Awareness, knowledge, and practice of on-target and off-target adverse
drug reactions among healthcare workers -- A cross sectional case-based
study
Abstract
Aims Healthcare workers’ (HCWs) ability to recognize, classify and
manage adverse reactions (ADR) is crucial to ensure patient safety. This
study assessed HCWs’ awareness, knowledge, and practice on ADR. Methods
This was a cross sectional online questionnaire case-based study,
involving clinical HCWs at two tertiary hospitals. Results We recruited
321 respondents with 256 doctors, 58 nurses and seven medical
assistants. HCWs with more than five years’ experience and
dermatologists had better ADR knowledge. Three-quarter failed to
recognize off-target nonimmune mediated non-steroidal anti-inflammatory
drugs reactions. About 26% (n=84) could not recognize severe cutaneous
adverse drug reactions (SCARs). In those who recognized SCARs, only
76.6% (n=177) will not re-introduce the implicated drugs. Knowledge in
managing anaphylaxis and awareness in paradoxical drug-induced reaction
was poor. About 18% (n=58) did not use adrenaline in anaphylaxis and
80% (n=259) were unfamiliar with the usefulness of tryptase in
anaphylaxis. Nearly 52% were ignorant of succinylated gelatin solution
as a hidden allergen. Nearly 90% (n=286) were unfamiliar with
utilization of fresh frozen plasma in severe ACE-inhibitor induced
angioedema. A significant proportion of respondents understood the
reporting pathway for ADRs to medications and vaccines, respectively.
Only up to 67.3% (n=216) understood the need to update ADR reporting
when a new reaction occurred. Conclusion The overall HCWs knowledge and
practice on ADRs is not satisfactory where they lacked awareness on many
aspects of ADRs. These findings provide supportive evidence for the
incorporation of ADR into the healthcare curricula and plan periodic
programs to ensure patient safety.