Belton K J
Wolfson Unit of Clinical Pharmacology, University of Newcastle Upon Tyne, UK.
Eur J Clin Pharmacol. 1997;52(6):423-7. doi: 10.1007/s002280050314.
This survey was conducted to assess the attitudes of medical practitioners in the European Union regarding their national spontaneous reporting scheme, to identify reasons for under-reporting and to determine what steps might be effective in increasing reporting rates. National spontaneous reporting schemes rely on health care professionals reporting individual cases of suspected ADRs to a central or regional agency. National schemes, however, vary considerably and reporting rates and patterns differ between member states. Accumulating evidence suggests that doctors' attitudes to national ADR reporting schemes are significant determinants of reporting rates.
A self-administered questionnaire and letter of invitation was sent to a random sample of approximately 1% of medical practitioners in each of nine EU member states (Denmark, France, Ireland, Italy, the Netherlands, Portugal, Spain, Sweden and the UK). One month later, a reminder letter and a second copy of the questionnaire was sent to the non-responders (except Denmark and Italy).
Response rates, and the percentage of responders who stated that they had reported previously an ADR, varied substantially between countries. Issues that appeared to discourage reporting included lack of availability of report forms; the address or telephone number of the reporting agency; lack of information on how to report; and not having enough time to report. Issues which did not apparently discourage reporting included concern about patient confidentiality; fear of legal liability or appearing foolish; reluctance to admit that harm had been caused to a patient; and ambition to collect and publish a personal series of cases.
The results of this survey demonstrate some of the advantages and disadvantages of transnational, multilingual studies of this type, but indicate that there is scope for the further development of such techniques and their use on a wider basis in the EU and elsewhere.
开展此项调查以评估欧盟医学从业者对本国自发报告计划的态度,找出报告不足的原因,并确定哪些措施可能有效提高报告率。国家自发报告计划依赖于医疗保健专业人员向中央或地区机构报告疑似药品不良反应的个别病例。然而,各国的计划差异很大,成员国之间的报告率和模式也有所不同。越来越多的证据表明,医生对国家药品不良反应报告计划的态度是报告率的重要决定因素。
向九个欧盟成员国(丹麦、法国、爱尔兰、意大利、荷兰、葡萄牙、西班牙、瑞典和英国)中约1%的医学从业者随机抽样发送了一份自填式问卷和邀请函。一个月后,向未回复者(丹麦和意大利除外)发送了提醒信和问卷的第二份副本。
各国的回复率以及表示曾报告过药品不良反应的回复者百分比差异很大。似乎阻碍报告的问题包括:没有报告表格;报告机构的地址或电话号码;缺乏如何报告的信息;以及没有足够时间报告。显然不阻碍报告的问题包括对患者保密的担忧;对法律责任或显得愚蠢的恐惧;不愿承认对患者造成了伤害;以及收集和发表个人病例系列的意愿。
本次调查结果显示了此类跨国、多语言研究的一些优缺点,但表明此类技术在欧盟及其他地区有进一步发展和更广泛应用的空间。