ABSTRACT
Background and Objectives: Evidence-based medicine (EBM) promotes the integration of updated- best evidence with patient preferences and medical expertise for clinical decision-making. Despite the availability of high-quality evidence such as systematic review and meta-analysis, some clinicians manage their patients based on past experiences and expert opinion. Thus, this study was proposed to assess the knowledge, attitude, and practice of EBM among resident doctors at a tertiary care hospital in India. Participants and Methods: This cross-sectional questionnaire-based study was conducted among senior residents and final-year postgraduates (PGs) who were independently involved in clinical decision-making. By convenience sampling method, the participants were recruited, and the validated EBM Questionnaire (EBMQ) was distributed online for assessing the knowledge, attitude, and practice of EBM. Descriptive statistics were represented as frequency and proportions. Results: A total of 102 resident doctors participated with male preponderance (74.5%). Nearly, 96 (94.1%) participants were already practicing EBM and 21.6% had undergone EBM training. Textbooks (50%) were the most often referred sources for EBM information. Specific EBM databases such as MEDLINE and Cochrane were also utilized by 37.3% of participants. More than 70% of participants understood the terms such as a randomized controlled trial, case-control study, and P value. A higher proportion (80.4%) of participants showed a positive attitude about patient care improved by EBM. Conclusions: The majority of the resident doctors exhibited good knowledge and a positive attitude toward applying EBM in clinical decision-making. Periodic training through workshops or courses and integration of EBM with the PG curriculum would potentially enhance the EBM practice.
ABSTRACT
Background and Objectives: Under-reporting of adverse drug reactions (ADRs) is a major concern of the pharmacovigilance program of India and has deteriorated further with the Coronavirus Disease 2019 (COVID-19) pandemic. Imparting the knowledge of pharmacovigilance among nursing students would significantly enhance patient care. Hence, this study was framed to evaluate the effect of an educational intervention on awareness and attitude of ADR reporting among nursing students during the COVID-19 pandemic. Materials and Methods: A quasi-experimental pretest-post-test study was conducted among nursing students of a tertiary care hospital in South India. The students were asked to fill out a validated questionnaire to assess Knowledge, Attitude, and Practice on ADR reporting, before and after the educational intervention. Knowledge and attitude results were analysed using Mc Nemar's test. Results: A total of 135 nursing students attended the educational intervention and completed pretest and post-test questionnaires. Around 130 (96.3%) and 107 (79.3%) students were aware of pharmacovigilance and ADR monitoring center following the intervention. Median (interquartile range) of knowledge scores before and after the intervention were 3 (2-3) and 5 (3-7), respectively. Overall knowledge score of ADR reporting significantly improved after the intervention. Sixty two (45.9%) students agreed that ADR reporting would enhance patient safety. ADR reporting was practised by 52 (38.5%) participants. Nearly, 107 (79.3%) students were interested to participate in similar pharmacovigilance training programs. Conclusion: Educational intervention in pharmacovigilance improved the cognitive and affective domains of pharmacovigilance in nursing students. Periodic training programs are essential for sustained behavioural change in students.
ABSTRACT
BACKGROUND: Drug-induced hypersensitivity reaction is a potentially life-threatening condition reported among patients of different age groups. Phenytoin is a prototypic drug prescribed for the treatment of a variety of seizure disorders. Allergic reaction to phenytoin therapy in a newborn is relatively a rare clinical manifestation that is not frequently reported. OBJECTIVE: The objective of this study is to report a suspected case of hypersensitivity reaction in a newborn possibly due to phenytoin and the strategies to prevent these immune-mediated reactions. CASE REPORT: An early term newborn on the 4th day of life developed erythematous rashes over the abdominal region following phenytoin treatment for recurrent generalized tonic-clonic seizures. Prenatal history was uneventful except for the mother had preeclampsia during the third trimester of pregnancy. The suspected phenytoin was replaced with phenobarbitone to control seizure episodes. Subsequently, the rashes disappeared. The baby had also suffered from skin discolouration after phototherapy. Radiological investigations and cerebrospinal fluid culture were performed to detect the etiology of seizures. CONCLUSION: Hypersensitivity reaction to phenytoin in newborns is a rare clinical entity but may lead to serious lethal complications. Thus, stringent clinical monitoring of patients on phenytoin therapy is mandatory, especially in the pediatric population.
