Knowledge, attitude and practices of pharmacovigilance and adverse drug reaction reporting among pharmacists working in secondary and tertiary governmental hospitals in Kuwait

Barriers and Facilitators on Pharmacovigilance Practice Among Pharmacists in Metro Manila, Philippines

PURPOSE

The underreporting of adverse drug reactions (ADRs) remains a significant challenge in the Philippines. Pharmacists play a crucial role in ensuring medication safety, improving patient outcomes, and enhancing the overall effectiveness of pharmacovigilance (PV) systems. This study explored the barriers and facilitators affecting PV practices among pharmacists in Metro Manila.

METHODS

This study employed qualitative research through in-depth interviews using a semi-structured topic guide. Researchers interviewed pharmacists until data saturation was reached, where no new insights emerged. Qualitative data were analyzed inductively, utilizing Braun and Clarke's thematic analysis to identify key themes. MAXQDA was used to facilitate coding and analyzing the qualitative data.

RESULTS

A total of 40 pharmacists (72.5% female) participated in this study, evenly distributed across various practice areas and geographic locations in Metro Manila. The analysis identified four main themes related to pharmacists' nonreporting of ADRs: competency gaps, organizational challenges, reporting issues, and workplace constraints. Pharmacists' limited knowledge of ADRs and lack of experience in ADR reporting appear to be the primary barriers, along with environmental factors. Conversely, critical strategies for improving ADR notifications include capacity building, motivation and rewards, and work optimization.

CONCLUSION

Pharmacists recognize the importance of reporting ADRs and view it as a professional responsibility. By prioritizing knowledge enhancement, training, and system improvements, the identification and reporting of ADRs can be strengthened, ultimately enhancing patient safety and PV practices. This positive attitude toward ADR reporting lays the groundwork for interventions designed to overcome barriers and promote a culture of active reporting among pharmacists.

Knowledge, Attitude, and Practice Regarding Pharmacovigilance and Barriers to Reporting Adverse Drug Reactions Among the General Population in Saudi Arabia

Background

Pharmacovigilance (PV) is an essential part of the healthcare system's framework. In Saudi Arabia, pharmacovigilance is still a relatively new concept though it is well established in many countries.

Study Aim

In this study, we aim to evaluate knowledge, attitude, and practice regarding pharmacovigilance and barriers to reporting adverse drug reactions (ADRs) among the general public in Saudi Arabia.

Methods

This is a cross-sectional study that used a self-administered online questionnaire to assess knowledge, attitude, and practice of PV and ADRs. The study included only the adult population in Saudi Arabia. A scoring system was generated with a scale from 0 to 100, where 80% was set as a cut-off point, as any higher score resembled adequate knowledge, a positive attitude, and good practice. We used the Statistical Package for Social Sciences (SPSS) version 26 for performing the statistical analysis, where para-normal tests were used to associate scores with the socio-demographic characteristics of participants.

Results

The study collected 1098 complete responses. The mean age (±SD) of participants was 37.9±11.2 years. Females comprised 68.9% of the participants. The average knowledge score among participants was 37.8±18.5, where only 4.3% of respondents had adequate knowledge. The average attitude score was 90.1±19.2, where 83.4% had a positive attitude. The average practice score was 70.4±18, and 34.5% of participants had good practice.

Conclusion

The study found that the majority of participants had inadequate knowledge, a positive attitude, and poor practice. Individuals holding a master's degree or higher and those working in the healthcare sector had the highest knowledge scores, whereas the group aged 31 to 50 years old, participants from the Al Jawf region, participants who are married with children, holders of a master's degree or higher, and healthcare workers had the best attitude scores. Higher practice scores were seen among married individuals with children and those who work in the healthcare sector.

Healthcare professionals' willingness to utilize a mobile health application for adverse drug reaction reporting in a limited resource setting: An input for digital health, 2023

Background

Adverse drug reactions (ADRs) are a significant public health concern, particularly in limited resource settings where underreporting is prevalent due to various challenges. Mobile health applications (mHealth apps) offer a promising solution to enhance pharmacovigilance by facilitating easier and more efficient ADR reporting. However, despite the increasing availability and use of mHealth apps, there is a lack of evidence on healthcare professionals' willingness to adopt them for ADR reporting in resource-constrained environments. Therefore, this study aimed to assess the willingness of healthcare professionals in Ethiopia to utilize mobile health applications for adverse drug reaction reporting and identify associated factors.

Methods

We carried out a cross-sectional study involving 422 healthcare professionals working in institutional settings. We gathered data through a pretested questionnaire that participants completed themselves. We inputted the data using Epi Data V.4.6 and analyzed it using SPSS V.26. Our analysis involved conducting multivariable logistic regression to identify the factors influencing the likelihood of healthcare professionals using mobile applications to report adverse drug reactions.

Results

The study involved 389 healthcare professionals. Approximately 301 (77.4 %) of them expressed willingness to utilize mobile applications for reporting adverse drug reactions. The willingness to utilize mobile applications was significantly associated with the type of mobile phone (smart: AOR 3.56; 95 % CI 2.15-5.67), basic computer training (AOR 4.43; 95 % CI 2.27-8.64), mobile health-related training (AOR 1.96; 95 % CI 1.01-3.79), attitude (AOR 4.01; 95 % CI 2.19-7.35), perceived ease of use (AOR 2.91; 95 % CI 1.59-5.23), and perceived usefulness (AOR 2.10; 95 % CI 1.15-3.85).

Conclusions

Overall, there was a high proportion of healthcare professionals willing to use mobile devices for reporting drug adverse reactions. Their willingness correlated with factors such as the type of mobile phone, perceived ease of use, attitude, training, and perceived usefulness of mobile applications. With the increasing use of smartphones, motivation among healthcare professionals is rising. Basic computer and mHealth-related training are crucial for enhancing the acceptability of such applications and should be incorporated into future implementations. Taking these factors into account could offer insights into the design and implementation of mobile applications for adverse drug reactions in Ethiopia.

MetaLAB-HOI: Template standardization of health outcomes enable massive and accurate detection of adverse drug reactions from electronic health records

PURPOSE

This study aimed to advance the MetaLAB algorithm and verify its performance with multicenter data to effectively detect major adverse drug reactions (ADRs), including drug-induced liver injury.

METHODS

Based on MetaLAB, we created an optimal scenario for detecting ADRs by considering demographic and clinical records. MetaLAB-HOI was developed to identify ADR signals using common model-based multicenter electronic health record (EHR) data from the clinical health outcomes of interest (HOI) template and design for drug-exposed and nonexposed groups. In this study, we calculated the odds ratio of 101 drugs for HOI in Konyang University Hospital, Seoul National University Hospital, Chungbuk National University Hospital, and Seoul National University Bundang Hospital.

RESULTS

The overlapping drugs in four medical centers are amlodipine, aspirin, bisoprolol, carvedilol, clopidogrel, clozapine, digoxin, diltiazem, methotrexate, and rosuvastatin. We developed MetaLAB-HOI, an algorithm that can detect ADRs more efficiently using EHR. We compared the detection results of four medical centers, with drug-induced liver injuries as representative ADRs.

CONCLUSIONS

MetaLAB-HOI's strength lies in fully utilizing the patient's clinical information, such as prescription, procedure, and laboratory results, to detect ADR signals. Considering changes in the patient's condition over time, we created an algorithm based on a scenario that accounted for each drug exposure and onset period supervised by specialists for HOI. We determined that when a template capable of detecting ADR based on clinical evidence is developed and manualized, it can be applied in medical centers for new drugs with insufficient data.

Pharmacovigilance Concept Knowledge, Perspectives and Attitudes: A Cross-Sectional Study Among Community Pharmacists

The concept of pharmacovigilance (PV) is currently highlighted after emergency authorization and worldwide distribution of the urgently launched COVID-19 novel vaccinations. As they typically serve as the initial point of patient contact for medication-related issues, understanding the knowledge, perspectives, and attitudes of community pharmacists in PV and reporting adverse drug reactions (ADRs) is crucial to improving the healthcare system and public health policies. However, previous studies in Jordan have not focused entirely on community pharmacists. This study aimed to assess community pharmacists' knowledge, perspectives, and attitudes on PV and ADRs reporting in Jordan. The applied methodology in this study was based on a cross-sectional study design using a validated questionnaire distributed to a convenient sample of Jordanian community pharmacists. Seventeen questions were designed from different pieces of literature relating to knowledge, perspectives, and attitudes of PV among community pharmacists. Descriptive statistics (frequencies and percentages) were used to report the results data. The study questionnaire was completed by 180 of 325 community pharmacists willing to participate (a response rate of 55.4%). Of them (n = 132, 73%) were aware of the concept of PV. Additionally (n = 84, 47%) of the community pharmacists would use the concept and policy of PV in their everyday work. Nevertheless, only (n = 36, 20.0%) of the community pharmacists thought an ADR should be reported if seen, and approximately 120 pharmacists (67.0%) believed it was essential to report ADRs as patient health matters. Although community pharmacists in Jordan showed a considerable awareness level of PV, they demonstrated a low level of its application. Thus, ADR reporting is not considered a mainstay among them, and the implementation of PV is not yet addressed. The results from this study shed light on community pharmacists' perceptions and attitudes regarding ADR reporting and PV.

Understanding, readiness, and response of healthcare professionals in combating falsified medical products in Eritrea: a population-based survey

Background

The circulation of falsified medical products is a global threat and is expected to be higher in low- and middle-income countries.

Objective

This study was conducted to assess the understanding, readiness, and response of Eritrea's healthcare professionals (HCPs), and identify potential areas of intervention to combat circulation of falsified medical products.

Design

This was a nationwide population-based cross-sectional survey, conducted in December 2021.

Methods

This study enrolled representative samples of HCPs working in public and private health facilities. Two-stage stratified cluster sampling was used to select study participants and data were collected through face-to-face interviews. Descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test along with their post hoc tests, Jonckheere-Terpstra, and logistic regression analyses were performed as appropriate.

Results

The study enrolled 707 HCPs, and 96.6% were successfully surveyed. The majority of the participants (62.5%) encountered products with suspected quality defects and 63.8% claimed that they had reported the incident(s) at least once. About 85% reported that complaints should be submitted to the Eritrean Pharmacovigilance Centre and 74.0% indicated that it should be reported at the earliest time possible even if the reporter lacks details. The standard reporting form for suspected product quality issues was correctly recognized by 13.8%. Overall, the median knowledge and attitude scores were found to be 9 out of 17 (interquartile range, IQR: 4.0) and 30 out of 35 (IQR: 4.0), respectively. Not knowing how to report (55.6%) and what to report (34.9%), no/delayed feedback from the regulatory authority (30.0%), and unavailability of reporting forms (29.0%) were the frequently reported barriers to reporting. In addition, profession (p = 0.027), no/delayed feedback (adjusted odds ratio [AOR]: 4.70; 95% CI: 2.17-10.18; p < 0.001), and not knowing how to report (AOR: 0.12; 95% CI: 0.05-0.28; p < 0.001) were found to be determinants of reporting suspected product quality defects.

Conclusion

The readiness and response of Eritrea's HCPs in detecting and reporting falsified medical products seems promising, although a significant knowledge gap was observed.

A national survey of knowledge, attitude, practice, and barriers towards pharmacovigilance and adverse drug reaction reporting among hospital pharmacy practitioners in the United Arab Emirates

BACKGROUND

Pharmacovigilance (PV) is an essential component of patient safety and pharmacists are expected to be aware of the PV processes and willing to report ADRs. This study assessed the hospital pharmacists' knowledge, attitude, and practice toward PV, barriers faced by them in ADR reporting, and factors influencing ADR reporting.

METHOD

A cross-sectional nationwide questionnaire survey was conducted among randomly chosen hospital pharmacists across UAE from March to July 2022. The filled questionnaires were assessed both descriptively [median (IQR scores), maximum 5 for Likert type and 1 for knowledge questions] and inferentially using the Mann-Whitney U test (for dichotomous variables) and the Kruskal-Wallis test (for variables with more than two responses) at alpha value = 0.05. Post hoc analyses and correlations were performed wherever applicable.

RESULTS

Of the 342 respondents, the majority were knowledgeable about the concepts of PV (93.3%; n = 319) and ADRs (86.8%; n = 297). The overall median (IQR) knowledge score was 5 (3-7)/9. Knowledge levels within 'qualification groups' varied significantly (p-value < 0.001) and participants 'between 10 and 14 years of experience' had more knowledge than those 'with < 5 years of experience' (p-value < 0.001, Bonferroni test). The overall median (IQR) attitude score was 22 (20-24)/30. Most respondents (90.6%; n = 311) were willing to spare time to review patients' ADR reports. The overall median (IQR) practice score was 17.5 (11-21)/24. Although 71.1% (n = 243) noticed ADRs during the previous year, only 53.2% (n = 182) reported an ADR, the reasons for underreporting being mainly due to a lack of proper training [median IQR score 4(4-5)/5]. The 'clinical pharmacists' engaged themselves more in pharmacovigilance than 'pharmacists' (p-value =  < 0.001), and 'inpatient pharmacists' reported more ADRs than 'pharmacists' (p-value = 0.018); Bonferroni test. The overall median (IQR) barrier score was 26 (23-29)/40 and the common barrier was 'lack of awareness about the national ADR reporting system 4 (4-5)'. The pharmacists in this study suggested incentives for reporting ADRs (69.3%; n = 237).

CONCLUSION

The authors concluded professional training courses for practicing pharmacists and educational curriculums related to PV and ADR reporting processes are to be considered for future pharmacists in order to inculcate ADR reporting culture and practices.

Healthcare professionals' awareness, attitudes and practices towards pharmacovigilance and spontaneous adverse drug reaction reporting in Jazan Province, Saudi Arabia: A survey study

Background

Globally, adverse drug reactions (ADRs) are the foremost cause of morbidity as well as mortality. This necessitates a system of surveillance that can effectively and efficiently monitor the effect of drugs on the general population. The role of pharmacovigilance (PV) is paramount in ensuring drug safety through spontaneous ADR reporting.

Methods

Data collection in the current research was carried out by an anonymous, online 36-item self-report questionnaire amongst a sample of 351 working healthcare professionals (HCPs) across different regions of Jazan Province, Kingdom of Saudi Arabia (KSA). The current sample comprised 54.4% males and 45.6% females, having an age range of 26-57 years, and was conducted between August 21 and October 21, 2022. Participants were recruited using the convenience snowball sampling technique.

Results

The participants' awareness of PV as well as spontaneous ADR reporting, had a significant association with having <40 years of age (χ² = 27.40; p < 0.001), being pharmacists (χ² = 212.20; p < 0.001), with more than five years of experience (χ² = 40.80; p < 0.001), having Masters (or) Doctorate/Fellowship (χ² = 171.94; p < 0.001), and having their practice located in an urban area (χ² = 50.30; p < 0.001). It was also observed that most participants with excellent awareness of PV and spontaneous ADR reporting also demonstrated excellent attitudes (χ² = 147.70; p < 0.001). Similarly, it was also seen that almost all (97%) of the study sample with excellent attitudes towards PV and spontaneous ADR reporting also demonstrated excellent practices (χ² = 250.73; p < 0.001).

Conclusion

Our results demonstrate a need for designing and conducting educational programs, providing training and conducting workshops for all the HCPs to improve their awareness towards PV and spontaneous ADR reporting while also highlighting the need and importance of having positive attitudes towards spontaneous ADR reporting. Cooperation between different HCPs should be encouraged to improve their practices towards spontaneous ADR reporting.

Evaluation of health care professionals' knowledge, attitudes, practices and barriers to pharmacovigilance and adverse drug reaction reporting: A cross-sectional multicentral study

BACKGROUND

Healthcare professionals' involvement and reporting of adverse drug reactions are essential for the success of a pharmacovigilance program. The aim of this study was to assess healthcare professionals (medical doctors, pharmacists, nurses, dentists, midwives, and paramedics) current knowledge, attitude, practices, and barriers regarding pharmacovigilance and adverse drug reactions reporting in multicentral healthcare settings.

METHODS

A cross-sectional face-to-face survey was conducted among currently working healthcare professionals in various hospitals in ten districts of Adana province, Türkiye from March to October 2022. A self-administered, pretested questionnaire (Cronbach's alpha = 0.894 for knowledge, attitudes and practices variables) was used for data collection. The questionnaire's final draft included five sections (sociodemographic/general information, knowledge, attitude, practices, and barriers) with 58 questions. The collected data was analyzed in SPSS (version 25) using descriptive statistics, the chi-square test, and logistic regression.

RESULTS

Of the total 435 distributed questionnaires, 412 completed the entire questionnaire, yielding a 94% response rate. The majority of healthcare professionals (60.4%; n = 249) had never received pharmacovigilance training. Among healthcare professionals 51.9% (n = 214), 71.1% (n = 293) and 92.5% (n = 381) had poor knowledge, positive attitudes and poor practices, respectively. Only 32.5% of healthcare professionals kept the record of an adverse drug reaction and only 13.1% reported adverse drug reactions. The profession (medical doctors, pharmacists, nurses, dentists, midwives, and paramedics) of healthcare professionals and a lack of training were predictors of poor adverse drug reaction reporting (p < 0.05). A statistically significant difference in healthcare professionals and knowledge, attitude and practices scores was also observed (p < 0.05). The main barriers which were supposed to discourage adverse drug reactions reporting by the healthcare professionals were higher workload (63.8%) followed by thinking that a single adverse drug reaction report makes no impact (63.6%) and lack of a professional atmosphere (51.9%).

CONCLUSION

In the current study, most healthcare professionals had poor knowledge and practice, but they had a positive attitude toward pharmacovigilance and adverse drug reactions reporting. Barriers to under-reporting of adverse drug reactions were also highlighted. Periodic training programs, educational interventions, systematic follow-up of healthcare professionals by local healthcare authorities, interprofessional links between all healthcare professionals, and the implementation of mandatory reporting policies are critical for improving healthcare professionals knowledge, practices, patient safety and pharmacovigilance activities.

The impact of educational interventional session on healthcare providers knowledge about pharmacovigilance at a tertiary Jordanian teaching hospital

OBJECTIVE

A limited number of educational interventions among health care providers and students have been made in Jordan concerning the pharmacovigilance. Therefore, the main aim of this study was to evaluate how an educational workshop affected the understanding of and attitudes toward pharmacovigilance among healthcare students and professionals in a Jordanian institution.

METHODS

A questionnaire was used before and after an educational event to evaluate the pre- and post-knowledge and perception of pharmacovigilance and reporting of adverse drug reactions (ADRs) among a variety of students and healthcare professionals at Jordan University Hospital.

RESULTS

The educational workshop was attended by 85 of the 120 invited healthcare professionals and students (a response rate of 70.8%). The majority of respondents were capable of defining ADRs (n = 78, 91.8%) and pharmacovigilance accurately (n = 74, 87.1%) in terms of their prior understanding of the topic. Around 54.1% of the participants (n = 46) knew the definition of type A ADRs while 48.2% of them (n = 41) knew the definition of type B ADRs. Additionally, around 72% of the participants' believed that only serious and unexpected ADRs should be reported (n = 61, 71.8%), also, 43.5% of them (n = 37) believed that ADRs should not be reported until the specific medication that caused it is known. The majority of them (n = 73, 85.9%) agreed that reporting of ADRs was their responsibility. The interventional educational session has significantly and positively impacted participants' perceptions (p value ≤ 0.05). The most reason for not reporting ADRs as stated by the study participants was the lack of information provided by patients (n = 52, 61.2%) and the lack of enough time to report (n = 10, 11.8%).

CONCLUSION

Participants' perspectives have been greatly and favorably impacted by the interventional educational session. Thus, ongoing efforts and suitable training programs are required to assess the effect of bettering knowledge and perception on the practice of ADRs reporting.

Evaluation of Knowledge, Attitudes, and Practices about Pharmacovigilance among Community Pharmacists in Qassim, Saudi Arabia

BACKGROUND

Pharmacovigilance (PV) is an essential activity to detect adverse drug reactions (ADRs) and ensure patient safety. Hence, we aimed to evaluate knowledge, attitudes, and practices (KAP) regarding PV among community pharmacists in Qassim, Saudi Arabia.

METHODS

A cross-sectional study was conducted by using a validated questionnaire after obtaining ethical approval from the Deanship of Scientific Research, Qassim University. The sample size was calculated based on the total number of pharmacists in the Qassim area by using Raosoft, Inc. Statistical Package for the Social Sciences version 20 was used for data entry and analysis. Ordinal logistic regression was performed to identify the predictors of KAP. A p-value of <0.05 was considered statistically significant.

RESULTS

A total of 209 community pharmacists participated in the study; 62.9% of them defined the PV correctly, and 59% of them defined ADRs correctly. However, only 17.2% knew where to report ADRs. Interestingly, the majority of participants (92.9%) reported that it is necessary to report ADRs, and 73.8% of them were willing to report ADRs. A total of 53.8% of the participants identified ADRs during their careers; however, only 21.9% reported ADRs. Barriers discourage ADR reporting; the majority of the participants (85.6%) do not know how to report ADRs.

CONCLUSION

Community pharmacists who participated in the study were knowledgeable about PV, and their attitude towards reporting ADRs was highly positive. However, the number of reported ADRs was low because of the lack of knowledge on how and where to report ADRs. Continuous education and motivation about ADRs reporting and PV are warranted among community pharmacists for the rational use of medications.

Knowledge, attitudes and practice regarding pharmacovigilance and adverse drug reaction reporting among physicians and pharmacists in Egypt: a step toward personalized medicine implementation

Aim: To assess the knowledge, attitudes, and practices of the healthcare professionals working at Children's Cancer Hospital Egypt regarding pharmacovigilance (PV) and adverse drug reaction (ADR) reporting, in addition to the ADR reporting barriers. Materials & methods: A cross-sectional study was conducted at Children's Cancer Hospital Egypt from July to September 2021 using a validated questionnaire. Results: About 37 physicians (20.3%) and 145 pharmacists (79.7%) responded to the survey. Overall, the knowledge (median: 40%) and practice (median: 50%) of PV and the reporting of ADRs were low; however, attitudes were mostly positive. The main barrier to reporting ADRs was The difficulty of determining whether or not ADRs occurred (42.3%). Conclusion: Understanding of PV and ADR reporting could improve the huge gap between ADRs experienced and ADRs reported. In order to be able to assess the impact of personalized medicine implementation, adequate ADR reporting should be well established.

Ali S, Ting KN, Boardman H. Pharmacists’ experiences on adverse drug reaction: 10 years later

Adverse drug reaction (ADR) is one of the leading public health concerns associated with high mortality rate. Healthcare professionals, particularly pharmacists, have a significant role in monitoring and preventing ADRs. This study was conducted on Malaysian Pharmaceutical Society (MPS) pharmacists who worked at the hospitals, health clinics, and community pharmacies to determine if pharmacists’ experiences on ADRs are still the same 10 years later. In 2010, a postal survey and in 2020, an online survey were conducted among these pharmacists. A total of 472 pharmacists and 208 participated in 2010 and 2020, respectively. About 82% and 90% of hospital/health clinic pharmacists (HCPs) observed an ADR over the last 6 months in 2010 and 2020, while 60% and 100% community pharmacists in 2010 and 2020 observed an ADR, respectively. Perindopril was the top drug (HCPs: p = 0.657; CPs: p = 0.98), and rash was the top ADR reported by the pharmacists in both years (HCPs: p &lt; 0.001; CPs: p = 0.679). The most common actions taken by HCPs in 2010 were to report the ADR (p = 0.343), while in 2020, most HCPs explained to patients regarding the reaction (p = 0.061), which was also the same in the CP group in 2020 (p = 0.958). The top factor encouraging ADR reporting in both years and both pharmacist groups was the high degree of severity of the reaction (HCPs: p &lt; 0.001; CPs: p = 0.769). While the top factors discouraging ADR reporting were a lack of information from the affected patients (HCPs: p = 0.2; CPs: p = 0.656), reaction is widely known (HCPs: p = 0.001; CPs: p = 0.144) and uncertainty of the causal relationship (HCPs: p = 0.169; CPs: p = 0.609). Majority of the pharmacists agreed that severe reactions should be reported (HCPs: p = 0.158; CPs: p = 0.501) and the main aim for reporting is to measure the incidence of ADRs (HCPs: p = 0.148; CPs: p = 0.762). Despite being able to identify ADRs during the daily practice, many pharmacists especially community pharmacists are not reporting them. There is a misconception on the purpose of reporting ADRs. An interventional program and ADR reporting training would be a useful step in improving ADR reporting practice.

Knowledge, attitudes and practices of clinical pharmacists to medication error reporting in ministry of health and population hospitals in Egypt

Objective

This study aimed to assess the knowledge, attitudes and practices toward medication errors (MEs) reporting among pharmacists working in Ministry of Health and Population (MOHP) hospitals in Alexandria.

Methods

A cross-sectional study was conducted among all pharmacists who are responsible for reporting medication errors in the Egyptian online reporting system (NO HARMe).

Results

The majority of pharmacists received training on MEs reporting using the Egyptian online reporting system. Around half of the pharmacists knew the correct definition for medication errors. All respondents were aware of the presence of a MEs reporting system in Egypt. Clinical pharmacists’ attitudes towards MEs reporting was favorable with an overall mean score of 4.20 ± 0.73 in a score ranging from 1 (most unfavorable attitudes score) to 5 (most favorable score). Only 60.7% of the surveyed pharmacists used the system to report MEs. Antibiotics were the most frequent drug category reported and the prescribing stage was the stage in which pharmacists perceived the greatest volume of reports were made (89.3% and 71.4%, respectively). Lack of time was the most frequently identified barrier to reporting, followed by lack of feedback to the report submitted (73.2%, 54.5%, respectively). Inconsistent with the results of other studies, fear from legal consequences and being recognized as an incompetent provider was reported by only 12.5% and 11.6% of pharmacists, respectively.

Conclusion

The majority of pharmacists have good knowledge and favorable attitudes towards medication error reporting, however around two fifths do not report medication errors.

Knowledge, attitude and practice of hospital pharmacists towards Pharmacovigilance and adverse drug reaction reporting in Najran, Saudi Arabia

Introduction

 Pharmacovigilance (PV) is critical in determining the risk–benefit ratio of medicines and encouraging their safe, rational, and effective use, hence enhancing patient safety and care. Pharmacists, as drug experts, share responsibility for ensuring that medicines remain safe.

Objective

 The study aimed to assess the knowledge, attitude, and practice of hospital pharmacists towards PV and adverse drug reaction (ADR) reporting and to know factors that discourage them from reporting ADRs in Najran, Saudi Arabia.

Methods

A pre-tested self-administered questionnaire was distributed to all the pharmacists working in government hospitals who consented to participate in the study. Data was collected over three months, from 01 June 2018 to 31 Aug 2018. Data were analyzed using Statistical Package for Social Science (SPSS) software for Windows, version 23. Descriptive statistics such as frequency and percentages, mean ± standard deviation (SD) were calculated, and the Pearson's Chi-square test was used to examine the relationship between different variables.

Results

A total of 145 questionnaires were distributed, and the response rate obtained was 70.3%. The definition of PV and ADR were correctly identified by 42% and 68.3% of participants, respectively. A noteworthy finding is that 95% of participants were aware of the existence of the ADR reporting system, and 88.9% knew the responsible regulatory agency. Participants showed a positive attitude towards PV and ADR reporting; 90.1% considered ADR reporting a part of professional obligation, and 94.1% believed that there should be collaboration between pharmacists and other healthcare professionals. A majority of participants (86.1%) had identified an ADR during their practice, and 71.3% had reported an ADR. The unavailability of a professional environment to discuss ADR and insufficient pharmacotherapy/clinical knowledge was cited as the main factors discouraging from reporting ADRs.

Conclusions

Overall, the pharmacists had an average to good knowledge of and positive attitude towards PV and ADR reporting and a good ADR reporting practice. The concept of PV and ADR reporting should be further strengthened, and there is a vast potential for the same.

J. Khojah H, Susan Dewey R. Spontaneous adverse drug reaction reporting by community pharmacists: preparedness and barriers

Background

Adverse drug reactions (ADRs) are undesired, unintended responses to drugs, and are significantly underreported. Pharmacists are drug experts recognized as custodians of drug safety, who are expected to be prepared for and knowledgeable about ADR reporting.

Objectives

To identify Egyptian community pharmacists’ preparedness for and perceived barriers to spontaneous ADR reporting.

Methods

This cross-sectional study recruited a sample of community pharmacists across Egypt, who were invited to complete a self-administrated questionnaire during April 2020.

Results

A total of 923 pharmacists across Egypt responded to the questionnaire. Most pharmacists were knowledgeable about the definition of ADRs (93.9 %) and indicated they felt reporting ADRs benefits the patients (82.2%). Despite recognizing their public health value, only a small percentage of participants conveyed familiarity with the reporting process for both paper (19.2%) and electronic (30.4%) forms, indeed 56.6% of participants did not remember what the ADR report form looked like. Moreover, 75.4% of respondents said they felt that community pharmacies are not the right place for reporting, with 49% suggesting that reporting was the responsibility of physicians. However, only 32.1% reported having insufficient time being a barrier to ADR reporting.

Conclusions

Community pharmacists in Egypt are not well prepared for spontaneous ADR reporting due to a lack of knowledge about the formal process and not acknowledging their responsibility, although time was not a major barrier. Therefore, this highlights a clear opportunity for improvement likely involving targeted education.

Knowledge, attitude, practice and barriers towards pharmacovigilance and adverse drug reactions reporting among healthcare professionals in Turkey: a systematic review

BACKGROUND

Globally, pharmacovigilance (PV) is crucial for the patient's safety and proper use of drugs. Spontaneous reporting of adverse drug reaction (ADR) is a professional obligation of every healthcare professionals (HCPs). The purpose of this systematic review was to analyze the existing literature about the knowledge, attitude, and practices (KAP) level of HCPs regarding PV and ADRs reporting in Turkey.

METHODS

A systematic and comprehensive articles search strategy was carried out in different seven electronic databases (PubMed, PubMed Central, Goggle Scholar, Ovid-SP, MEDLINE, Wiley Online Library, DergiPark) from 2010 to 2020. We searched to identify existing literature about cross-sectional observational studies investigating the KAP of HCPs regarding PV and ADRs reporting in different geographical regions of Turkey. Quality assessment and risk of bias were assessed among included studies.

RESULTS

Fifteen studies were chosen for full-text analysis. Finally, according to inclusion criteria, seven research articles were selected for systematic review. Overall, the KAP of HCPs varies across the studies. The lack of a standardized validated measuring tool to evaluate the KAP and differences in questionnaire items were the main limitations in included studies. Around, 69.1% (range: 54.6-100%) of HCPs were not aware of the national pharmacovigilance center in Turkey. About, 37.5% (range: 7.1-75.7%) of HCPs believed that reporting of ADRs is not important and 87.5% (range: 69.3-100%) stated that they never reported ADR previously during their practice. The most frequently highlighted barriers to PV were lack of time, uncertainty and did not know where to report.

CONCLUSION

This systematic review revealed a major KAP gap in Turkey towards PV activities. Low ADR reporting practice of HCPs was a major identified issue. The creation of a mandatory unified PV education intervention for future HCPs to rationally report ADR of drugs are crucial for a better healthcare system.

Medication safety knowledge, attitude, and practice among hospital pharmacists in tertiary care hospitals in Saudi Arabia: a multi-center study

BACKGROUND

Pharmacovigilance (PV) demarcates all actions involving the detection and prevention of adverse drug reactions (ADR) for marketed drugs. However, ADRs are considerably underreported worldwide and continue to be a major concern to health care systems. This study aims to assess the knowledge, attitude, and perception of hospital pharmacists regarding medication safety concerning PV and ADRs across multiple tertiary care centers around Saudi Arabia.

METHODS

This cross-sectional study was conducted between July 2019 and January 2020. Pharmacists working in the tertiary care centers of Riyadh City, Saudi Arabia were asked to participate in the study. A self-administered questionnaire was used to conduct this study, it consisted of: 63 questions out of which 19 questions were knowledge-based, 15 were attitude-based, and 29 were practice-based questions.

RESULTS

A total of 350 pharmacists were distributed and 289 agreed to participate, giving a response rate of 82.6%. Most pharmacists were aware of the concept of VP and its functions (96.5%) and (87.2%), respectively. Moreover, 90% said that ADR can be preventable and non-preventable. However, the findings revealed inadequate knowledge about the overall PV field, where the majority of the pharmacists failed to correctly answer questions related to independent ADRs treatment, Augmented drug reaction, the international location of ADR, and the World Health Organization "online database" for reporting ADRs. Moreover, incomplete and/or wrong answers were recorded for questions that included single or multiple correct answers. Regarding the participants" attitude, 96.9% were interested in ADR reporting, agreeing that ADR is important to enable safe drug usage. Although a general positive attitude was recorded, pharmacists have stated that the three main barriers that hinder reporting ADRs are: unavailability of information about ADRs, lack of awareness about the need to report ADRs, and lack of time. Concerning practice, 69.2% said they received training in ADRs reporting, and 70% have reported ADRs more than once a week.

CONCLUSION

Surveyed pharmacists from Riyadh hospitals showed narrow knowledge of the PV field. However, a positive attitude and satisfactory practice was observed among pharmacists. These findings warrant the need for educational programs and an encouraging environment for ADR reporting to increase ADR reporting rates and support PV activities in Saudi Arabia.

Safety monitoring of herbal medicines in Nigeria: worrying state of pharmacovigilance system based on WHO core pharmacovigilance indicators

Introduction: Herbal medicines (HMs) have shown therapeutic and toxicological potentials. Thus, the WHO expanded the pharmacovigilance (PVG) scope to include HMs. This study appraised the state of PVG system in Nigeria for the safety monitoring of HMs using WHO core PVG indicators. Methods: Between January and June 2019, 39 PVG experts were requested to independently appraise the PVG system in Nigeria for safety monitoring of HMs using WHO PVG core structural (CSIs), process (CPIs) and outcome (COIs) indicators. The 27 indicators (CSIs = 10, CPIs = 9 and COIs = 8) were scored 3, 2, 1 and 0 for adequate, fairly adequate, inadequate and uncertain states, respectively. CSIs index (CSII) was determined by dividing the summation of CSIs mean score by total obtainable score (30) and expressed in percentage. This was applied to CPIs and COIs to obtain CPIs index (CPII) and COIs index (COII), respectively. Results: The mean ± standard deviation (SD) of participants’ age was 43.6 ± 10.3 years with mean ± SD work experience of 15.3 ± 9.3 years. Majority had doctoral degree (35.9%; 14/39; P >0.05) and were medical doctors (28.2%; 11/39; P > 0.05). Twelve of the 27 indicators scored at least 2.0 and CSIs, CPIs, and COIs accounted for 75.0% (9/12), 0.0% (0/12) and 25.0% (3/12), respectively (P < 0.05). The total mean score was 27.3 ± 0.2 for CSIs as against 8.0 ± 0.3 for CPIs and 11.2 ± 0.4 for COIs (P < 0.05). The CSII, CPII and COII were 91.0%; 29.6% and 46.7%, respectively (P < 0.05). Conclusion: Most of the structural elements are in place for safety monitoring of HMs in Nigeria. However, the process and outcome of PVG indicate an inadequate state. Thus, deliberate efforts are required to ensure the realization of PVG objectives.

Exploring healthcare professionals' knowledge, attitude, and practices towards pharmacovigilance: a cross-sectional survey

Background

Spontaneous reporting of adverse drug reactions (ADRs) is a method of monitoring the safety of drugs and is the basic strategy for the post-marketing surveillance of the suspected drugs. Despite its importance, there is very little reporting of ADRs by healthcare professionals. The present study has evaluated the knowledge, attitude and practices of health care professionals (HCPs) regarding pharmacovigilance activities in Lahore, Pakistan.

Methods

A cross-sectional questionnaire-based survey was employed, and a convenience sampling was opted to collect the data among physicians, pharmacists and nurses working in tertiary care public hospitals of Lahore, Pakistan from September 2018 to January 2019.

Results

Of the 384 questionnaires distributed, 346 health care professionals responded to the questionnaire (90.10% response rate). Most participants had good knowledge about ADR reporting, but pharmacist had comparatively better knowledge than other HCPs regarding ADR (89.18%) pharmacovigilance system (81.08%), its centres (72.97%) and function (91.89%). Most of the participants exhibited positive attitude regarding ADR reporting, such as 49.1% of physicians (P < 0.05), 70.2% pharmacists and 76.1% nurses showed a positive attitude that they are the most important HCPs to report an ADR. About 64.3% of physicians (P < 0.05) emphasized that consulting other colleagues is important before reporting an ADR. Of all, 77.7% physicians, 75.7% pharmacists and 68% of nurses had positive attitude that ADR reporting is a professional obligation and 67.6% of the pharmacists stated that they have reported ADRs in their workplace and 77.2% nurses have verbally reported ADRs to the concerned personnel or department.

Conclusion

Among all HCPs, pharmacists had better knowledge about ADR reporting and pharmacovigilance. All HCPs had positive attitude and inclination towards ADR reporting. The discrepancies were observed in the practices related to ADR reporting, whereas most of the participants including physicians and nurses did not report any ADR. Based on the above, strategies are needed to educate, train, and empower the HCPs in the domain of pharmacovigilance.

Knowledge, attitude and practice of pharmacists to pharmacovigilance and adverse drug reactions reporting process: a cross-sectional study in Kosovo

Pharmacovigilance (PV) and drug safety monitoring have an essential role in protecting public health. A cross-sectional study evaluated pharmacist knowledge, attitude and practice toward PV and adverse drug reactions (ADRs) reporting. The structured validated questionnaire was distributed to 550 randomly selected pharmacists in the whole Kosovo region. 405 out of 550 pharmacists responded to the questionnaire. Most pharmacists have insufficient knowledge about pharmacovigilance and the ADRs reporting process. The main reasons for under-reporting were little knowledge of pharmacovigilance and adverse reporting process, lack of time, and lack of infrastructure. However, pharmacists showed a positive attitude and stated that they would practice pharmacovigilance if they receive the training. There is a necessity to intensify communication among all stakeholders involved in PV. In addition, continuous training and education are needed to increase pharmacist's awareness and knowledge of PV and their participation in the ADRs reporting process. Keywords: Pharmacovigilance, adverse drug reaction, knowledge, attitude, practice, pharmacists, Kosovo

Using a global systematic framework tool to guide the advancement of the pharmacy workforce education and training on a national level

BACKGROUND

Systematic education and training strategies play a critical role in preparing a competent pharmacy workforce to meet the evolving healthcare needs of nations. Reports have shown that investing in healthcare workers' education and training not only has a positive impact on employment rates and economic growth but also results in measurable improvement in health and population outcomes. The goal of this study was to evaluate the use of globally validated workforce goals as a guide to the planning and advancement of the Kuwait pharmacy workforce's education and training.

METHODS

A mixed-approach qualitative study involving representatives of key stakeholders was conducted. Focus group interviews were carried out with pharmacists with patient and non-patient facing roles (N = 33). In addition, semi-structured interviews with the three main pharmacy Continuing Professional Development (CPD) providers in the country were conducted. Data were analysed using a framework analysis method. Interviews were transcribed verbatim and data were analysed and coded using MAXQDA-12. The International Pharmaceutical Federation Workforce Development Goals (FIP WDGs) were used as the framework for data analysis.

RESULTS

Participants' responses highlighted three main priorities: the importance of initial and post-graduation needs-based education (WDG 2), the need for competency development and competency frameworks (WDG 5), and the crucial role of active policy and regulations that would enforce the profession development (WDG 9). Investing in competency development was seen the top priority for the pharmacy workforce in Kuwait.

CONCLUSION

This study provided insights into areas in need of systematic development for pharmacy workforce in Kuwait including foundation training for early career pharmacists, competency development and competency frameworks, and policies and regulations that would enforce the profession development. In addition, the use of the FIP WDGs framework was found to offer a framing device to better understand and identify priorities and needs for pharmacy workforce development.

Competency development for pharmacy: Adopting and adapting the Global Competency Framework

BACKGROUND

With current accelerated changes in the role of the pharmacists across different sectors, evidence-based developmental tools are needed to re-define the scope of practice for early career pharmacists (foundation level) and to support pharmacists' career development. This study aimed to develop a foundation competency framework for pharmacists in Kuwait using the International Pharmaceutical Federation (FIP) Global Competency Framework (GbCF) in an adopt and adapt approach.

METHODS

A 4-phase adopt and adapt approach was followed to develop the Kuwait Foundation Competency Framework (KFCF). Phase one involved translating the FIP GbCF, into Arabic using parallel translation. Phase two utilises 2 consensus panels validation involving pharmacists from public and private sectors. Phase three involved a national survey to all registered pharmacists in Kuwait. The final phase involved focus groups with pharmacists and a consensus panel validation with key policy and decision makers in the pharmacy practice and education sectors in Kuwait. Qualitative data were thematically analysed, while quantitative data were analysed using IBM SPSS Statistics for Windows.

RESULTS

The translation phase yielded a bilingual framework that could be utilised by pharmacists in Kuwait. The initial validation phase identified 70 behavioural statements (out of the GbCF's 100) as 'highly relevant' or 'relevant' to pharmacy practice in Kuwait. Findings from the national survey identified a list of behaviours that could be adapted in Kuwait context as well as competencies that were perceived as least relevant to Kuwait practice. The final validation phase generated a list of 98 behavioural statements to be included in the KFCF along with recommendations and an action plan to facilitate the adaptation of the framework.

CONCLUSION

This study presents the first bilingual (Arabic/English) pharmacy foundation competency framework that builds on the FIP GbCF. The KFCF could be utilised as a developmental tool to support pharmacists' performance at foundation level.

Impact of an educational intervention on pharmacovigilance knowledge and attitudes among health professionals in a Nepal cancer hospital

BACKGROUND

Pharmacovigilance (PV) knowledge and attitudes among health care professionals (HCPs) directly affect the practice of PV and reporting of adverse drug reactions (ADRs) in a hospital. The main aim of the study was to assess the impact of an education intervention on the knowledge and attitude of HCPs attached to the regional PV center in an oncology based hospital of Nepal.

METHODS

A pre-post intervention questionnaire-based study was conducted amongst HCPs, i.e. nurses and pharmacists of an oncology based hospital of Nepal. A 21-item pretested PV questionnaire (twelve and four statements for assessing knowledge and attitude respectively) was used before and after an educational intervention among 89 HCPs working in the hospital. SPSS version 21.0 was used to analyze pre- and post-survey data with descriptive and inferential statistics. The knowledge and attitude scores before and after educational intervention were analyzed with Wilcoxon rank-sum test.

RESULTS

After the educational intervention, the mean score for knowledge about PV and ADR increased from [mean ± S.D] 6.90 ± 2.527 (pre-test) to 11.36 ± 1.189 (post-test, p < 0.001). There were significant improvements after an educational intervention in attitude from 1.80 ± 0.932 (pre-test) to 3.61 ± 0.556 (post-test, p < 0.001). Twenty-one (23.6%) of participants responded that they lacked the time to report ADR, while 12 (13.5%) replied that there was no remuneration for reporting ADR. Approximately 24% of them recommended frequent pharmacovigilance awareness programs via continuing medical education or other similar kinds of workshops for improvement of pharmacovigilance.

CONCLUSION

The preliminary findings of this study showed that knowledge and attitude scores were increased following an educational intervention. They also suggested that training on PV and ADR tends to have a positive impact on knowledge and attitude among nurses and pharmacists working at an oncology based hospital in Nepal.

Adverse Drug Reaction Monitoring and Reporting Among Physicians and Pharmacists in Pakistan: A Cross-sectional Study

BACKGROUND

The success of a reporting system of adverse drug reaction (ADR) depends on the knowledge, attitudes, and practices of the health care professionals. However, due to a lack of knowledge and poor contribution by healthcare workers, ADR remains underreported. To improve safety, proper identification and ADR reporting is necessary.

OBJECTIVE

This study was carried out to determine knowledge, attitude, and practices of ADR among physicians and pharmacists working in Pakistan and the factors which encourage and discourage effective reporting.

METHODS

A cross-sectional study was conducted using a pretested questionnaire. Questionnaires were distributed among 333 physicians and 34 pharmacists with a 95.5% response rate. The Statistical Package for Social Science (SPSS) was used for data analysis.

RESULTS

Pharmacists have more knowledge regarding ADR compared to physicians (47.1% vs. 13.8%, p < 0.001). Pharmacists also have a positive attitude compared to physicians (97.1% vs. 76.3%, p < 0.001). No significant difference was noticed in ADR practice by physicians and pharmacists (12.3% vs. 11.8, p = 0.92). The seriousness of ADR was the main factor that encouraged nearly all pharmacists to report, whereas among physician's, seriousness and the unusualness of reaction, the new drug involvement, and confidence in diagnosis were the factors which encouraged them to report ADR.

CONCLUSION

Overall, pharmacists had more knowledge and a positive attitude regarding ADR reporting compared to physicians, but practices of ADR reporting remained the same among both. Therefore, it is suggested that educational interventions, along with training programs, should be developed.

The Quality of Spontaneous Adverse Drug Reaction Reports in China: A Descriptive Study

Pharmacovigilance is important to monitor the safety of drugs. There are, however, problems with the quality of adverse drug reaction reports in China. This study aimed to analyze the quality of adverse drug reaction reports in China, identify the factors affecting it, and propose measures to improve it. In our study, the western province of Shaanxi, the central province of Hubei and the eastern province of Jiangsu were chosen as typical, and adverse drug reaction reports from these three provinces from 2015 to 2017 were systematically sampled. The sampling reports were scored and graded to assess their quality. The results showed that only 10.18% were considered high quality in a total of 3429 reports. There were statistically significant differences in quality by year, province, report type, report source, and occupation of the reporter (p < 0.001). Reports from Shaanxi were slightly poorer quality, and "new" and "serious" reports and those from pharmacists were higher quality. Five indicators were particularly poor quality: patient information, adverse drug reaction, reporter information, drug information and vigilance. In conclusion, the quality of adverse drug reaction reports in China still needs improvement. Factors affecting quality included timing, location, report type, report source, and reporter's occupation. It may be helpful to publicize the importance of monitoring adverse drug reactions and improve the knowledge of reporters.

An exploration of patient safety culture in Kuwait hospitals: a qualitative study of healthcare professionals' perspectives

OBJECTIVE

Patient safety culture (PSC) represents a key component of the quality of care offered by healthcare professionals. Therefore, it is crucial to understand the factors that influence the implementation of a safe culture. This study explored the knowledge and attitudes of healthcare professionals in Kuwait towards the factors that might affect the PSC.

METHODS

A qualitative study using semi-structured interviews with healthcare professionals was conducted between February and June 2018 at two major hospitals in Kuwait. Both hospitals had been accredited and have been applying the safety programmes recommended by the Kuwaiti Ministry of Health. Participants were purposively selected where 20 healthcare professionals were interviewed. The interviewees comprised of six physicians, six clinical pharmacists, six nurses and two members of the patient safety committee. Inclusion criteria involved healthcare professionals who had more than 1-year clinical experience, have interest in patient safety and had a good level of English. Interviews were audio-recorded and transcribed verbatim. Thematic analysis of the interview transcripts was conducted to identify the emergent themes.

KEY FINDINGS

Thematic analysis of the interviews yielded three major themes related to 'management', 'regulations and policies' and 'healthcare professionals'. Management issues included managerial support, resources, safety environment and staff training. Regulations and policies highlighted issues related to policies and procedures and incident reporting system. Healthcare professionals' theme covered factors related to knowledge, communication and teamwork among healthcare professionals.

CONCLUSIONS

This study gave insight into how healthcare professionals perceive the current PSC in Kuwait. Despite their positive attitudes and knowledge towards patient safety, various barriers were reported that hinder optimal PSC. These barriers were related to support, staffing, resources and response to error.

Pharmacists' knowledge and perceptions about pharmacovigilance and barriers towards adverse drug reactions reporting in Yemen

Objective

The current study aims to assess Yemeni pharmacists’ knowledge, attitude and practice of adverse drug reactions (ADRs) reporting systems and to determine barriers hindering them from reporting.

Methods

A cross-sectional descriptive study was conducted between August and October 2017. One hundred sixty-two pharmacists practicing in both community and hospital settings were recruited from five governorates using a convenient sampling technique. A validated self-administered questionnaire was used to collect data and to achieve the study objectives. Descriptive analysis was done using Statistical Package for Social Science version 20.

Key findings

Out of 260 questionnaires distributed, 162 pharmacists responded (Response rate of 62.3%). In terms of knowledge, 156 (96.3%) were not aware of the existence of ADRs reporting system in Yemen. The overall average knowledge score among pharmacists was 1.2 (SD = 1.2) out of 7. Concerning practice, about (140, 87.0%) of pharmacists disclosed that patients reported at least one ADRs annually. Insufficient clinical knowledge of pharmacist, unavailability of ADRs reporting form and unawareness of existence of the national ADRs reporting system were noticed to be the main barriers towards ADRs reporting.

Conclusions

Most of pharmacists were unaware of the ADRs reporting system in Yemen. However, advertising, education and intensive training are needed to improve awareness and to ensure an effective ADRs reporting process.

Educational intervention to improve the knowledge, attitude and practice of healthcare professionals regarding pharmacovigilance in South-South Nigeria

Background

Our aim in this study was to evaluate the effect of a combined educational intervention and year-long monthly text message reinforcements via the Short Messaging System (SMS) on the knowledge, attitude and practice (KAP) of healthcare professionals (HCPs) towards pharmacovigilance.

Methods

Six randomly selected teaching hospitals in the South-South zone of Nigeria were randomized in 1:1 ratio into intervention and control groups. The educational intervention consisted of delivering a seminar followed by sending monthly texts message reinforcements via SMS over 12 months. Then a semi-structured questionnaire regarding the KAP of pharmacovigilance was completed by HCPs working in the hospitals after the intervention. Data was analysed descriptively and inferentially.

Results

A total of 931 HCPs participated in the post intervention study (596 in the intervention and 335 in the control). The M:F ratio was 1:1.5. According to the KAP questionnaire, a significant difference was observed between the intervention and control groups, regarding knowledge of the types of adverse drug reactions (ADRs). ADR resulting from pharmacological action of the drug (85.6% versus 77%, p = 0.001), the fact that ADRs can persist for a long time; (60.1% versus 53.4%, p = 0.024) and a higher awareness of the ADR reporting form (48.7% versus 18.8%, p < 0.001). Most respondents in the intervention group (68.5% versus 60.6%, p = 0.001) believed they should report ADRs even if they were unsure an ADR has occurred, a greater proportion of HCPs from the intervention group had significantly observed an ADR (82% versus 73.4%, p = 0.001). Furthermore, of the 188 who had ever reported an ADR, 41% from the intervention group used the national ADR reporting form compared with 19.8% from the controls (p < 0.001).

Conclusion

This educational intervention and the use of SMS as a reinforcement tool appeared to have positively impacted on the knowledge and practice of pharmacovigilance in South-South Nigeria with a less-than-impressive change in attitude. Continuous medical education may be required to effect long-lasting changes.

A qualitative assessment of the pediatric content in pharmacy curricula adopted by pharmacy schools in Jordan

OBJECTIVE

The present study aimed to explore faculty (i.e., professors of various ranks) opinions and views regarding the pediatric content in courses taught to pharmacy students in Jordan.

METHODS

Purposeful sampling was used to identify faculty from ten pharmacy schools. Participants were identified through their institutions' websites. After obtaining required approvals, twelve in-depth interviews were conducted, recorded, transcribed and analyzed using NVivo 11 Software. Interviews followed a previously prepared and validated interview guide. The interview guide covered various aspects of pediatric undergraduate education and training.

RESULTS

Twelve professors (eight assistants and four associate professors) agreed to take part in the study. Qualitative analysis revealed four themes each with regard to respondents' knowledge of the pediatric content and their students' competency in dealing with pediatric patients. The emerging themes were: the lack of pediatric content in their current curriculum, the need for exposing students to more courses teaching pediatrics, and future aspirations to deal with this, and implications on practice.

CONCLUSIONS

This study highlights the deficiency of pediatric courses in pharmacy curriculum in Jordan. Respondent believed that this will have negative implications on pediatric pharmaceutical care and treatment efficacy and safety. It was thought that adding more pediatrics topics to undergraduate curricula, offering pediatric specialized postgraduate education, and implementing pre-registration training could alleviate the current situation.

Study on the Classification, Causality, Preventability and Severity of Adverse Drug Reaction Using Spontaneous Reporting System in Hospitalized Patients

Hospital-based adverse drug reaction (ADR) monitoring and reporting programs intend to identify and quantify the risks associated with the use of medicines. To examine the causality, preventability and severity of ADR in a hospital setting; a prospective cohort study on spontaneous ADR reporting was conducted from December 2015 to May 2016. Incidence of ADRs, causality, type, severity and preventability were assessed using necessary assessment scales. The study included 3157 hospitalized individuals, in whom 51 ADRs were detected among 49 patients. The overall incidence of suspected ADRs was found to be 1.6%. According to the causality assessment, most of the ADRs reported were probable (n = 26, 51.0%), and type A (augmented/pharmacological) reactions (n = 39, 76%) were the most common type of ADR found. The majority of ADRs were moderate to severe (n = 35, 68.6%), of which 37.3% were found to be potentially preventable. Predictability was observed in 28 (54.9%) reported ADRs. The prescribed medicines most frequently associated with ADRs were antibiotics, antiepileptics and antihypertensives. This feasibility study was able to highlight the clinical pharmacist's role in ADR monitoring service and create awareness about the way it could be done to promote safer medication use. Similar ADR reporting programs are necessary to educate and to improve awareness among healthcare professionals in some countries.

Primary Care Provider Counseling Practices about Adverse Drug Reactions and Interactions in Croatia

BACKGROUND

Prescribing medications is one of the most common medical decisions that is made by primary care providers (PCPs). In the Republic of Croatia, PCPs hold a key position in prescribing and evaluating the medications that are provided for patients. Accordingly, providing advice for patients regarding the potential adverse drug reactions (ADRs) and drug-drug interactions (DDIs) is frequently the responsibility of the PCPs. The aim of the current study was to assess the knowledge, attitudes, and counseling practices of PCPs regarding drug interactions and adverse effects.

METHODS

After enrolling 195 PCPs that were selected at random, a survey was conducted while using an anonymous questionnaire that was created based on previously published studies, adjusted in a way that includes the most commonly prescribed medications in Croatia.

RESULTS

Of the 10 questions on knowledge about DDIs and ADRs, the median number of correct responses by PCPs was 5 (interquartile range 4 to 7). More than half of respondents (56%) agreed with the claim that knowledge of drug side effects facilitated their work in family medicine. Almost all of the respondents (92.8%) explained side effects and drug interactions to special groups of patients (pregnant women, elderly patients etc.).

CONCLUSION

The results show a need for additional education in the field of drug prescribing. However, PCPs were aware of the importance of counseling practices about adverse drug reactions and interactions and counseling practices among special patients populations are satisfactory.

Reporting adverse drug reactions: contribution, knowledge and perception of German pharmacy professionals

Background The detection, assessment and prevention of adverse drug reactions along the product's life cycle is known as pharmacovigilance. German pharmacists are obliged by law to conduct pharmacovigilance measures, a specific training is not required. Objectives To assess the knowledge, contribution and perception of German pharmacy professionals regarding pharmacovigilance activities, in order to identify their needs to report better on the issue. Setting A semi-quantitative survey among German pharmacy professionals was conducted in November 2017. Method A questionnaire with 20 questions was developed and distributed to pharmacy professionals in four different German regions. Main outcome measures To assess the knowledge the number of right answered questions were examined; for perception a six-point-Likert was used and for contribution, yes or no questions. Results The participation ratio was 64.5% (n = 127). Nearly half of the participants (47.2%, n = 60) stated that they had already reported adverse drug reactions. Regarding the knowledge questions, there was neither a statistically significant difference between the correct answers of pharmacists and pharmacy technical assistents (p = 0.7209), nor between the different regions (p > 0.5054). For better reporting, the participants recommended better training, shorter forms to fill in and/or a contact person to call. Conclusion For the successful integration of pharmacovigilance reporting in daily practice, we suggest the following: (1) A structured, mandatory training of the pharmacy team. (2) The preparation of a standard operating procedure for the pharmacy or its integration into the pharmacy software.

Effect of educational intervention on healthcare providers knowledge and perception towards pharmacovigilance: A tertiary teaching hospital experience

Objective

Based on the theory on planned behavior, perception or attitude is found to be a well-established predictor of healthcare providers' intentions to perform different behaviors. Also, improving knowledge was proposed to affect their practice as well. In Jordan, many studies have been conducted to evaluate healthcare providers' knowledge and perception towards pharmacovigilance but no intervention or training was provided. Thus, the aim of this study was to evaluate the impact of an educational workshop on the knowledge and perception of healthcare providers towards pharmacovigilance in a Jordanian tertiary teaching hospital.

Methods

An interventional study conducted in Jordan University Hospital on various healthcare providers to assess their pre- and post-knowledge and perception towards pharmacovigilance and adverse drug reactions (ADRs) reporting via questionnaire before and after an educational workshop.

Results

Among the 200 invited healthcare providers, 150 attended the educational workshop (response rate 75.0%). Pre-workshop, healthcare providers showed an overall low knowledge score (7.8/19), where only 8.7% could define pharmacovigilance correctly. On the other hand, they showed a favorable perception score (33.6/39).Following educational workshop, knowledge scores significantly improved by 67.9% (P-value <0.05). A similar finding was obtained for perception scores, where perception scores significantly improved by 10.1% following workshop (P-value <0.05).

Conclusion

Continuous efforts are needed to implement different strategies including education modules and the provision of appropriate training programs to increase awareness and improve perception towards pharmacovigilance among healthcare providers. Future study is needed to evaluate the impact of improving knowledge and perception on ADRs reporting practice.

Assessment of knowledge, attitude and practice of adverse drug reaction reporting among healthcare professionals in secondary and tertiary hospitals in the capital of Pakistan

Adverse Drug Reactions (ADRs) underreporting is a great challenge to pharmacovigilance. Healthcare professionals should consider ADR reporting as their professional obligation because the effective system of ADR reporting is important to improve patient care and safety. This study was designed to assess the knowledge, attitude, practice and factors associated with ADR reporting by healthcare professionals (physicians and pharmacists) in secondary and tertiary hospitals of Islamabad. A pretested questionnaire comprising of 27 questions (knowledge 12, attitude 4, practice 9 and factors influencing ADR reporting 2) was administered to 384 physicians and pharmacists in public and private hospitals. Respondents were evaluated for their knowledge, attitude and practice related to ADR reporting. Additionally, the factors which encourage and discourage respondents to report ADRs were also determined. The data was analysed by using SPSS statistical software. Among 384 respondents, 367 provided responses to questionnaire, giving a response rate of 95.5%. The mean age was 28.3 (SD = 6.7). Most of the respondents indicated poor ADR reporting knowledge (83.1%). The majority of respondents (78.2%) presented a positive attitude towards ADR reporting and only a few (12.3%) hospitals have good ADR reporting practice. The seriousness of ADR, unusualness of reaction, new drug involvement and confidence in the diagnosis of ADR are the factors which encourage respondents to report ADR whereas lack of knowledge regarding where and how to report ADR, lack of access to ADR reporting form, managing patient is more important than reporting ADR legal liability issues were the major factors which discourage respondents to report ADR. The study reveals poor knowledge and practice regarding ADR reporting. However, most of the respondents have shown a positive attitude towards ADR reporting. There is a serious need for educational training as well as sincere and sustained efforts should be made by Government and Hospital Authorities to ensure proper implementation of ADR reporting system in all of the hospitals.

Reporting of Adverse Drug Reactions in Primary Care Settings in Kuwait: A Comparative Study of Physicians and Pharmacists

OBJECTIVE

To investigate and compare knowledge, attitudes, and practices regarding pharmacovigilance (PV) and the reporting of adverse drug reactions (ADR) among physicians and pharmacists in primary care settings.

SUBJECTS AND METHODS

A cross-sectional study was conducted, in which a validated self-administered questionnaire was distributed to 386 physicians and 197 pharmacists in 38 primary care clinics in Kuwait. Categorical variables were described using numbers and percentages. The Pearson χ2 test, Fisher exact test, and Mann-Whitney U test were used as appropriate. p < 0.05 was considered statistically significant.

RESULTS

Of the 583 questionnaires distributed, 485 were completed (by 318 physicians and 167 pharmacists), giving an overall response rate of 83.2%. A total of 52.8% (n = 256) and 70.5% (n = 341) of the study participants were knowledgeable about the definitions of PV and ADR, respectively, with pharmacists demonstrating significantly better knowledge of PV (n = 105/167 vs. 151/318, i.e., 62.9 vs. 47.5%; p < 0.001) and purpose (n = 123/167 vs. 177/318, i.e., 74.1 vs. 55.7%; p < 0.001). However, the majority (n = 434/485; 89.4%) were not aware of an ADR reporting system in Kuwait. Almost every participant (n = 474/485; 97.7%) thought it was necessary to report ADR. However, significantly fewer physicians than pharmacists (n = 248/318 vs. 147/167, i.e., 78.0 vs. 88.0%; p < 0.01) believed that ADR reporting was a professional obligation. Only 27.8% (n = 133/485) had reported ADR, with pharmacists having reported significantly fewer than physicians (n = 35/167 vs. 98/318, i.e., 21.7 vs. 30.8%; p = 0.036).

CONCLUSIONS

This study indicated that the attitude was positive but there was suboptimal knowledge and poor practice among primary care physicians and pharmacists with regard to ADR reporting. Targeted training about ADR reporting while ensuring a robust regulatory framework would encourage ADR reporting practices in the primary health care setting in Kuwait.

Adverse drug reaction reporting among physicians working in private and government hospitals in Kuwait

Introduction

To improve patient safety and care, the identification and reporting of adverse drug reactions (ADRs) should be systematic and mandatory for all healthcare professionals (HCPs). Physicians remain the main HCPs with direct patient care whose role in ADRs reporting should not be ignored.

Objective

To document the awareness and attitude of physicians working in private and government hospitals in Kuwait with regard to pharmacovigilance (PV) and ADR reporting and to identify their practices of reporting ADRs.

Material and methods

A cross-sectional study was conducted using a paper-based 25-item questionnaire. The Statistical Package for Social Science (SPSS) was used for data analysis.

Results

A total of 1017 questionnaires were distributed to the eligible physicians in the government and private hospitals, giving a response rate of 84.2% and 83.0%, respectively (an overall response rate of 83.8%). Private physicians exhibited a better knowledge profile with regards to the purpose of PV (75.2% vs 64.8%; p = 0.002) and the correct ADR definition (75.8% vs 65.3%; p = 0.001). The majority of physicians showed good attitude towards reporting ADRs, nevertheless, private physicians had a significantly stronger belief that reporting ADRs is a professional obligation (93.4% vs 85.5%; p = 0.001). Three quarters of the study population (74.6%) had identified an ADR during their daily practice, however, only a small proportion (34.2%) confirms having ever reported ADRs. Regardless, significantly more private physicians had done so (42.4% vs 29.6%; p < 0.001). ADR reporting was significantly higher in physicians who knew the correct ADRs to be reported (adjusted OR = 1.86, p = 0.036), and those who were aware of any center or ADR reporting system in Kuwait (adjusted OR = 2.88, p = 0.020).

Conclusions

A national PV center empowered by clear legislation on “how” and “what” to report should improve physicians’ reporting practices and hence is required in the country. This should be combined with constant training and education in this regard.