ABSTRACT
Aim: To determine the level of awareness, knowledge and attitudes among health workers in different settings of health care in Nnewi, Nigeria towards the reporting of adverse drug reactions (ADRs). Methods: A descriptive cross-sectional study of 372 health workers in different health facilities in Nnewi North LGA of Anambra state, Nigeria was done. The participants were doctors, pharmacists and nurses, selected using multistage sampling technique. Data collection employed pretested, self-administered structured questionnaires. Data was analysed using statistical package for social sciences version 17. Chi-square test for proportions was used to document statistical significance among variables. A p value of < 0.05 was considered significant. Results: Two hundred and fifty five (68.5%) were females and 117 (31.5%) were males. This comprises 241 (64.8%) nurses/related cadres, 109 (29.3%) doctors and 22 (5.9%) pharmacists. Majority of them, 221 (59.4%) were not aware of the existence of the national ADR reporting scheme/guideline. The Pharmacists were more aware compared to other health professionals (P=.000). Respondents from tertiary health facility showed greatest awareness (43.2%). A total of 131 (35.2%) respondents have knowledge of the criteria for reporting ADR though it does not have a relationship with profession (P=.71) and does not depend on the level of the health facility where one worked (P=.30). Conclusion: This study showed poor awareness, knowledge gaps and poor attitude to ADR reporting across the professional groups. There is need for regular sensitization, training and retraining as well as attitudinal changes of health care providers to ADR reporting.
ABSTRACT
BACKGROUND/AIMS: The recent introduction of computerized surveillance systems has promoted the monitoring of adverse drug reactions (ADRs), a feature that facilitates voluntary reports and enables prompt feedback. To investigate the causative agents and severity of ADRs that occurred in a single hospital, we analyzed the features of 980 ADRs that occurred over 14 months after developing a computerized ADR reporting system in Hallym Sacred Heart Hospital. METHODS: ADR data collected prospectively from September 2007 to October 2008 by a computerized reporting system were analyzed. The World Health Organization-Uppsala Monitoring Center (WHO-UMC) criteria were used to determinate causality for each ADR. RESULTS: The number of ADR cases reported voluntarily increased rapidly since the introduction of the computerized ADR reporting system. Of the 980 cases, antibiotics (34.5%) were the most common causative drugs, followed by analgesics such as tramadol and its compound (15.2%), radiocontrast media (7.0%), narcotics (5.9%), and nonsteroidal anti-inflammatory drugs (NSAIDs) (5.5%). Fifty-nine (6.0%) and 206 (21.0%) cases were classified as severe and moderate reactions, respectively. The mean age was older in patients with severe ADRs than in patients with non-severe ADRs. The most common clinical features were skin manifestations, such as pruritus, skin eruptions, and urticaria. Gastrointestinal symptoms including nausea, vomiting, and diarrhea were the second most frequently reported ADRs. Among antibiotics, first-generation cephalosporins were the most frequently reported causative drugs, followed by second-generation cephalosporins, penicillin/beta-lactamase inhibitors, and third-generation cephalosporins. While 11.6% of ADRs related to penicillin/beta-lactamase inhibitors were classified as severe, there was only one severe ADR (1.1%) for first-generation cephalosporins. Most ADRs were reported equally in men and women, although female cases constituted about two thirds of ADRs associated with tramadol and NSAIDs. CONCLUSIONS: We believe that a computerized reporting and replying system promoted the monitoring of ADRs. Antibiotics were reported most frequently as the causative agent of ADRs. Elderly patients seemed to be more susceptible to severe ADRs. With the voluntary reporting system, skin manifestations and gastrointestinal symptoms were detected successfully, while laboratory abnormalities without prominent symptoms seemed to be overlooked. Further efforts to screen for automated ADR signals are required.