Demographic data of respondents.

Ghana’s rate of reporting adverse drug reaction (ADRs) over the past years has consistently been below the WHO standard despite utilizing the spontaneous or voluntary reporting system. While underreporting undermines the pharmacovigilance system and poses a huge threat to public health safety, there is limited information on the perspectives of healthcare workers directly involved in drug administration. The present study investigated the knowledge, attitude and practice of physicians and nurses at the Cape Coast Teaching Hospital (CCTH) towards spontaneous reporting of ADRs (SR-ADRs). A descriptive cross-sectional survey was employed in the study. Pre-tested (Cronbach’s alpha value of 0.72) and validated questionnaires comprising 37 open-ended and close-ended questions were administered to 44 doctors and 116 nurses at the CCTH who had been practicing for at least six months prior to study. Out of the 160 administered questionnaires, 86 was administered face-to-face and the remaining via e-mails. Descriptive analysis was performed and the results were presented in simple frequencies and percentages. Binary logistic regression model was used to test association of the independent variables with SR-ADRs. With a response rate of 86.4% for physicians and 59.5% for nurses, 38 (35.5%) physicians and 69 (64.5%) nurses completed the questionnaires and returned same. Majority (82.3%, 88) of the respondents knew that it is their responsibility to report ADRs although their knowledge levels was found to be inadequate (that is ≤80%) in majority (66.7%) of the text items that assessed knowledge levels. On the attitude of respondents, it was found that 57% (61) of them agreed that under-reporting was due to complacency whereas 80.4% (86) of them agreed that it was due the lack of adequate training. On the issues of practice, the prevalence of encountering, assisting in the management, and reporting of ADRs were 26.1% (28), 17.8% (19) and 7.5% (8) respectively. Also, nurses were 1.22 times more likely to encounter a patient with ADRs and twice more likely to fill and forward ADR form than doctors during management. Respondents with more than six months but less than one year of practice experience were more likely (AOR = 1.38, 95% CI: 2.72–7.3) to encounter a patient with ADRs as compared to those with just six months of practice experience. Furthermore, male respondents were more likely (AOR = 2.42, 95% CI: 1–5.85) to encounter patients with ADRs but less likely (AOR = 0.49, 95% CI: 0.91–2.6) to fill and forward ADR form compared to their female counterparts. In conclusion, doctors and nurses at the CCTH had inadequate knowledge about ADRs and its existing pharmacovigilance systems, thus accounting for the low spontaneous ADRs reporting in the facility.

过去数年来，加纳的药品不良反应（adverse drug reaction, ADR）报告率始终低于世界卫生组织（World Health Organization, WHO）标准，尽管该国采用了自发/自愿报告系统（spontaneous or voluntary reporting system）。漏报不仅会削弱药物警戒（pharmacovigilance）体系，还对公共卫生安全构成严重威胁，但目前针对直接参与药品给药的医护人员的相关认知研究信息仍较为匮乏。本研究针对海岸角教学医院（Cape Coast Teaching Hospital, CCTH）的医师与护士开展描述性横断面调查（descriptive cross-sectional survey），旨在探究其对药品不良反应自发报告（spontaneous reporting of ADRs, SR-ADRs）的认知、态度与实践行为。本研究采用该调查设计，向海岸角教学医院内至少有6个月执业经验的44名医师及116名护士共160人，发放经预试验（克朗巴赫α系数（Cronbach’s alpha）为0.72）且通过信效度验证的调查问卷（questionnaires），该问卷共包含37道开放式与封闭式问题。在发放的160份问卷中，86份采用面对面方式发放，其余通过电子邮件发放。研究采用描述性分析，以简单频数与百分比呈现结果；同时构建二元逻辑回归模型（binary logistic regression model），检验自变量与药品不良反应自发报告行为的关联。本次调查的医师应答率为86.4%，护士应答率为59.5%，最终共有38名医师（占比35.5%）与69名护士（占比64.5%）完成并返还问卷。多数受访者（82.3%，共88人）知晓报告药品不良反应是自身职责，但在评估认知水平的66.7%的测评项目中，受访者的认知得分不足80%（即≤80%），提示其整体认知水平仍存在不足。在态度维度方面，57%的受访者（共61人）认为漏报源于履职懈怠，80.4%的受访者（共86人）则认同漏报是由于缺乏充分培训。在实践行为维度，受访者遭遇药品不良反应患者、协助开展不良反应事件处置、上报不良反应的比例分别为26.1%（28人）、17.8%（19人）与7.5%（8人）。此外，护士遭遇药品不良反应患者的概率较医师高1.22倍，且在诊疗过程中填写并提交不良反应报告表的概率是医师的2倍。与仅拥有6个月执业经验的受访者相比，执业时长6个月至1年的受访者遭遇药品不良反应患者的概率更高（调整比值比（Adjusted Odds Ratio, AOR）=1.38，95%置信区间（95% confidence interval, 95% CI）：2.72–7.3）。进一步分析显示，男性受访者遭遇药品不良反应患者的概率更高（AOR=2.42，95%CI：1–5.85），但相较于女性受访者，其填写并提交不良反应报告表的概率更低（AOR=0.49，95%CI：0.91–2.6）。综上，海岸角教学医院的医护人员对药品不良反应及其现行药物警戒系统的认知水平不足，这也是该机构药品不良反应自发报告率偏低的核心原因。