Table 2.
Methods of ADR monitoring by profession.
| Method | Profession of Respondents, N (%) | p-Value a | |||
|---|---|---|---|---|---|
| Physician (n = 22) |
Pharmacist (n = 27) |
Nurse (n = 108) |
Total (n = 157) |
||
| General ADR identification methods | |||||
| Observe abnormal symptoms | 22 (100.0) | 20 (74.1) | 97 (89.8) | 139 (88.5) | 0.015 b,* |
| High-alert drug list | 11 (50.0) | 12 (44.4) | 62 (57.4) | 85 (54.1) | 0.441 |
| Abnormal laboratory data | 11 (50.0) | 13 (48.1) | 18 (16.7) | 42 (26.8) | <0.001 * |
| Alerting orders | 10 (45.5) | 14 (51.9) | 24 (22.2) | 48 (30.6) | 0.003 * |
| Trigger tools or antidotes | 8 (36.4) | 18 (66.7) | 24 (22.2) | 50 (31.8) | <0.001 * |
| Report from patients | 13 (59.1) | 23 (85.2) | 58 (53.7) | 94 (59.9) | 0.012 * |
| HCP team ADR monitoring systems | 10 (45.5) | 19 (70.4) | 32 (29.6) | 61 (38.9) | <0.001 * |
| Additional methods for identification of severe ADRs | |||||
| Drug-gene testing | 5 (22.7) | 8 (29.6) | 8 (7.4) | 21 (13.4) | 0.003 b,* |
| Skin test | 3 (13.6) | 6 (22.2) | 12 (11.1) | 21 (13.4) | 0.279 b |
| Additional patient history taking | 20 (90.9) | 27 (100.0) | 99 (91.7) | 146 (93.0) | 0.271 b |
| Additional laboratory data | 5 (22.7) | 8 (29.6) | 3 (2.8) | 16 (10.2) | <0.001 b,* |
| Use specific ADR criteria c | 4 (18.2) | 12 (44.4) | 13 (12.0) | 29 (18.5) | 0.001 b,* |
| Recognize methods of ADR causality assessment | |||||
| WHO-UMC criteria | 8 (36.4) | 14 (51.9) | 40 (37.0) | 62 (39.5) | 0.352 |
| Naranjo’s algorithm | 8 (36.4) | 26 (96.3) | 0 (0.0) | 34 (21.7) | <0.001 * |
| ADR management methods | |||||
| Stop the suspected drug | 22 (100.0) | 27 (100.0) | 90 (83.3) | 139 (88.5) | 0.005 b,* |
| Change to alternative drug | 17 (77.3) | 19 (70.4) | 20 (18.5) | 56 (35.7) | <0.001 * |
| Use additional drug to treat ADR symptoms | 10 (45.5) | 14 (51.9) | 1 (0.9) | 25 (15.9) | <0.001 b,* |
| Decrease drug dose | 6 (27.3) | 9 (33.3) | 6 (5.6) | 21 (13.4) | <0.001 b,* |
| Change drug administration time | 4 (18.2) | 4 (14.8) | 4 (3.7) | 12 (7.6) | 0.013 b,* |
| Change drug administration rate | 5 (22.7) | 15 (55.6) | 8 (7.4) | 28 (17.8) | <0.001 b,* |
| Change drug dosage form | 7 (31.8) | 1 (3.7) | 2 (1.9) | 10 (6.4) | <0.001 b,* |
| Advise patients about the drug | 11 (50.0) | 18 (66.7) | 63 (58.3) | 92 (58.6) | 0.497 |
| Monitor patient | 5 (22.7) | 8 (29.6) | 18 (16.7) | 31 (19.7) | 0.296 |
| ADR prevention methods | |||||
| Advise patients about recurrent drug allergy | 20 (90.9) | 26 (96.3) | 93 (86.1) | 139 (88.5) | 0.370 b |
| Drug allergy card | 15 (68.2) | 27 (100.0) | 41 (38.0) | 83 (52.9) | <0.001 * |
| Transfer drug allergy data to responsible agency | 13 (59.1) | 18 (66.7) | 82 (75.9) | 113 (72.0) | 0.221 |
| Adjust drug dose in special populations | 10 (45.5) | 9 (33.3) | 9 (8.3) | 28 (17.8) | <0.001 b,* |
| Check drug interactions | 12 (54.5) | 11 (40.7) | 23 (21.3) | 46 (29.3) | 0.003 * |
| Search ADR reference books | 4 (18.2) | 8 (29.6) | 16 (14.8) | 28 (17.8) | 0.213 b |
| Record ADR history in medical notes | 16 (72.7) | 24 (88.9) | 44 (40.7) | 84 (53.5) | <0.001 * |
| Record ADR history in computer programs | 12 (54.5) | 25 (92.6) | 37 (34.3) | 74 (47.1) | <0.001 * |
| Attach drug allergy sticker to medical notes | 6 (27.3) | 25 (92.6) | 43 (39.8) | 74 (47.1) | <0.001 * |
| Attach drug allergy label to the patient’s bed | 5 (22.7) | 5 (18.5) | 24 (22.2) | 34 (21.7) | 0.908 |
| Staff/organization to whom HCPs reported the ADRs | |||||
| Responsible physicians | 12 (54.5) | 19 (70.4) | 97 (89.8) | 128 (81.5) | <0.001 b,* |
| Pharmacists on ADR duty | 21 (95.5) | 21 (77.8) | 82 (75.9) | 124 (79.0) | 0.121 |
| Responsible nurses | 13 (59.1) | 15 (55.6) | 67 (62.0) | 95 (60.5) | 0.818 |
| Pharmacy department | 7 (31.8) | 13 (48.1) | 29 (26.9) | 49 (31.2) | 0.102 |
| The Ministry of Public Health (MOPH) | 0 (0.0) | 5 (18.5) | 0 (0.0) | 5 (3.2) | <0.001 b,* |
a Pearson’s chi-squared Test; b Fisher’s exact test; c Specific ADR criteria: vancomycin evaluation criteria (n = 1), anaphylaxis evaluation criteria (n = 1), drug-use manual for hospital (n = 10), RegiSCAR (Registry of Severe Cutaneous Adverse Reactions) score for DRESS (n = 4), not identified (n = 13); * the level of significant different < 0.05.