Karuppannan Mahmathi, Mohamad Rizal Nur Azzrin Nisha, Wong Kok-Thong, Mohd Ali Salmiah, Ting Kang-Nee, Boardman Helen
Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Cawangan Selangor, Puncak Alam Campus, Shah Alam, Malaysia.
Hospital Sultanah Nora Ismail, Batu Pahat, Malaysia.
Front Pharmacol. 2022 Sep 29;13:932942. doi: 10.3389/fphar.2022.932942. eCollection 2022.
Adverse drug reaction (ADR) is one of the leading public health concerns associated with high mortality rate. Healthcare professionals, particularly pharmacists, have a significant role in monitoring and preventing ADRs. This study was conducted on Malaysian Pharmaceutical Society (MPS) pharmacists who worked at the hospitals, health clinics, and community pharmacies to determine if pharmacists' experiences on ADRs are still the same 10 years later. In 2010, a postal survey and in 2020, an online survey were conducted among these pharmacists. A total of 472 pharmacists and 208 participated in 2010 and 2020, respectively. About 82% and 90% of hospital/health clinic pharmacists (HCPs) observed an ADR over the last 6 months in 2010 and 2020, while 60% and 100% community pharmacists in 2010 and 2020 observed an ADR, respectively. Perindopril was the top drug (HCPs: = 0.657; CPs: = 0.98), and rash was the top ADR reported by the pharmacists in both years (HCPs: < 0.001; CPs: = 0.679). The most common actions taken by HCPs in 2010 were to report the ADR ( = 0.343), while in 2020, most HCPs explained to patients regarding the reaction ( = 0.061), which was also the same in the CP group in 2020 ( = 0.958). The top factor encouraging ADR reporting in both years and both pharmacist groups was the high degree of severity of the reaction (HCPs: < 0.001; CPs: = 0.769). While the top factors discouraging ADR reporting were a lack of information from the affected patients (HCPs: = 0.2; CPs: = 0.656), reaction is widely known (HCPs: = 0.001; CPs: = 0.144) and uncertainty of the causal relationship (HCPs: = 0.169; CPs: = 0.609). Majority of the pharmacists agreed that severe reactions should be reported (HCPs: = 0.158; CPs: = 0.501) and the main aim for reporting is to measure the incidence of ADRs (HCPs: = 0.148; CPs: = 0.762). Despite being able to identify ADRs during the daily practice, many pharmacists especially community pharmacists are not reporting them. There is a misconception on the purpose of reporting ADRs. An interventional program and ADR reporting training would be a useful step in improving ADR reporting practice.
药物不良反应（ADR）是一个主要的公共卫生问题，死亡率很高。医疗保健专业人员，尤其是药剂师，在监测和预防药物不良反应方面发挥着重要作用。本研究针对在医院、健康诊所和社区药房工作的马来西亚药学会（MPS）药剂师展开，以确定10年后药剂师对药物不良反应的经验是否依然相同。2010年进行了邮寄调查，2020年对这些药剂师进行了在线调查。2010年和2020年分别有472名和208名药剂师参与。2010年和2020年，分别约有82%和90%的医院/健康诊所药剂师（HCPs）在过去6个月中观察到药物不良反应，而2010年和2020年社区药剂师观察到药物不良反应的比例分别为60%和100%。培哚普利是最常涉及的药物（医院/健康诊所药剂师： = 0.657；社区药剂师： = 0.98），皮疹是这两年药剂师报告的最常见药物不良反应（医院/健康诊所药剂师： < 0.001；社区药剂师： = 0.679）。2010年医院/健康诊所药剂师采取的最常见行动是报告药物不良反应（ = 0.343），而在2020年，大多数医院/健康诊所药剂师向患者解释了该反应（ = 0.061），2020年社区药剂师组也是如此（ = 0.958）。这两年两个药剂师群体中鼓励报告药物不良反应的首要因素是反应的严重程度高（医院/健康诊所药剂师： < 0.001；社区药剂师： = 0.769）。而阻碍报告药物不良反应的首要因素是受影响患者提供的信息不足（医院/健康诊所药剂师： = 0.2；社区药剂师： = 0.656）、反应广为人知（医院/健康诊所药剂师： = 0.001；社区药剂师： = 0.144）以及因果关系的不确定性（医院/健康诊所药剂师： = 0.169；社区药剂师： = 0.609）。大多数药剂师同意应报告严重反应（医院/健康诊所药剂师： = 0.158；社区药剂师： = 0.501），报告的主要目的是衡量药物不良反应的发生率（医院/健康诊所药剂师： = 0.148；社区药剂师： = 0.762）。尽管在日常工作中能够识别药物不良反应，但许多药剂师，尤其是社区药剂师并未报告。对于报告药物不良反应的目的存在误解。一个干预项目和药物不良反应报告培训将是改善药物不良反应报告实践的有益举措。
