Department of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia.
University College of Pharmacy, University of the Punjab, Lahore 54000, Pakistan.
Int J Environ Res Public Health. 2020 Mar 25;17(7):2209. doi: 10.3390/ijerph17072209.
Developed countries have established pharmacovigilance systems to monitor the safety of medicines. However, in the developing world, drug monitoring and reporting are facing enormous challenges. The current study was designed to explore the challenges related to the understanding and practices of physicians in reporting adverse drug reactions in Lahore, Pakistan. Through the purposive sampling technique, 13 physicians were interviewed. All interviews were audio-recorded, transcribed verbatim, and analyzed for a thematic content analysis. The thematic content analysis yielded six major themes: (1) Familiarity with medication safety and adverse drug reaction (ADR) concept, (2) Knowledge about pharmacovigilance activities, (3) Practices related to ADR reporting, (4) Barriers impeding ADR reporting, (5) Acknowledgement of the pharmacist's role, and (6) System change needs. The majority of the physicians were unaware of the ADR reporting system; however, they were ready to accept practice changes if provided with the required skills and training. A lack of knowledge, time, and interest, a fear of legal liability, poor training, inadequate physicians' and other healthcare professionals' communication, and most importantly lack of a proper reporting system were reported as barriers. The findings based on emerging themes can be used to establish an effective pharmacovigilance system in Pakistan. Overall, physicians reported a positive attitude towards practice changes, provided the concerned authorities support and take interest in this poorly acknowledged but most needed component of the healthcare system.
发达国家已经建立了药物警戒系统来监测药品的安全性。然而，在发展中国家，药物监测和报告面临着巨大的挑战。本研究旨在探讨巴基斯坦拉合尔医生在报告药物不良反应方面的理解和实践所面临的挑战。通过目的抽样技术，对 13 名医生进行了访谈。所有访谈均进行了录音、逐字转录，并进行了主题内容分析。主题内容分析产生了六个主要主题：（1）对药物安全和药物不良反应（ADR）概念的熟悉程度，（2）对药物警戒活动的了解，（3）与 ADR 报告相关的实践，（4）阻碍 ADR 报告的障碍，（5）对药剂师角色的认可，以及（6）系统变革的需要。大多数医生对 ADR 报告系统不了解；但是，如果提供所需的技能和培训，他们愿意接受实践上的改变。缺乏知识、时间和兴趣、对法律责任的恐惧、培训不足、医生和其他医疗保健专业人员之间沟通不畅，以及最重要的是缺乏适当的报告系统，这些都被报道为障碍。基于新兴主题的研究结果可以用于在巴基斯坦建立一个有效的药物警戒系统。总的来说，医生对实践上的改变持积极态度，只要有关当局支持并对这一被严重忽视但却是医疗保健系统最需要的组成部分感兴趣。
