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药物不良反应警示卡系统在预防药物不良反应复发中的有效性评估

Evaluation of the Effectiveness of the Adverse Drug Reaction Alert Card System in Preventing the Recurrence of Adverse Drug Reactions.

作者信息

Mulkalwar Sarita, Chitale Shantanu, Dandage Prachi, Bapat Shraddha, Tilak Abhijeet V, Patil Sayali

机构信息

Pharmacology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND.

Pharmacology, D. Y. Patil University, School of Medicine, Navi Mumbai, IND.

出版信息

Cureus. 2024 Jul 16;16(7):e64653. doi: 10.7759/cureus.64653. eCollection 2024 Jul.

DOI:10.7759/cureus.64653
PMID:39149672
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11326754/
Abstract

Introduction Adverse drug reactions (ADRs) are among the leading causes of morbidity and mortality. It causes a significant prolongation of hospital stays, leading to an increased economic and infrastructural burden on the healthcare system. Thus, primary prevention will help in preventing recurrent ADRs. People are often unable to state whether they have suffered an ADR from a medicine or not. The patients also find it difficult to recall the offending drug. They seldom seem to carry any information that would warn others of their reactions. Thus, there was a need to introduce the ADR Alert Card. A pilot study was first conducted in 2018 to assess the feasibility of this card. All patients suffering from an ADR were thus provided an alert card. Following its implementation, there was a general acceptability regarding the potential of this card in ADR recurrence prevention among healthcare professionals (HCPs). Therefore, there is a need to assess the effectiveness of this card for ADR recurrence prevention. Objective This study aims to estimate the percentage of people who have shown the ADR Alert Card to their HCPs and benefited from it. Methods This was a prospective observational study, which was conducted at Dr. D. Y. Patil Medical College, Pune, from November 2022 to May 2024 and received approval from the Institutional Ethics Committee (IEC) before its initiation. All the patients who faced an ADR were given an ADR Alert Card by their HCP. All the patients to whom their HCP had given the card were part of this study. Any patient who suffered an ADR due to overdosage of medication was excluded from the study. After screening for inclusion and exclusion criteria, the data were analyzed using MS Excel (Microsoft Corporation, Redmond, Washington). A questionnaire was validated by professors in pharmacology, medicine, and community medicine. The patients were contacted through telephone conversations and provided with this questionnaire. They were asked questions regarding the ease of carrying the card, the benefit it provided them, whether they had shown it to their HCP, whether it helped them in an emergency, and their willingness to link it digitally. Their responses were recorded in Google Forms, and pie charts were generated. Results All 110 patients (100%) agreed that the ADR Alert Card was beneficial. Most (99, 90%) patients had shown the card to their HCP at their subsequent visit. The card helped 107 (97%) patients to describe their medical history easily. All the patients (110, 100%) agreed that carrying the card was easy, and most patients (95, 86%) agreed to recommend using the card to others. Additionally, most patients (79, 72%) were willing to link their card to their National Health ID. However, a small proportion of patients (28, ~25%) were skeptical whether they would link the card to the National Health ID or not. The card had helped 28 (25%) patients in an emergency. Approximately 11 (10%) patients had reported an ADR to the regulatory authority. Conclusion The patients welcomed this new concept to be inculcated in their daily lives as an effective means to enhance their healthcare. This study evaluates the number of patients who actually benefitted from using this card. It encourages patients to participate actively in their own healthcare. In an emergency situation, it proves to be a source of important health information. This study could lay the foundation for further research to prevent recurrent ADRs.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f09f/11326754/176373c51343/cureus-0016-00000064653-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f09f/11326754/07337cd33f11/cureus-0016-00000064653-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f09f/11326754/2496080b9070/cureus-0016-00000064653-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f09f/11326754/176373c51343/cureus-0016-00000064653-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f09f/11326754/07337cd33f11/cureus-0016-00000064653-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f09f/11326754/2496080b9070/cureus-0016-00000064653-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f09f/11326754/176373c51343/cureus-0016-00000064653-i03.jpg
摘要

引言

药物不良反应(ADR)是发病和死亡的主要原因之一。它会显著延长住院时间,给医疗系统带来更大的经济和基础设施负担。因此,一级预防有助于预防药物不良反应的复发。人们常常无法说明自己是否遭受过药物不良反应。患者也很难回忆起引发不良反应的药物。他们似乎很少携带能警示他人其不良反应的任何信息。因此,有必要引入药物不良反应警示卡。2018年首次进行了一项试点研究,以评估该卡片的可行性。所有遭受药物不良反应的患者都因此获得了一张警示卡。在实施之后,医疗保健专业人员(HCP)普遍认可该卡片在预防药物不良反应复发方面的潜力。因此,有必要评估该卡片预防药物不良反应复发的有效性。

目的

本研究旨在估计向其医疗保健专业人员出示过药物不良反应警示卡并从中受益的人群比例。

方法

这是一项前瞻性观察性研究,于2022年11月至2024年5月在浦那的D.Y.帕蒂尔医学院进行,并在研究开始前获得了机构伦理委员会(IEC)的批准。所有经历过药物不良反应的患者都由其医疗保健专业人员给予一张药物不良反应警示卡。所有其医疗保健专业人员给过卡片的患者都是本研究的一部分。因药物过量导致药物不良反应的任何患者都被排除在研究之外。在筛选纳入和排除标准后,使用MS Excel(微软公司,华盛顿州雷德蒙德)对数据进行分析。一份问卷由药理学、医学和社区医学方面的教授进行了验证。通过电话联系患者并向他们提供这份问卷。询问他们关于携带卡片的便利性、卡片给他们带来的益处、他们是否向其医疗保健专业人员出示过卡片、卡片在紧急情况下是否对他们有帮助以及他们将卡片与数字信息关联的意愿等问题。他们的回答记录在谷歌表格中,并生成了饼图。

结果

所有110名患者(100%)都认为药物不良反应警示卡有益。大多数(99名,90%)患者在随后的就诊中向其医疗保健专业人员出示了卡片。该卡片帮助107名(97%)患者轻松描述了他们的病史。所有患者(110名,100%)都认为携带卡片很容易,大多数患者(95名,86%)同意向他人推荐使用该卡片。此外,大多数患者(79名,72%)愿意将他们的卡片与国家健康ID关联。然而,一小部分患者(28名,约25%)对是否会将卡片与国家健康ID关联持怀疑态度。该卡片在紧急情况下帮助了28名(25%)患者。大约11名(10%)患者向监管机构报告了药物不良反应。

结论

患者欢迎将这一新概念融入他们的日常生活,作为增强医疗保健的有效手段。本研究评估了实际从使用该卡片中受益的患者数量。它鼓励患者积极参与自身的医疗保健。在紧急情况下,它被证明是重要健康信息的来源。本研究可为预防药物不良反应复发的进一步研究奠定基础。

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