Knowledge And Practice Of Clinicians Regarding Adverse Effects Of Contrast Media And Their Predisposing Factors

Abstract

Background: Contrast medium is an agent used to enhance the difference in appearance between different structures and fluids in the body during imaging and is among the most commonly used drugs. Adverse contrast media reactions to are seen in up to 12% of patients in which 0.26% are severe or very severe and about 1.1 to 1.2 per million fatal. Knowledge on the adverse reactions of contrast agents and their predisposing factors is essential to ensure that measures are taken to prevent their occurrence. Objective: This study’s aim was to determine the knowledge and practice of clinicians working in Kenyatta National Hospital (KNH) in regard to contrast agent adverse reactions and their predisposing factors. Materials and methods: A cross sectional study was carried out among 197 clinicians who had no radiological training working in KNH between April 2015 and December 2015. Simple random sampling was used to select participants. Questionnaires assessing the level of knowledge were administered to the clinicians. Prior to this, practice was assessed by reviewing 220 patients for risk factors followed by evaluation of their request forms for the same. Statistical package for social studies (SPSS) was utilized for data analysis. Results: Most of the respondents gave a satisfactory definition of contrast media reactions (59.4%). However, there were low levels of awareness among clinicians working in KNH on specific examples of adverse effects of contrast media and their predisposing factors. Anaphylactic reactions and contrast induced kidney injury were the most documented reactions; however, they were documented by a minority of the respondents. Only 2% of the clinicians correctly stated that there are no absolute contraindications to contrast media administration. Conclusion: Referring clinicians working in KNH demonstrated inadequate knowledge on contrast media reactions and their predisposing factors. Recommendations: Better interaction between radiologists and clinicians, structured training of clinicians on contrast media reactions and a checklist on contrast media reactions and their predisposing factors are warranted.