Primary Care Provider Counseling Practices about Adverse Drug Reactions and Interactions in Croatia
Abstract
:1. Introduction
2. Experimental Section
2.1. Study Tool
2.2. Validity and Reliability of the Study Tool
2.3. Ethical Approval
2.4. Study Design and Sample Recruitment
2.5. Data Analysis
3. Results
3.1. Demographic Characteristics of General Practitioners
3.2. PCP Knowledge of Drug-Drug Interactions
3.3. Attitudes and Practices of PCPs in Advising Patients about Drug Interactions and Adverse Effects
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Number (%) of Correspondents | |
---|---|
Gender | |
Male | 38 (19.5) |
Female | 157 (80.5) |
Level of education | |
Medical doctors who passed the state exam | 97 (49.7) |
General/family medicine specialists | 90 (46.2) |
Other specialties | 8 (4.1) |
Location of practice | |
City | 95 (48.7) |
Regional center (Zagreb, Split, Rijeka, Osijek) | 40 (20.5) |
Countryside | 60 (30.8) |
Inland | 147 (75) |
Coastal area | 48 (25) |
Working experience | |
Up to 4 years | 57 (29.2) |
5–9 years | 13 (6.7) |
10–14 years | 19 (9.7) |
15 or more years | 106 (54.4) |
The Number of Questions | Median of the Correct Answers | Interquartile Range |
---|---|---|
10 | 5 | 4–7 |
Median (Interquartile Range) of Correct Answers | p * | |
---|---|---|
Gender | ||
Male | 5 (4–6) | 0.22 * |
Female | 5 (4–7) | |
Level of education | ||
Medical doctors who passed the state exam | 5 (4–6) | 0.01 * |
General/family medicine specialists | 6 (4–7) | |
Location of practice | ||
City | 5 (4–7) | 0.22 † |
Regional center (Zagreb, Split, Rijeka, Osijek) | 5 (4–6) | |
Countryside | 6 (4–7) | |
Working experience | ||
Up to 4 years | 5 (4–6) | 0.21 † |
5–9 years | 5 (4–6) | |
10–14 years | 6 (5–7) | |
15 or more years | 5 (4–7) |
Question | Number (%) of Correspondents |
---|---|
In my daily work with patients, I always advise patients about side effects and drug interactions | |
No | 120 (61.5) |
Yes | 75 (38.5) |
In my daily work with patients, I only advise special groups of patients (pregnant women, children, elderly patients) about side effects and drug interactions in the following way: | |
I give oral advice to patients or accompanying person. | 181 (92.8) |
I instruct the patient to read a summary of the description of drug properties or other educational materials. | 7 (3.6) |
I do not advise about side effects and drug interactions. | 7 (3.6) |
The most significant obstacle in advising about drug interactions in my daily practice is: | |
Lack of time. | 84 (43.1) |
Patient noncompliance | 12 (6.2) |
Lack of education in pharmacovigilance. | 60 (30.8) |
Lack of knowledge in rational pharmacotherapy. | 19 (9.7) |
None of the above because I do advise my patients about adverse effects and drug interactions in my daily practice. | 20 (10.3) |
Number (%) of Correspondents | |||||
---|---|---|---|---|---|
Fully Disagree | Disagree | Undecided | Agree | Fully Agree | |
Medical school gave me enough knowledge about drug side effects. | 52 | 61 | 68 | 12 | 2 |
(27) | (31) | (35) | (6) | (1) | |
Physicians specialists monitor and review the possibility of drug side effects when prescribing medications. | 40 | 53 | 51 | 38 | 13 |
(21) | (27) | (26) | (19) | (7) | |
I only tell patients about side effects if they ask me. | 53 | 61 | 58 | 18 | 5 |
(27) | (31) | (30) | (9) | (3) | |
I do not think I should tell patients about side effects because it scares them. | 63 | 43 | 64 | 22 | 3 |
(32) | (22) | (33) | (11) | (2) | |
Knowledge about side effects and interactions makes my work in practice easier. | 0 | 1 | 16 | 68 | 110 |
(1) | (8) | (35) | (56) | ||
Qualitative knowledge of drug side effects could significantly prevent patient mortality. | 1 | 5 | 48 | 50 | 91 |
(0.5) | (2.6) | (24.6) | (25.6) | (46.7) | |
The prevention of polypragmasia (simultaneous use of multiple medicines) is the responsibility of a family medicine practitioner. | 29 | 30 | 48 | 41 | 47 |
(14.9) | (15.4) | (24.6) | (21) | (24.1) | |
Medical school gave me enough knowledge about drug interactions. | 56 | 68 | 57 | 11 | 3 |
(28.7) | (34.9) | (29.2) | (5.6) | (1.5) | |
Physicians specialists monitor and review the possibility of drug interactions when prescribing medications. | 34 | 60 | 54 | 33 | 14 |
(17.4) | (30.8) | (27.7) | (16.9) | (7.2) | |
I only tell patients about interactions if they ask me. | 59 | 49 | 59 | 19 | 9 |
(30.3) | (25.1) | (30.3) | (9.7) | (4.6) | |
I do not think I should tell patients about drug interactions because it scares them. | 64 | 52 | 57 | 18 | 4 |
(32.8) | (26.7) | (29.2) | (9.2) | (2.1) | |
The multiple uses of drugs can be harmful to the patient. | 2 | 10 | 39 | 52 | 92 |
(1) | (5.1) | (20) | (26.7) | (47.2) | |
After the physician recommends the medication, I go through the possible side effects of this drug. | 1 | 7 | 47 | 79 | 61 |
(0.5) | (3.6) | (24.1) | (40.5) | (31.3) | |
After the physician recommends the medication, I go through the possible interactions of this drug. | 0 | 10 | 47 | 81 | 57 |
(5.1) | (24.1) | (41.5) | (29.2) | ||
In elderly people, I try to cope every symptom with medication. | 38 | 71 | 61 | 21 | 4 |
(19.5) | (36.4) | (31.3) | (10.8) | (2.1) | |
I refer an elderly patient who takes more than eight types of medication to a clinical pharmacologist. | 93 | 50 | 33 | 17 | 2 |
(47.7) | (25.6) | (16.9) | (8.7) | (1) | |
I revise the list of medications in elderly patients every six months. | 18 | 37 | 66 | 54 | 20 |
(9.2) | (19) | (33.8) | (27.7) | (10.3) | |
I read articles about prevention of side effects of drugs my patients use. | 16 | 33 | 66 | 68 | 12 |
(8.2) | (16.9) | (33.8) | (34.9) | (6.2) | |
When prescribing medicine, I advise patient about side effects. | 1 | 15 | 76 | 77 | 26 |
(0.5) | (7.7) | (39) | (39.5) | (13.3) | |
If side effects occur, I’m trying to find out if the patient is using over-the-counter medication. | 5 | 8 | 29 | 75 | 78 |
(2.6) | (4.1) | (14.9) | (38.5) | (40) | |
In elderly patients that have warfarin in their therapy, I look at the summary of described characteristics of warfarin before I include a new medication. | 9 | 22 | 42 | 81 | 41 |
(4.6) | (11.3) | (21.5) | (41.5) | (21) |
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Raguz Lucic, N.; Jakab, J.; Smolic, M.; Milas, A.-M.; Omanovic Kolaric, T.; Nincevic, V.; Bojanic, K.; Kralik, K.; Miskulin, M.; Wu, G.Y.; et al. Primary Care Provider Counseling Practices about Adverse Drug Reactions and Interactions in Croatia. J. Clin. Med. 2018, 7, 231. https://doi.org/10.3390/jcm7090231
Raguz Lucic N, Jakab J, Smolic M, Milas A-M, Omanovic Kolaric T, Nincevic V, Bojanic K, Kralik K, Miskulin M, Wu GY, et al. Primary Care Provider Counseling Practices about Adverse Drug Reactions and Interactions in Croatia. Journal of Clinical Medicine. 2018; 7(9):231. https://doi.org/10.3390/jcm7090231
Chicago/Turabian StyleRaguz Lucic, Nikola, Jelena Jakab, Martina Smolic, Ana-Maria Milas, Tea Omanovic Kolaric, Vjera Nincevic, Kristina Bojanic, Kristina Kralik, Maja Miskulin, George Y. Wu, and et al. 2018. "Primary Care Provider Counseling Practices about Adverse Drug Reactions and Interactions in Croatia" Journal of Clinical Medicine 7, no. 9: 231. https://doi.org/10.3390/jcm7090231