›› 2011, Vol. 31 ›› Issue (1): 84-.doi: 10.3969/j.issn.1674-8115.2011.01.020

• 论著(卫生事业管理) • 上一篇    下一篇

临床医师防范和应对药品不良反应纠纷的调查分析

阎仲珩, 黄登笑, 黄淇敏   

  1. 上海交通大学 医学院附属第三人民医院门诊办公室, 上海 201900
  • 出版日期:2011-01-28 发布日期:2011-02-01
  • 通讯作者: 黄淇敏, 电子信箱: qiminh@126.com。
  • 作者简介:阎仲珩(1981—), 男, 住院医师, 硕士生;电子信箱: yanzhongheng@sina.com。
  • 基金资助:

    上海市宝山区科委基金(08-E-2);上海市教委基金(09YS109);上海交通大学医学院基金(YW1001)

Investigation of prevention and response of clinicians to disputes of adverse drug reactions

YAN Zhong-heng, HUANG Deng-xiao, HUANG Qi-min   

  1. Office of Out-patient Clinic, The Third People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201900, China
  • Online:2011-01-28 Published:2011-02-01
  • Supported by:

    Foundation from Science and Technology Committee of Baoshan District,Shanghai, 08-E-2;Shanghai Education Committee Foundation, 09YS109;Foundation from Shanghai Jiaotong University School of Medicine, YW1001

摘要:

目的 调查临床医师对药品不良反应(ADR)纠纷的防范和应对情况,探索医疗机构防范和应对ADR纠纷较为有效的方法。方法 对上海交通大学及其医学院的10家附属医院中的370名临床医师进行问卷调查,问卷分为两部分:第一部分为被调查者的基本情况;第二部分为专题调查,包括ADR基本概念、对ADR纠纷防范措施的认同度和接受应用程度、对ADR纠纷应对措施的认同度。结果 回收问卷361份,回收率97.57%;有效问卷347份,有效率96.12%。大部分临床医师对目前常用的ADR纠纷防范和应对措施表示认可。在ADR纠纷防范措施的认同度方面,各项防范措施均得到60%以上的医师认可。在ADR纠纷应对措施的认同度方面,37.5%的医师认可免除收费措施,其他纠纷应对措施均得到60%以上的医师认可。结论 目前医疗机构中常用的ADR案例规范上报、多参考药品说明书、治疗前告知、临床药师参与指导的纠纷防范措施得到了临床医师的认同,制定统一规范的处理程序、第一时间处理ADR以及作好相关记录的纠纷应对措施也得到了临床医师的广泛认同,但免除收费的纠纷应对方式认同度较低。

关键词: 药品不良反应, 纠纷, 防范, 应对, 临床医师

Abstract:

Objective To investigate the prevention and response of clinicians to disputes of adverse drug reactions (ADR), and explore effective ways for medical institutions to deal with disputes of ADR. Methods Questionnaire survey was conducted in 370 clinicians selected from 10 affiliated hospitals of Shanghai Jiaotong University School of Medicine. The questionnaires were composed of two sections. The basic conditions of clinicians were included in one section, and the other section was about a specific survey concerned with the basic concept of ADR, and the recognition and application of prevention measures and methods dealing with ADR disputes. Results A total of 361 questionnaires (97.57%) were recovered, with 347 effective questionnaires (96.12%). Most clinicians were in favor of the commonly adopted prevention measures and methods dealing with ADR disputes. More than 60% of clinicians believed that all the prevention measures to ADR disputes were effective. For the methods dealing with ADR disputes, 37.5% of clinicians were for the measure of “waiving charges”, and more than 60% of clinicians approved the other methods dealing with ADR disputes. Conclusion At present, “standard reporting cases”, “referring to drug manual”, “notification before treatment” and “guidance of clinical pharmacists” are commonly used in medical institutions for the prevention of disputes, and “establishing a uniform and standard process”, “dealing with ADR in the first time” and “making relevant records” are common responses to disputes, while “waiving charges” has a low recognition degree.

Key words: adverse drug reaction, dispute, prevention, response, clinician