KNOWLEDGE, PERCEPTION AND PRACTICES RELATING TO PHARMACOVIGILANCE AMONG HEALTHCARE PROFESSIONALS AT THE UNIVERSITY COLLEGE HOSPITAL IBADAN, NIGERIA

Abstract

Adverse Drug Reaction (ADR) constitutes a major public health problem worldwide and pharmacovigilance is an effective strategy for addressing it. In Nigeria, there is inadequate information about the practice of pharmacovigilance among healthcare professionals in tertiary healthcare settings. This study was designed to assess the knowledge, perception and practices relating to pharmacovigilance among healthcare professionals at the University College Hospital (UCH), Ibadan, Nigeria, The study was a cross-sectional survey. A 3- stage stratified random sampling technique was used to select 589 healthcare professionals comprising doctors, Pharmacists and nurses. A validated questionnaire which included a 30-point knowledge scale was used for data collection. Data were analysed using descriptive, ANOVA and Chi-square statistics. The participants consisted of 50.1% doctors, 44.1% nurses and 5.8% pharmacists with a mean age of 35.0±8.3 years. Majority (64.4%) of the participants were females. Most (91.3%) participants had heard about pharmacovigilance. Of this number, 56.6% doctors, 91.2% pharmacists and 71.5% nurses were aware of the pharmacovigilance programme in UCH. Very few (1.2%) participants however knew the location of the pharmacovigilance office in the hospital. The listed causes of ADR which should constitute the focus of pharmacovigllance included use of substandard drugs (92.7%), drug over-dose (92.0%), medication error (89.8%) and polypharmacy (89.8%). The participants' mean knowledge score on pharmacovigilance including ADR was 22.6.±3.7 with the difference in the mean knowledge scores for doctors 23.9±3.1, pharmacists (22.1±3,8) and nurses (21.1±3.7) being significant (p<0.05). The mean knowledge scores of the males and females were 23.7±3.3 and 22.1±3.7 respectively (p<0.05). All the pharmacists, 90.4% nurses and 90.2% doctors perceived that reporting of ADR is mandatory professional responsibility. Most pharmacists (97.1%), 94.6% doctors and 87.7% nurses did not consider pharmacovigilance as an unnecessary burden. Cases of suspected ADR had been witnessed by 83.7% doctors, 78.1% nurses and 64.7% pharmacists. A majority (62.5%) of participants had ever received reports about suspected cases of ADR from their patients. The nurses, doctors and pharmacists that had ever reported cases of suspected ADR were 31.6%, 23.7% and 17.6% respectively. There was no significant difference between nurses (6.5%) doctors (2.9%) and pharmacists (2.7%) who had ever reported cases of ADR by completing and submitting the required forms to the pharmacovigilance unit. Participants' varying levels of confidence in their ability to recognize cases of ADR were as follows: very confident (37.9%); fairly confident (59.5%); not confident at all (2.6%). Reasons adduced for not reporting ADR by participants included, inadequate patient follow-up (77.1%) and lack of time (76.7%). The frequencies of the practice of telling patients to report a case of suspected ADR after consultation among the participants were as follow: always- 43.6%; occasionally- 30.2%; rarely- 16.5% not at all- 7.7%. The knowledge and positive perception of pharmacovigilance among the participants did not translate into the practice of reporting suspected ADRs to the pharmacovigilance unit. Health education strategies such as advocacy and training to increase their level of confidence regarding the ability to recognize ADRs are needed to improve the practice of pharmacovigilance among the health professionals.