Awareness and attitudes of healthcare professionals in Wuhan, China to the reporting of adverse drug reactions.

BACKGROUND: A voluntary procedure for reporting adverse drug reactions (ADRs) was formally put in place in 1989. However, only a small proportion of ADR reports are actually forwarded to the national monitoring center. To identify the reasons for underreporting, the authors investigated the awareness and attitudes of healthcare professionals (doctors, nurses, and administrators) toward the ADR system in China. In addition, the authors sought to formulate approaches to improve the current ADR reporting system. METHODS: Structured interviews were carried out in 16 hospitals selected from 27 municipal hospitals in Wuhan, Hubei Province, China. A questionnaire survey of a stratified random sample of approximately 15% of healthcare professionals in each selected hospital was conducted during February to March 2003. RESULTS: The response rate of this survey was 85%. One thousand six hundred and fifty-three questionnaires were used in the final analysis. Only 2.7% of the healthcare professionals had a correct understanding to the definition of ADR. Eighty-nine point two percent of the healthcare professionals had encountered ADRs. Ninety-four percent of them were aware of the need to report these to the ADR monitoring center. However, only 28.5% of doctors, 22.8% of nurses, and 29.7% of administrators actually submitted a report. For the most part, they reported ADRs to the hospital pharmacy (66.0%), to other departments in the hospital (72.5%), and to the pharmaceutical industry (23.0%), rather than to the national monitoring center (2.9%) or regional monitoring center (9.5%). Severe or rare ADRs and ADRs to new products were generally perceived to be significant enough to report. Sixty-two point one percent of the healthcare professionals had encountered ADRs, yet not reported them to anybody. The major reasons for not reporting included no knowledge of the reporting procedure (71.4%), unavailability of the reporting center mailing address (67.9%), unavailability of the ADR report form (60.4%), lack of knowledge of the existence of a national ADR reporting system (52.2%), and belief that the ADR in question was already well known (44.1%). CONCLUSIONS: Healthcare professionals in Wuhan, China have little basic knowledge of ADR and of the voluntary reporting system. The main reasons for underreporting were lack of basic knowledge about ADRs and the voluntary reporting procedure. Education and training of healthcare professionals is needed to improve the current ADR reporting system.

[Preparation, characterization and three way catalytic performance for Pd/CZ/Al2O3 catalyst].

Pd/CZ/Al2O3 catalyst was prepared by impregnating a noble metal solution to the support CZ/Al2O3 which was prefabricated by co-impregnation. The investigation results show that Pd/CZ/Al2O3 has a superior three-way catalytic performance, which is comparable to Pd/CZ for the fresh sample and a better one after thermal ageing. Based on the XRD, BET and TPR characterizations, the internal relationship between catalytic performance, composition and structure was discussed. The relatively high activity after thermal ageing is ascribed to the maintenance of the Strong Metal-Support Interaction (SMSI).

[Preparation method of Pd/Ce0.5Zr0.5O2 three-way catalysts].

1% Pd/Ce0.5Zr0.5O2(CZ) catalysts were prepared by deposition-precipitation (DP), mixing (MIX) and conventional impregnation (IMP) methods, and the effects of the preparation methods on the three-way catalytic behaviors were investigated. Hydrogen temperature-programmed reduction (H2-TPR) and in situ diffuse reflectance infrared fourier transform spectroscopy (DRIFTS) were performed to understand the Pd-support interaction and the three-way catalytic reaction mechanisms. The experiments results reveal that the catalyst prepared by deposition-precipitation (DP) method shows the strongest Pd-support interaction and the best light-off performance. In situ DRIFTS results suggest that there exists alternative route of NOx reduction over Pd-DP catalyst. And it is supposed that Pd-support interaction leads to the difference of reaction mechanism and then the diversity of light-off performances.

[Study on the knowledge and attitude to adverse drug reactions reporting among healthcare professionals in Wuhan city].

OBJECTIVE: To investigate the knowledge and attitudes of healthcare professionals (doctors, nurses and administrators) to adverse drug reactions (ADR) in Wuhan city and to identify the reasons for under-reporting. METHODS: Structured interviews were carried out in Wuhan, Hubei province. Questionnaire survey to approximately 15% of the medical practitioners selected from 16 hospitals, was conducted during the period from February to March 2003. RESULTS: Only 2.7% of the interviewees knew the definition of adverse drug reactions. 61.7% of the doctors, 62.7% of the nurses and 61.1% of the administrators had ever encountered an ADR during their practices, but did not report to the national monitoring center or other centers. The major reasons for not reporting included: ignorant about the requirement and the reporting process of ADR (71.4%); address of the reporting agency and Forms unavailable (67.9%, 60.4%); unaware of the existence of a national ADR reporting system (52.2%); needless to report as the ADR being too well known (44.1%). They mainly reported an ADR to the hospital pharmacy or other departments, or to the pharmaceutical administration. Education, training and developing new institutions were ways to improve the reporting system. CONCLUSIONS: Our results showed that healthcare professionals had little knowledge on the basic ADR knowledge. The main reasons for underreporting were related to factors on reporting process, address of related centers and unavailable of the Forms. Education and training to doctors and nurses to enhance the awareness of administrators were the ways to improve the reporting system.