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住院状态下精神科医疗机构内药品不良反应报告的认知与障碍

Perceptions and barriers of adverse drug reaction reporting within inpatient state psychiatric facilities.

作者信息

O'Donnell Carolyn, Demler Tammie Lee, Dzierba Charisse

机构信息

Pharmacy Manager, The New York State Office of Mental Health at Buffalo Psychiatric Center, Buffalo, New York; Residency Program Director and Professor (adjunct), Department of Pharmacy Practice, State University of New York at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, New York; Clinical Associate Professor, Department of Psychiatry, State University of New York at Buffalo School of Medicine, Buffalo, New York.

Clinical Pharmacist, The New York State Office of Mental Health at Buffalo Psychiatric Center, Buffalo, New York.

出版信息

Ment Health Clin. 2022 Aug 23;12(4):247-253. doi: 10.9740/mhc.2022.08.247. eCollection 2022 Aug.

Abstract

INTRODUCTION

Adverse drug reactions (ADRs) are a leading cause of morbidity and mortality for hospitalized patients. Health care organizations track ADRs to reduce patient mortality, reduce hospital readmissions, decrease costs, and improve patient care. Differing definitions of ADRs cause confusion among providers, leading to hesitation with ADR reporting. The objective of this study was to understand health care professionals' perspectives of ADR reporting within inpatient state psychiatric facilities.

METHODS

A survey was sent to 143 health care professionals throughout 25 inpatient state psychiatric facilities within 1 state. The survey assessed the definition of an ADR, confidence in reporting, barriers to reporting, the role of reporting, who should report and review ADRs, and strategies for process improvement.

RESULTS

The survey had a 75.5% response rate with 108 respondents. Most respondents could identify the definition of an ADR, were moderately confident in reporting ADRs, and understood the importance of ADR reporting. Barriers to ADR reporting included the reaction not being serious, a lack of information about the ADR, or not enough clarity on how to report an ADR. Fear of retaliation was an additional barrier to ADR reporting. Training and direction on ADR reporting, education on real versus perceived consequences, a designated point person to aid in reporting, and better access to reporting technology were suggested improvements for ADR reporting.

DISCUSSION

From this survey, it is evident that respondents believe improved education and training, improved communication regarding reporting consequences, and consensus on the definition of an ADR would encourage reporting.

摘要

引言

药物不良反应(ADR)是住院患者发病和死亡的主要原因。医疗机构追踪药物不良反应以降低患者死亡率、减少医院再入院率、降低成本并改善患者护理。药物不良反应的不同定义在医疗服务提供者之间造成了混乱,导致他们在报告药物不良反应时犹豫不决。本研究的目的是了解医疗保健专业人员对住院精神病专科医院内药物不良反应报告的看法。

方法

向一个州内25家住院精神病专科医院的143名医疗保健专业人员发送了一份调查问卷。该调查评估了药物不良反应的定义、报告的信心、报告的障碍、报告的作用、谁应该报告和审查药物不良反应以及流程改进策略。

结果

该调查的回复率为75.5%,有108名受访者。大多数受访者能够确定药物不良反应的定义,对报告药物不良反应有一定信心,并理解药物不良反应报告的重要性。药物不良反应报告的障碍包括反应不严重、缺乏关于药物不良反应的信息或对如何报告药物不良反应不够明确。害怕报复是药物不良反应报告的另一个障碍。建议对药物不良反应报告进行培训和指导,对实际后果与感知后果进行教育,指定专人协助报告,并更好地使用报告技术,以改进药物不良反应报告。

讨论

从本次调查中可以明显看出,受访者认为改善教育和培训、改善关于报告后果的沟通以及就药物不良反应的定义达成共识将鼓励报告。

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