%, n = 132). Most of respondents (94%, n = 141) claimed to double check the calculations of doses of medicines before dispensing off-label medicines and 60% (n = 90) of them felt that parents and guardians should be told when an off-label medicine has been prescribed for their children.
CONCLUSION
The majority of respondents were not familiar with the concept of offlabel medicines. While reporting to have gained their knowledge from their professional experience, only a minority of respondents reported knowingly dispensing off-label medicines for pediatric patients. Respondents indicated that manufacturing more appropriate formulations for pediatric patients would reduce such practices in this population. Having concerns regarding the efficacy and safety of off-label medicines used for pediatric patients, respondents felt that the use of off-label medicines would increase the likelihood of adverse drug reactions (ADRs). Finally, respondents felt that such practice of prescribing and dispensing should receive parental consent.
背景
随着药剂师在确保公众健康和安全用药方面的责任日益加重，了解围绕非标签用药处方的问题对于药剂师就此类做法做出明智决策至关重要。本研究的目的是评估医院药剂师对向儿童进行非标签用药配药的看法和态度。
方法
在获得所需批准后，向250名随机挑选的医院药剂师发放了一份关于向儿科患者进行非标签配药的有效问卷。
结果
共收回150份完整问卷。不到一半的受访者（44%，n = 66）承认熟悉非标签配药的概念，声称基本上是通过配药经验而非教育获得这方面知识的。少数受访者（36%，n = 54）报告在其工作中明知故犯地配给非标签药物。大多数受访者对非标签药物的疗效（82%，n = 123）和安全性（98%，n = 147）表示担忧。受访者给出的配药处方为非标签的最常见原因是年龄比推荐年龄小（88%，n = 132）。大多数受访者（94%，n = 141）声称在配给非标签药物前会再次核对药物剂量计算，其中60%（n = 90）的人认为当为其孩子开了非标签药物时应告知家长和监护人。
结论
大多数受访者不熟悉非标签药物的概念。虽然报告称从专业经验中获得了相关知识，但只有少数受访者报告明知故犯地为儿科患者配给非标签药物。受访者表示，为儿科患者生产更合适的制剂将减少该人群中的此类做法。由于对用于儿科患者的非标签药物的疗效和安全性表示担忧，受访者认为使用非标签药物会增加药物不良反应（ADR）的可能性。最后，受访者认为这种处方和配药做法应获得家长同意。
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