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García-Abeijon P, Costa C, Taracido M, Herdeiro MT, Torre C, Figueiras A. Factors Associated with Underreporting of Adverse Drug Reactions by Health Care Professionals: A Systematic Review Update. Drug Saf 2023:10.1007/s40264-023-01302-7. [PMID: 37277678 DOI: 10.1007/s40264-023-01302-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2023] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Underreporting is a major limitation of the voluntary reporting system of adverse drug reactions (ADRs). A 2009 systematic review showed the knowledge and attitudes of health professionals were strongly related with underreporting of ADRs. OBJECTIVE Our aim was to update our previous systematic review to determine factors (sociodemographic, knowledge and attitudes) associated with the underreporting of ADRs by healthcare professionals. METHODS We searched the MEDLINE and EMBASE databases for studies published between 2007 and 2021 that met the following inclusion criteria: (1) published in English, French, Portuguese or Spanish; (2) involving health professionals; and (3) the goal was to evaluate factors associated with underreporting of ADRs through spontaneous reporting. RESULTS Overall, 65 papers were included. While health professional sociodemographic characteristics did not influence underreporting, knowledge and attitudes continue to show a significant effect: (1) ignorance (only serious ADRs need to be reported) in 86.2%; (2) lethargy (procrastination, lack of interest, and other excuses) in 84.6%; (3) complacency (the belief that only well tolerated drugs are allowed on the market) in 46.2%; (4) diffidence (fear of appearing ridiculous for reporting merely suspected ADRs) in 44.6%; and (5) insecurity (it is nearly impossible to determine whether or not a drug is responsible for a specific adverse reaction) in 33.8%, and the absence of feedback in 9.2%. In this review, the non-obligation to reporting and confidentiality emerge as new reasons for underreporting. CONCLUSIONS Attitudes regarding the reporting of adverse reactions continue to be the main determinants of underreporting. Even though these are potentially modifiable factors through educational interventions, minimal changes have been observed since 2009. CLINICAL TRIALS REGISTRATION PROSPERO registration number CRD42021227944.
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Affiliation(s)
- Patricia García-Abeijon
- Department of Public Health, Faculty of Farmacy, University of Santiago de Compostela, Praza do Seminario de Estudos Galegos, s/n, 15705, Santiago de Compostela, Spain
| | - Catarina Costa
- Faculdade de Farmácia da, Universidade de Lisboa, Lisbon, Portugal
| | - Margarita Taracido
- Department of Public Health, Faculty of Farmacy, University of Santiago de Compostela, Praza do Seminario de Estudos Galegos, s/n, 15705, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), Madrid, Spain
| | - Maria Teresa Herdeiro
- Department of Medical Sciences, Institute of Biomedicine-iBiMED, University of Aveiro, Aveiro, Portugal
| | - Carla Torre
- Faculdade de Farmácia da, Universidade de Lisboa, Lisbon, Portugal
- Laboratory of Systems Integration Pharmacology, Clinical and Regulatory Science, Research Institute for Medicines (iMED.ULisboa), Lisbon, Portugal
| | - Adolfo Figueiras
- Department of Public Health, Faculty of Farmacy, University of Santiago de Compostela, Praza do Seminario de Estudos Galegos, s/n, 15705, Santiago de Compostela, Spain.
- Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), Madrid, Spain.
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Rotimi K, Aiden J, Dabes C, Maduka K, Oguche D, Itiola AJ, Oresanya O. Pharmacovigilance reporting during seasonal malaria chemoprevention campaign: Findings from northern Nigeria. SCIENTIFIC AFRICAN 2022. [DOI: 10.1016/j.sciaf.2022.e01283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Adedeji WA, Adegoke AB, Fehintola FA. Adverse drug reactions reporting practice and associated factors among community health extension workers in public health facilities, Southwest, Nigeria. Pan Afr Med J 2022; 40:165. [PMID: 34970407 PMCID: PMC8683451 DOI: 10.11604/pamj.2021.40.165.28574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/28/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction timely adverse drug reactions (ADRs) reporting has contributed immensely towards public health safety. Community health extension workers (CHEWs) provides basic medical care in rural areas. This study assessed the knowledge, attitude, practice, and determinants of ADRs reporting among CHEWs in public health institutions, Southwest, Nigeria. Methods a cross-sectional survey of 333 CHEWs randomly selected from public health facilities using self-administered questionnaires. The questionnaire sought information on the knowledge, attitude and practice of CHEWs towards ADRs reporting. The knowledge and attitude questions were scored and categorized. The association between dependent and independent variables assessed with bivariate and multivariate logistic regressions, and p < 0.05 considered statistically significant. Results among 333 respondents, 205 (61.6%) had encountered patients with ADRs but only 26 (12.6%) had reported it with yellow forms. About half, 169 (50.8%), and 191 (57.4%) respondents had a positive attitude and inadequate knowledge of ADRs reporting respectively. Sex (aOR: 2.84, 95% CI: 2.10-7.10; p < 0.0001), working in Ogbomoso area (aOR: 3.3, 95% CI: 1.34-8.21; p=0.01), and training (aOR: 2.01, 95% CI: 1.20-3.42; p = 0.01) were factors associated with adequate knowledge. The determinant of ADRs reporting was training (aOR: 3.63, 95% CI: 1.13-11.63; p = 0.03). Conclusion though CHEWs had a slightly positive attitude, they had inadequate knowledge and poor ADRs reporting. The determinant of inadequate ADRs reporting knowledge and under reporting was lack of training. There is an urgent need for educational intervention programmes towards improving knowledge and practices of ADRs reporting among CHEWs.
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Affiliation(s)
- Waheed Adeola Adedeji
- Department of Pharmacology and Therapeutics, University of Ibadan, Ibadan, Oyo State, Nigeria.,Department of Clinical Pharmacology, University College Hospital, Ibadan, Oyo State, Nigeria
| | - AbdulKabir Babajide Adegoke
- Department of Community Health and Primary Care, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - Fatai Adewale Fehintola
- Department of Pharmacology and Therapeutics, University of Ibadan, Ibadan, Oyo State, Nigeria.,Department of Clinical Pharmacology, University College Hospital, Ibadan, Oyo State, Nigeria
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Adegbuyi TA, Fadare JO, Araromi EJ, Sijuade AO, Bankole I, Fasuba IK, Alabi RA. Assessment of Knowledge, Attitude and Practice of Adverse Drug Reaction Reporting Among Healthcare Professionals working in Primary, Secondary and Tertiary Healthcare Facilities in Ekiti State, South-West Nigeria. Hosp Pharm 2021; 56:751-759. [PMID: 34732934 DOI: 10.1177/0018578720957968] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Adverse drug reactions (ADRs) constitute a significant global healthcare challenge associated with increased morbidity, mortality and healthcare costs; however, there are concerns that ADRs are grossly under-reported by different categories of healthcare professionals (HCPs) in many countries. The main objective of this study was to assess the knowledge, attitude and practice of ADR reporting of HCPs working at the primary, secondary and tertiary levels of care in Ekiti State, Nigeria. Methodology This was a self-administered questionnaire-based study conducted among HCPs working in Ekiti State, South-west Nigeria. The questionnaire which was adapted from ones used in similar studies was reviewed for content validity by experts in the field. Healthcare professionals (medical doctors, pharmacists, nurses, community health extension workers, and other allied HCPs) working in the 3 tiers of healthcare participated in the study. The questionnaire consisted of sections on the demographics of respondents, their knowledge, attitude and practice of ADR reporting. Data analysis was done using SPSS (version 25) employing t test, ANOVA and chi-square as appropriate with P-value < .05 accepted as being statistically significant. Results Three hundred HCPs comprising of nurses (112; 37.3%), physicians (75; 25.0%), pharmacists (53; 17.7%), community health extension workers (40; 13.3%) and others (20; 6.7%) completed the questionnaire with 166 (55.3%) of them working in tertiary healthcare facilities. Male respondents (6.3 ± 1.7; P = .003), pharmacists (7.0 ± 1.6; P < .0001), HCPs and those from tertiary centers (6.2 ± 1.7; P = .028) had higher knowledge scores. While 228 (76%) respondents had observed incidents of ADR during their professional practice, only 75 (25%) have ever reported it. Only 113 (37.7%) of respondents had seen the adverse drug reaction reporting form with only 53 (17.7%) ever using it. The reporting methods preferred by respondents were through email/internet (102; 34.0%), phone/SMS (78; 26.0%) and using the hard copy of the forms (95; 31.7%). The attitude of respondents towards ADR reporting was mainly positive. Conclusion There was significant variation in the knowledge of different categories of HCPs and facility levels about ADR reporting. Encouragingly, the overall attitude of respondents towards ADR reporting was positive. Based on the above, strategies are needed to build capacity of HCPs in the area of on adverse drug reaction and its' reporting.
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Affiliation(s)
| | - Joseph O Fadare
- Ekiti State University, Ado-Ekiti, Nigeria.,Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | | | | | - Iyanu Bankole
- Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
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Adedapo ADA, Adedeji WA, Adedapo IA, Adedapo KS. Cohort study on adverse drug reactions in adults admitted to the medical wards of a tertiary hospital in Nigeria: Prevalence, incidence, risk factors and fatality. Br J Clin Pharmacol 2020; 87:1878-1889. [PMID: 32991765 DOI: 10.1111/bcp.14577] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 12/15/2022] Open
Abstract
AIMS Intensive monitoring of medical patients for adverse drug reactions (ADRs) to assess prevalence, incidence, risk factors and fatality of ADRs leading to hospital admission or occurring in the hospital. METHODS Prospective cohort study on 1280 adult patients admitted to the medical wards of a tertiary institution over 12 months. Patients were assessed for ADRs during and throughout admission; causality and preventability of ADRs were assessed. RESULTS Sixty-seven (5.2%) patients had ADRs, 51 (3.9%) caused hospitalisation while 17(1.3%) occurred during hospitalisation, and 42 (62.7%) of total ADRs were preventable. Nonsteroidal anti-inflammatory drugs, 14 (20.3%), antidiabetics, 12 (17.4%) and antibacterial, 11 (15.8%) were the most implicated drug classes. Gastrointestinal tract (37%), central nervous system (30.2%), and skin (24.7%) were the most affected organ/systems, while upper gastrointestinal bleeding and hypoglycaemia were the most observed ADRs. ADRs led to deaths in 7 (10.4%) patients, with an overall case fatality rate of 0.5%. The highest number of deaths were among patients with Stevens-Johnson syndrome 2/7 (28.6%) and hepatotoxicity 2/7 (28.6%). Risk factors, adjusted odds ratio (AOR [95% confidence interval, CI]) for ADRs leading to hospitalisation was male sex 3.11 (1.11, 8.73) while for ADRs during hospitalisation were number of drugs used before admission (AOR [95% CI] = 6.67 [1.16, 38.47]) and comorbidities (AOR [95% CI] = 3.0 [1.13, 8.01]). Patients admitted with ADRs had prolonged hospital stay (AOR [95% CI] = 3.37 [1.11, 8.71]). CONCLUSION Preventable ADRs are common and important causes of hospitalisation and inpatients' morbidity and mortality among medical patients in Nigeria. Upper gastrointestinal bleeding and hypoglycaemia, resulting from nonsteroidal anti-inflammatory drugs and antidiabetic drugs were the most observed ADRs.
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Affiliation(s)
- Aduragbenro D A Adedapo
- Department of Pharmacology and Therapeutics, University of Ibadan, Ibadan, Oyo State, Nigeria.,Department of Clinical Pharmacology, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Waheed A Adedeji
- Department of Pharmacology and Therapeutics, University of Ibadan, Ibadan, Oyo State, Nigeria.,Department of Clinical Pharmacology, University College Hospital, Ibadan, Oyo State, Nigeria
| | | | - Kayode S Adedapo
- Department of Chemical Pathology, College of Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
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Gidey K, Seifu M, Hailu BY, Asgedom SW, Niriayo YL. Healthcare professionals knowledge, attitude and practice of adverse drug reactions reporting in Ethiopia: a cross-sectional study. BMJ Open 2020; 10:e034553. [PMID: 32102821 PMCID: PMC7046472 DOI: 10.1136/bmjopen-2019-034553] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE This study aimed to assess the knowledge, attitude and practice of adverse drug reactions (ADRs) reporting and identify factors associated with ADRs reporting among healthcare professionals (HCPs) working in Tigray region, Ethiopia. MATERIALS AND METHODS A cross-sectional study was conducted between January and March of 2019 in a tertiary care hospital in Tigray region, Ethiopia. A self-administered, pretested questionnaire was administered to HCPs. Data were summarised using descriptive statistics. Logistic regression analysis was used to identify factors associated with poor ADRs reporting practices. RESULTS In total, 362 questionnaires were distributed, and the response rate was 84.8% (n=307). Of all respondents, 190 (61.9%) were nurses, 63 (20.5%) were pharmacist and 54 (17.6%) were physicians. About 58.3% of HCPs had poor knowledge of ADRs reporting. The majority of the respondents had a positive attitude (59.9%), and only a few (32.1%) respondents have good ADRs reporting practices. Poor knowledge (adjusted OR (AOR)=2.63, 95% CI: 1.26 to 5.45) and lack of training on ADRs reporting (AOR=7.31, 95% CI: 3.42 to 15.62) were both negatively associated with ADRs reporting practice, whereas higher work experience (≥10 years) (AOR=0.36, 95% CI: 0.13 to 0.97) was positively associated with ADRs reporting practice. CONCLUSIONS The majority of HCPs had poor knowledge and practice, but a positive attitude towards ADRs reporting. Poor knowledge, less work experience and lack of training were associated with poor ADRs reporting practice. Hence, strategies to improve the knowledge and practice of ADRs reporting should be implemented, particularly for untrained and less experienced HCPs.
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Affiliation(s)
- Kidu Gidey
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Mohammedamin Seifu
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Berhane Yohannes Hailu
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Solomon Weldegebreal Asgedom
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Yirga Legesse Niriayo
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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Avong YK, Jatau B, Gurumnaan R, Danat N, Okuma J, Usman I, Mordi D, Ukpabi B, Kayode GA, Dutt S, El-Tayeb O, Afolabi B, Ambrose I, Agbaji O, Osakwe A, Ibrahim A, Ogar C, Nosiri H, Avong EB, Adekanmbi V, Uthman O, Abimiku A, Oni YO, Mensah CO, Dakum P, Mberu KE, Ogundahunsi OAT. Addressing the under-reporting of adverse drug reactions in public health programs controlling HIV/AIDS, Tuberculosis and Malaria: A prospective cohort study. PLoS One 2018; 13:e0200810. [PMID: 30133453 PMCID: PMC6104922 DOI: 10.1371/journal.pone.0200810] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 07/03/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Adverse Drug Reactions (ADRs) are a major clinical and public health problem world-wide. The prompt reporting of suspected ADRs to regulatory authorities to activate drug safety surveillance and regulation appears to be the most pragmatic measure for addressing the problem. This paper evaluated a pharmacovigilance (PV) training model that was designed to improve the reporting of ADRs in public health programs treating the Human Immunodeficiency Virus (HIV), Tuberculosis (TB) and Malaria. METHODS A Structured Pharmacovigilance and Training Initiative (SPHAR-TI) model based on the World Health Organization accredited Structured Operational Research and Training Initiative (SOR-IT) model was designed and implemented over a period of 12 months. A prospective cohort design was deployed to evaluate the outcomes of the model. The primary outcomes were knowledge gained and Individual Case Safety Reports (ICSR) (completed adverse drug reactions monitoring forms) submitted, while the secondary outcomes were facility based Pharmacovigilance Committees activated and health facility healthcare workers trained by the participants. RESULTS Fifty-five (98%) participants were trained and followed up for 12 months. More than three quarter of the participants have never received training on pharmacovigilance prior to the course. Yet, a significant gain in knowledge was observed after the participants completed a comprehensive training for six days. In only seven months, 3000 ICSRs (with 100% completeness) were submitted, 2,937 facility based healthcare workers trained and 46 Pharmacovigilance Committees activated by the participants. Overall, a 273% increase in ICSRs submission to the National Agency for Food and Drug Administration and Control (NAFDAC) was observed. CONCLUSION Participants gained knowledge, which tended to increase the reporting of ADRs. The SPHAR-TI model could be an option for strengthening the continuous reporting of ADRs in public health programs in resource limited settings.
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Affiliation(s)
- Yohanna Kambai Avong
- Institute of Human Virology, Nigeria, Maina Court, Central Business District, Abuja, Nigeria
| | - Bolajoko Jatau
- Institute of Human Virology, Nigeria, Maina Court, Central Business District, Abuja, Nigeria
| | - Ritmwa Gurumnaan
- Institute of Human Virology, Nigeria, Maina Court, Central Business District, Abuja, Nigeria
| | - Nanfwang Danat
- Institute of Human Virology, Nigeria, Maina Court, Central Business District, Abuja, Nigeria
| | - James Okuma
- Institute of Human Virology, Nigeria, Maina Court, Central Business District, Abuja, Nigeria
| | - Istifanus Usman
- Institute of Human Virology, Nigeria, Maina Court, Central Business District, Abuja, Nigeria
| | - Dennis Mordi
- Institute of Human Virology, Nigeria, Maina Court, Central Business District, Abuja, Nigeria
| | - Blessing Ukpabi
- Institute of Human Virology, Nigeria, Maina Court, Central Business District, Abuja, Nigeria
| | - Gbenga Ayodele Kayode
- Institute of Human Virology, Nigeria, Maina Court, Central Business District, Abuja, Nigeria
| | - Saswata Dutt
- Institute of Human Virology, Nigeria, Maina Court, Central Business District, Abuja, Nigeria
| | - Osman El-Tayeb
- Demian Foundation of Belgium, Ibadan, Oyo State, Nigeria
| | - Bamgboye Afolabi
- Health, Environment and Development Foundation, Lagos State, Lagos, Nigeria
| | - Isah Ambrose
- Faculty of Pharmaceutical Sciences, University of Benin, Benin City, Edo State, Benin, Nigeria
| | - Oche Agbaji
- Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | | | - Ali Ibrahim
- National Agency for Food and Drug Administration and Control, Federal Capital Territory, Abuja, Nigeria
| | - Comfort Ogar
- National Agency for Food and Drug Administration and Control, Federal Capital Territory, Abuja, Nigeria
| | - Helga Nosiri
- National Agency for Food and Drug Administration and Control, Federal Capital Territory, Abuja, Nigeria
| | | | - Victor Adekanmbi
- Division of Population Medicine, Cardiff University, Cardiff, United Kingdom
| | - Olalekan Uthman
- Warwick Medical School, University of Warwick, Coventry United Kingdom
| | - Alash’le Abimiku
- Institute of Human Virology, Nigeria, Maina Court, Central Business District, Abuja, Nigeria
| | - Yetunde O. Oni
- National Agency for Food and Drug Administration and Control, Federal Capital Territory, Abuja, Nigeria
| | - Charles Olalekan Mensah
- Institute of Human Virology, Nigeria, Maina Court, Central Business District, Abuja, Nigeria
| | - Patrick Dakum
- Institute of Human Virology, Nigeria, Maina Court, Central Business District, Abuja, Nigeria
| | - Kamau Edward Mberu
- Special Program for Research in Tropical Diseases, World Health Organization (TDR), Geneva, Switzerland
| | - Olumide A. T. Ogundahunsi
- Special Program for Research in Tropical Diseases, World Health Organization (TDR), Geneva, Switzerland
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Dorji C, Tragulpiankit P, Riewpaiboon A, Tobgay T. Knowledge of Adverse Drug Reaction Reporting Among Healthcare Professionals in Bhutan: A Cross-Sectional Survey. Drug Saf 2017; 39:1239-1250. [PMID: 27743333 DOI: 10.1007/s40264-016-0465-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The Bhutan National Pharmacovigilance Centre (NPC) became an official member of the WHO Programme for International Drug Monitoring in December 2014; however, the number of adverse drug reactions (ADRs) reported is very low (50 reports per 773,722 inhabitants over 10 years). Surveys of healthcare professionals (HCPs) in similar countries have indicated that adequate knowledge of both ADRs and ADR reporting is likely to increase the number of ADR reports submitted. OBJECTIVE The aim of this study was to investigate the level of knowledge of both ADRs and ADR reporting among HCPs, including traditional medicine practitioners. METHODS A cross-sectional survey was conducted, using a validated self-administered questionnaire. The questionnaires were distributed to 670 HCPs, including clinical doctors, nurses, pharmacists and traditional medicine practitioners from four referral hospitals. The survey consisted of 12 questions pertaining to ADRs and 10 questions pertaining to knowledge of ADR reporting. The collected response was then analysed descriptively and results presented as mean ± standard deviation (SD) using SPSS version 20. RESULTS The overall response rate was 434 (65 %) questionnaires, with HCPs consisting of clinical doctors (94, 22 %), nurses (257, 59 %), pharmacists (52, 12 %) and traditional medicine practitioners (31, 7 %). The overall mean ± SD score with regard to the level of knowledge of ADRs was 6.52 ± 2.81 out of a maximum score of 12, among which clinical doctors scored 7.48 ± 2.95, nurses 6.15 ± 2.47, pharmacists 8.15 ± 2.49 and traditional medicine practitioners 4.13 ± 3.18. The mean ± SD score with regard to the level of knowledge of ADR reporting among HCPs was 3.94 ± 1.89 out of a maximum score of 10, among which clinical doctors scored 3.93 ± 1.81, nurses 3.75 ± 1.74, pharmacists 5.00 ± 1.81 and traditional medicine practitioners 4.00 ± 1.77. CONCLUSION Clinical doctors and pharmacists have better knowledge of ADRs than nurses and traditional medicine practitioners, while knowledge of ADR reporting was low for all HCPs surveyed.
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Affiliation(s)
- Choki Dorji
- Department of Pharmacy, Faculty of Pharmacy, Mahidol University, 447 Sri-Ayudhaya Road, Bangkok, 10400, Thailand.,Drug Regulatory Authority, Thimphu, Bhutan
| | - Pramote Tragulpiankit
- Department of Pharmacy, Faculty of Pharmacy, Mahidol University, 447 Sri-Ayudhaya Road, Bangkok, 10400, Thailand.
| | - Arthorn Riewpaiboon
- Department of Pharmacy, Faculty of Pharmacy, Mahidol University, 447 Sri-Ayudhaya Road, Bangkok, 10400, Thailand
| | - Tashi Tobgay
- Khesar Gyalpo University of Medical Sciences, Thimphu, Bhutan
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Iribhogbe OI, Emmanuel I, Odianosen M. Comparative analysis of the safety and tolerability of fixed-dose artesunate/amodiaquine versus artemether/lumefantrine combinations for uncomplicated falciparum malaria in pregnancy: a randomized open label study. Clin Pharmacol 2017; 9:45-54. [PMID: 28533699 PMCID: PMC5431733 DOI: 10.2147/cpaa.s131351] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
A comparative clinical study was conducted to evaluate the safety and tolerability of two commonly used fixed dose artemisinin-based combinations for the treatment of uncomplicated Plasmodium falciparum malaria in the second and third trimester of pregnancy. To achieve this, a total of 155 participants were recruited for the study. Eighty of these were drawn from pregnant women who came for routine antenatal care while 40 nonpregnant participants were recruited from apparently healthy females in the community. Eighty pregnant participants with uncomplicated P. falciparum malaria were randomized into artesunate/amodiaquine (AA) and artemether/lumefantrine (AL) treatment arms while 40 nonpregnant and 35 nonmalarious pregnant women were used as control. The interventional groups received standard fixed dose combinations of AA (100/270 mg) daily or AL (20/120 mg) twice daily for 3 days. Blood samples were collected on day 4 and patients were followed-up closely to ascertain the safety of the drugs. The study showed a significant (p<0.0001) elevation of alkaline phosphatase in the AA and AL group compared to the nonpregnant control and a significant (p<0.05) elevation of alanine transaminase and aspartate transaminase level in the AL combination group when compared with the AA group. The elevated hepatic enzymes were within the normal range for pregnancy and were not clinically significant. Adverse event rate was higher in the AA group (n=28 [70%]) when compared to the AL group (n=4 [10%]) although the drugs were well-tolerated in both treatment arms. In conclusion, the use of these combinations is safe in the second and third trimester of pregnancy. However, we recommend active pharmacovigilance and spontaneous drug reporting of the agents in order to continuously monitor safety in the vastly heterogeneous population.
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Affiliation(s)
| | - Igue Emmanuel
- Department of Human Physiology College of Medicine, Ambrose Alli University Ekpoma, Edo State, Nigeria
| | - Marylove Odianosen
- Department of Human Physiology College of Medicine, Ambrose Alli University Ekpoma, Edo State, Nigeria
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10
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Evaluation of Pharmacovigilance Practice in Pharmaceutical Companies in Nigeria. Pharmaceut Med 2016. [DOI: 10.1007/s40290-016-0155-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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11
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Ezeuko AY, Ebenebe UE, Nnebue CC, Ugoji JO. Factors associated with the reporting of adverse drug reactions by health workers in nnewi Nigeria. Int J Prev Med 2015; 6:25. [PMID: 25949775 PMCID: PMC4387690 DOI: 10.4103/2008-7802.153862] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 01/01/2015] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Under-reporting of adverse drug reactions (ADRs) by the prescribers is a common public health problem. Monitoring of factors that influence ADR reporting will reduce risks associated with drug use; improve patients care, safety and treatment outcome. The aim of this study was to determine the factors associated with the reporting of ADRs by health workers in Nnewi Nigeria. METHODS A cross-sectional study of 372 health workers in different health facilities in Nnewi North Local Government Area of Anambra state, selected using multistage sampling technique was done. Data collection employed pretested, self-administered structured questionnaires. Data were analyzed using Statistical Package for Social Sciences version 17. Tests of statistical significance were carried out using Chi-square tests for proportions. A P < 0.05 was considered significant. RESULTS Out of the 372 respondents studied, 255 (68.5%) were females, and 117 (31.5%) were males. The modal age range (37.6%) was 31-40 years. Factors related by the respondents to influence ADR reporting include: Unavailability of electronic reporting (83.6%), unavailability of reporting forms (66.4%) and ignorance (58.2%). The difference among medical practitioners who related unavailability of electronic reporting process as obstacle to ADR reporting was not significant (P = 0.18). CONCLUSIONS The study results revealed the factors associated with the reporting of ADRs among health workers in Nnewi Nigeria. It is desirable to initiate electronic reporting process, training programs on ADR reporting and make reporting forms/guidelines available to relevant health workers.
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Affiliation(s)
- Amaka Y. Ezeuko
- Department of Pharmacy, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - Uzo E. Ebenebe
- Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - Chinomnso C Nnebue
- Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
- Department of HIV Care, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - John O. Ugoji
- Department of Pharmacy, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
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Avong YK, Isaakidis P, Hinderaker SG, Van den Bergh R, Ali E, Obembe BO, Ekong E, Adebamowo C, Ndembi N, Okuma J, Osakwe A, Oladimeji O, Akang G, Obasanya JO, Eltayeb O, Agbaje AV, Abimiku A, Mensah CO, Dakum PS. Doing no harm? Adverse events in a nation-wide cohort of patients with multidrug-resistant tuberculosis in Nigeria. PLoS One 2015; 10:e0120161. [PMID: 25781958 PMCID: PMC4364363 DOI: 10.1371/journal.pone.0120161] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 02/03/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Adverse events (AEs) of second line anti-tuberculosis drugs (SLDs) are relatively well documented. However, the actual burden has rarely been described in detail in programmatic settings. We investigated the occurrence of these events in the national cohort of multidrug-resistant tuberculosis (MDR-TB) patients in Nigeria. METHOD This was a retrospective, observational cohort study, using pharmacovigilance data systematically collected at all MDR-TB treatment centers in Nigeria. Characteristics of AEs during the intensive phase treatment were documented, and risk factors for development of AEs were assessed. RESULTS Four hundred and sixty patients were included in the analysis: 62% were male; median age was 33 years [Interquartile Range (IQR):28-42] and median weight was 51 kg (IQR: 45-59). Two hundred and three (44%) patients experienced AEs; four died of conditions associated with SLD AEs. Gastro-intestinal (n = 100), neurological (n = 75), ototoxic (n = 72) and psychiatric (n = 60) AEs were the most commonly reported, whereas ototoxic and psychiatric AEs were the most debilitating. Majority of AEs developed after 1-2 months of therapy, and resolved in less than a month after treatment. Some treatment centers were twice as likely to report AEs compared with others, highlighting significant inconsistencies in reporting at different treatment centers. Patients with a higher body weight had an increased risk of experiencing AEs. No differences were observed in risk of AEs between HIV-infected and uninfected patients. Similarly, age was not significantly associated with AEs. CONCLUSION Patients in the Nigerian MDR-TB cohort experienced a wide range of AEs, some of which were disabling and fatal. Early identification and prompt management as well as standardized reporting of AEs at all levels of healthcare, including the community is urgently needed. Safer regimens for drug-resistant TB with the shortest duration are advocated.
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Affiliation(s)
| | - Petros Isaakidis
- Médecins Sans Frontières, Operational Research Unit, Luxembourg City, Luxembourg
| | | | - Rafael Van den Bergh
- Médecins Sans Frontières, Operational Research Unit, Luxembourg City, Luxembourg
| | - Engy Ali
- Médecins Sans Frontières, Operational Research Unit, Luxembourg City, Luxembourg
| | | | | | - Clement Adebamowo
- Institute of Human Virology, Abuja, Nigeria
- University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | | | | | - Adeline Osakwe
- National Agency for Food and Drug Administration Control, Abuja, Nigeria
| | - Olanrewaju Oladimeji
- Zankli Medical Centre, Abuja, Nigeria
- Liverpool School of Tropical Medicines, Pembroke Place, Liverpool, United Kingdom
| | - Gabriel Akang
- National Tuberculosis and Leprosy Control Program, Abuja, Nigeria
| | | | - Osman Eltayeb
- Damien Foundation Belgium, Nigeria Project, Ibadan, Nigeria
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Nde F, Fah ABD, Simo FA, Wouessidjewe D. State of knowledge of Cameroonian drug prescribers on pharmacovigilance. Pan Afr Med J 2015; 20:70. [PMID: 26090028 PMCID: PMC4450046 DOI: 10.11604/pamj.2015.20.70.3873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 01/05/2015] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION The present study conducted in Cameroon from June 2013 to February 2014 aimed to estimating the level of pharmacovigilance knowledge and practice of health professionals in Cameroon. METHODS We conducted a descriptive cross-sectional survey on 149 health professionals in Cameroon from June to September 2013. Data were analyzed using software IBM SPSS 20.0. We calculated proportions and odd ratio, and confident interval of their values, keeping a threshold of p of 0.05 to determine the level of significance. RESULTS Ninety percent (90%) of declaration of side effects were made to the medical representatives and 4% to the National Pharmacovigilance Centre. Fifty four percent (54%) of physicians were not aware of the existence of a National Pharmacovigilance system. Ten (10%) of prescribers had never heard of pharmacovigilance, however respondents answered unanimously that they need training on pharmacovigilance. A wrong definition was given by most of the nurses and dentists (61,1% and 58,3% respectively) as compared to physicians and pharmacists (respectively 15.2% and 26,5%). Given the results of this study, the establishment of a National Pharmacovigilance system based on a solid legal foundation is necessary in Cameroon. This implementation must go through the involvement of all stakeholders and their awareness raising on the importance of this activity and its positive impact on the health of populations. CONCLUSION Pharmacovigilance is a public health problem in Cameroon, with due to lack of good knowledge and practice of prescribers, precisely physicians, pharmacists, nurses, and dentists who are not always aware of an existing pharmacovigilance system in Cameroon.
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Affiliation(s)
- Francis Nde
- Acute Medicine, Medicine of Catastrophes, Public Health, Epidemiology, Biostatistics, Pharmaceutical Medicine, Faculty of Medicine and Pharmaceutical Sciences, at University of Douala, Douala, Cameroon
| | | | | | - Denis Wouessidjewe
- Joseph Fourier de Grenoble University, UFR de Pharmacology, Department Molecular Pharmacology, UMR 5063, Bât. E (André Rassat), Pôle chimie - BP53, 38041 Grenoble
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Kiguba R, Karamagi C, Waako P, Ndagije HB, Bird SM. Recognition and reporting of suspected adverse drug reactions by surveyed healthcare professionals in Uganda: key determinants. BMJ Open 2014; 4:e005869. [PMID: 25421337 PMCID: PMC4244492 DOI: 10.1136/bmjopen-2014-005869] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To assess extent and determinants of past-month recognition of suspected adverse drug reactions (ADR) and past-year ADR reporting among healthcare professionals (HCPs) in Uganda. SETTING Geographically diverse health facilities (public, private for-profit, private not-for-profit). PARTICIPANTS Of 2000 questionnaires distributed, 1345 were completed: return rate of 67%. PRIMARY AND SECONDARY OUTCOME MEASURES Per cent HCPs who suspected ADR in the past month; reported ADR in the past year. RESULTS Nurses were the majority (59%, 792/1345). Only half the respondents had heard about pharmacovigilance: 39% of nurses (295/763; 95% CI 35% to 42%), 70% otherwise (383/547; 95% CI 66% to 74%). One fifth (268/1289 or 21%; 95% CI 19% to 23%) had suspected an ADR in the previous 4 weeks, 111 of them were nurses; 15% (190/1296) had reported a suspected ADR in the past year, 103 of them were nurses. Past-month ADR suspicion was more likely by non-nurses (OR=1.7, 95% CI 1.16 to 2.40) and with medical research involvement (OR=1.5, 95% CI 1.05 to 2.15) but past-month receipt of patient ADR-complaint predominated (OR=19, 95% CI 14 to 28). Past-year ADR reporting was higher by hospital staff (OR=1.9, 95% CI 1.18 to 3.10), especially in medicine (OR=2.3, 95% CI 1.08 to 4.73); but lower from private for-profit health facilities (OR=0.5, 95% CI 0.28 to 0.77) and by older staff (OR=0.6, 95% CI 0.43 to 0.91); more likely by HCPs who had ever encountered a fatal ADR (OR=2.9, 95% CI 1.94 to 4.25), knew to whom to report (OR=1.7, 95% CI 1.18 to 2.46), or suggested how to improve ADR reporting (OR=1.6, 95% CI 1.04 to 2.49). Two attitudinal factors were important: diffidence and lethargy. CONCLUSIONS One in five HCPs suspected an ADR in the past-month and one in seven reported ADR in the previous year. Empowering patients could strengthen ADR detection and reporting in Africa.
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Affiliation(s)
- Ronald Kiguba
- Department of Pharmacology and Therapeutics, Makerere University College of Health Sciences, Kampala, Uganda
| | - Charles Karamagi
- Clinical Epidemiology Unit, Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Paul Waako
- Department of Pharmacology and Therapeutics, Makerere University College of Health Sciences, Kampala, Uganda
| | - Helen B Ndagije
- National Pharmacovigilance Centre, National Drug Authority, Kampala, Uganda
| | - Sheila M Bird
- Medical Research Council Biostatistics Unit, Cambridge, UK
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Santosh KC, Tragulpiankit P, Gorsanan S, Edwards IR. Attitudes among healthcare professionals to the reporting of adverse drug reactions in Nepal. BMC Pharmacol Toxicol 2013; 14:16. [PMID: 23497690 PMCID: PMC3599543 DOI: 10.1186/2050-6511-14-16] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 02/27/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Healthcare professional's knowledge and attitudes to adverse drug reaction (ADR) and ADR reporting play vital role to report any cases of ADR. Positive attitudes may favour ADR reporting by healthcare professionals. This study was aimed to investigate the attitudes towards and ways to improve adverse drug reaction (ADR) reporting among healthcare professionals working at four Regional Pharmacovigilance Centres (RPCs) of Nepal. METHODS A cross sectional study was done by survey using a self-administered structured questionnaire. The questionnaire was distributed to 450 healthcare professionals working at four RPCs. RESULTS The overall response rate was 74.0%. There were 74.8% of healthcare professionals who had seen patient experiencing an ADR; however, only 20.1% had reported. Reporting form not available (48.1%) and other colleagues not reporting ADR cases (46.9%) would significantly discourage the ADR reporting among healthcare professionals working at four RPCs. Healthcare professionals perceived that seriousness of the reaction (75.6%); unusual reaction (64.6%); reaction to new product (71.2%); new reaction to existing product (70.2%); and confidence in diagnosis of ADR (60.8%) were important factors on the decision to report ADR. Awareness among healthcare professionals (85.9%), training (76.0%), collaboration (67.0%), and involve pharmacist for ADR reporting (63.1%) were mostly recognized ways to improve reporting. Regular newsletter on current awareness in drug safety (71.2%), information on new ADR (65.8%), and international drug safety information (64.0%) were the identified feedbacks they would like to receive from the Nepal pharmacovigilance programme. CONCLUSION Healthcare professionals working at four RPCs of Nepal have positive attitudes towards ADR reporting. Awareness among healthcare professionals, training and collaboration would likely improve reporting provided they would receive appropriate feedback from the national pharamcovigilance programme.
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Affiliation(s)
- K C Santosh
- Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
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Oreagba IA, Ogunleye OJ, Olayemi SO. The knowledge, perceptions and practice of pharmacovigilance amongst community pharmacists in Lagos state, south west Nigeria. Pharmacoepidemiol Drug Saf 2010; 20:30-5. [DOI: 10.1002/pds.2021] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Oshikoya KA. Extent of pharmacovigilance among resident doctors in Edo and Lagos states of Nigeria: important issues unaddressed by the authors. Pharmacoepidemiol Drug Saf 2010; 19:878-9. [DOI: 10.1002/pds.1996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2010. [DOI: 10.1002/pds.1850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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