Clinical Practice and Knowledge of Primary Health Care Physicians Toward Adverse Drug Reactions: Can We Recognize Adverse Drug Reactions and What Should We do to Maximize Patient Safety and to Improve Self-confidence of Doctors When Prescribing Medicines?

Abstract

Aim: A suspicion about adverse drug reactions is sufficient for adverse drug reactions reporting. However, assessing the causal drug-disturbance(s) relation is the primary issue in physicians’ clinical practice, due to their principal responsibility among health care workers for patients' health, including patients' safety, while the far more studied adverse drug reactions reporting is the secondary one. Thus, adverse drug reactions, and the need for introducing activities for physicians toward adverse drug reactions. Study Design: It was a prospective, multicentric, questionnaire based, self-administered, and anonymous study, conducted during two months among physicians employed in five public (state) primary health care centers in the Republic of Serbia settled in Sombor, Mladenovac, Pozarevac, Cacak and Pirot. Results: It was questionnaired 238 out of 461 employed physicians. Doctors declared to diagnose adverse drug reactions (n = 213) but rarely report them (n = 49). They usually withdrew the drug suspected for adverse drug reactions (n = 212) and seldom introduce it to the same patient in the future (n = 5). They claimed to have difficulties in both the adverse drug reactions diagnosing (n = 146) and treating (n = 113). Almost all considered the improvement of the knowledge about adverse drug reactions beneficial for their clinical practice, adverse drug reactions diagnosing and treating (P < .001 for all the statements). With a very few exceptions, answers were not influenced by physicians’ ages and medical education. Conclusion: Physicians recognized the dimension of their problems in the field of adverse drug reactions, especially diagnosing, which is crucial for patient health. Better education and training are the most important strategies for improving existing weaknesses, which have to be translated into routine clinical practice.