Knowledge, attitude, practice and barriers towards pharmacovigilance and adverse drug reactions reporting among healthcare professionals in Turkey: a systematic review

Globally, pharmacovigilance (PV) is crucial for the patient’s safety and proper use of drugs. Spontaneous reporting of adverse drug reaction (ADR) is a professional obligation of every healthcare professionals (HCPs). The purpose of this systematic review was to analyze the existing literature about the knowledge, attitude, and practices (KAP) level of HCPs regarding PV and ADRs reporting in Turkey. A systematic and comprehensive articles search strategy was carried out in different seven electronic databases (PubMed, PubMed Central, Goggle Scholar, Ovid-SP, MEDLINE, Wiley Online Library, DergiPark) from 2010 to 2020. We searched to identify existing literature about cross-sectional observational studies investigating the KAP of HCPs regarding PV and ADRs reporting in different geographical regions of Turkey. Quality assessment and risk of bias were assessed among included studies. Fifteen studies were chosen for full-text analysis. Finally, according to inclusion criteria, seven research articles were selected for systematic review. Overall, the KAP of HCPs varies across the studies. The lack of a standardized validated measuring tool to evaluate the KAP and differences in questionnaire items were the main limitations in included studies. Around, 69.1% (range: 54.6–100%) of HCPs were not aware of the national pharmacovigilance center in Turkey. About, 37.5% (range: 7.1–75.7%) of HCPs believed that reporting of ADRs is not important and 87.5% (range: 69.3–100%) stated that they never reported ADR previously during their practice. The most frequently highlighted barriers to PV were lack of time, uncertainty and did not know where to report. This systematic review revealed a major KAP gap in Turkey towards PV activities. Low ADR reporting practice of HCPs was a major identified issue. The creation of a mandatory unified PV education intervention for future HCPs to rationally report ADR of drugs are crucial for a better healthcare system.

在全球范围内，药物警戒（pharmacovigilance, PV）对于保障患者安全与药品合理使用至关重要。药品不良反应（adverse drug reaction, ADR）的自发报告是所有医疗保健专业人员（healthcare professionals, HCPs）的职业义务。本系统综述旨在分析现有关于土耳其医疗保健专业人员针对药物警戒与药品不良反应报告的知识、态度及实践（knowledge, attitude, and practices, KAP）水平的相关文献。
研究于2010年至2020年间，在7个不同的电子数据库（PubMed、PubMed Central、谷歌学术（Google Scholar）、Ovid-SP、MEDLINE、Wiley Online Library、DergiPark）中采用系统化且全面的文献检索策略。本研究旨在检索针对土耳其不同地理区域内医疗保健专业人员药物警戒与药品不良反应报告相关知识、态度及实践的横断面观察性研究的现有文献。对纳入的研究进行质量评价与偏倚风险评估。最终选取15项研究进行全文分析，最终根据纳入标准筛选出7篇研究论文用于本系统综述。
总体而言，各研究中医疗保健专业人员的知识、态度及实践水平存在差异。纳入研究的主要局限性在于缺乏用于评估知识、态度及实践水平的标准化验证量表，且调查问卷条目存在差异。约69.1%（范围：54.6%~100%）的医疗保健专业人员并不知晓土耳其国家药物警戒中心。约37.5%（范围：7.1%~75.7%）的医疗保健专业人员认为药品不良反应报告并不重要，且87.5%（范围：69.3%~100%）的人员表示在其执业过程中从未报告过药品不良反应。药物警戒工作最常被提及的障碍包括时间不足、认知不确定以及不清楚报告渠道。
本系统综述揭示了土耳其在药物警戒活动方面存在显著的知识、态度及实践水平差距。医疗保健专业人员较低的药品不良反应报告率是一项核心问题。为未来的医疗保健专业人员制定强制性统一的药物警戒教育干预方案，以使其能够合理报告药品不良反应，对于构建更完善的医疗体系至关重要。