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医学生作为药物不良反应管理者,在学习药物不良反应的同时,提高其在临床实践中的报告能力。

Medical students as adverse drug event managers, learning about side effects while improving their reporting in clinical practice.

机构信息

Pharmacotherapy Section, Department of Internal Medicine, Amsterdam UMC, location VU University Medical Center, De Boelelaan 1117, 1081, HV, Amsterdam, The Netherlands.

Research and Expertise Center in Pharmacotherapy Education (RECIPE), De Boelelaan 1117, 1081, HV, Amsterdam, The Netherlands.

出版信息

Naunyn Schmiedebergs Arch Pharmacol. 2021 Jul;394(7):1467-1476. doi: 10.1007/s00210-021-02060-y. Epub 2021 Mar 5.

Abstract

Managing adverse drug reactions (ADRs) is a challenge, especially because most healthcare professionals are insufficiently trained for this task. Since context-based clinical pharmacovigilance training has proven effective, we assessed the feasibility and effect of a creating a team of Junior-Adverse Drug Event Managers (J-ADEMs). The J-ADEM team consisted of medical students (1st-6th year) tasked with managing and reporting ADRs in hospitalized patients. Feasibility was evaluated using questionnaires. Student competence in reporting ADRs was evaluated using a case-control design and questionnaires before and after J-ADEM program participation. From Augustus 2018 to Augustus 2019, 41 students participated in a J-ADEM team and screened 136 patients and submitted 65 ADRs reports to the Netherlands Pharmacovigilance Center Lareb. Almost all patients (n = 61) found it important that "their" ADR was reported, and all (n = 62) patients felt they were taken seriously by the J-ADEM team. Although attending physicians agreed that the ADRs should have been reported, they did not do so themselves mainly because of a "lack of knowledge and attitudes" (50%) and "excuses made by healthcare professionals" (49%). J-ADEM team students were significantly more competent than control students in managing ADRs and correctly applying all steps for diagnosing ADRs (control group 38.5% vs. intervention group 83.3%, p < 0.001). The J-ADEM team is a feasible approach for detecting and managing ADRs in hospital. Patients were satisfied with the care provided, physicians were supported in their ADR reporting obligations, and students acquired relevant basic and clinical pharmacovigilance skills and knowledge, making it a win-win-win intervention.

摘要

管理药物不良反应(ADR)是一项挑战,尤其是因为大多数医疗保健专业人员在这方面的培训不足。由于基于情境的临床药物警戒培训已被证明是有效的,因此我们评估了创建初级药物不良反应事件管理员(J-ADEM)团队的可行性和效果。J-ADEM 团队由负责管理和报告住院患者 ADR 的医学生(第 1-6 年)组成。通过问卷调查评估可行性。通过病例对照设计和问卷调查,在参加 J-ADEM 项目前后评估学生报告 ADR 的能力。从 2018 年 8 月至 2019 年 8 月,41 名学生参加了 J-ADEM 团队,筛选了 136 名患者,并向荷兰药物警戒中心 Lareb 提交了 65 份 ADR 报告。几乎所有患者(n=61)认为“他们”的 ADR 被报告很重要,所有患者(n=62)都感到他们受到 J-ADEM 团队的重视。尽管主治医生认为应该报告 ADR,但他们自己没有这样做,主要是因为“缺乏知识和态度”(50%)和“医护人员的借口”(49%)。J-ADEM 团队的学生在管理 ADR 和正确应用诊断 ADR 的所有步骤方面明显比对照组学生更有能力(对照组 38.5%对干预组 83.3%,p<0.001)。J-ADEM 团队是一种在医院中检测和管理 ADR 的可行方法。患者对所提供的护理感到满意,医生在报告 ADR 方面得到了支持,学生获得了相关的基本和临床药物警戒技能和知识,使这成为一个双赢的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbe5/8233281/1f52899b4160/210_2021_2060_Fig1_HTML.jpg

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