Abstract:
Background
Lack of adequate detail compromises analysis of reported suspected adverse drug reactions
(ADRs). We investigated how comprehensively Ugandan healthcare professionals
(HCPs) described their most recent previous-month suspected ADR, and determined the
characteristics of HCPs who provided comprehensive ADR descriptions.We also identified
rare, serious, and unanticipated suspected ADR descriptions with medication safetyalerting
potential.
Methods
During 2012/13, this survey was conducted in purposively selected Ugandan health facilities
(public/private) including the national referral and six regional referral hospitals representative
of all regions. District hospitals, health centres II to IV, and private health facilities
in the catchment areas of the regional referral hospitals were conveniently selected. Healthcare
professionals involved in prescribing, transcribing, dispensing, and administration of
medications were approached and invited to self-complete a questionnaire on ADR reporting.
Two-thirds of issued questionnaires (1,345/2,000) were returned.
Results
Ninety per cent (241/268) of HCPs who suspected ADRs in the previous month provided information
on five higher-level descriptors as follows: body site (206), drug class (203), route
of administration (127), patient age (133), and ADR severity (128). Comprehensiveness
(explicit provision of at least four higher-level descriptors) was achieved by at least two-fifths
(46%, 124/268) of HCPs. Received descriptions were more likely to be comprehensive from
HCPs in private health facilities, regions other than central, and those not involved in teaching medical students. Overall, 106 serious and 51 rare previous-month suspected
ADRs were described. The commonest serious and rare ADR was Stevens-Johnson syndrome
(SJS); mostly associated with oral nevirapine or cotrimoxazole, but haemoptysis
after diclofenac analgesia and paralysis after quinine injection were also described.
Conclusion
Surveyed Ugandan HCPs who had suspected at least one ADR in the previous month competently
provided comprehensive ADR descriptions: more, indeed, than are received per
annum nationally. Properly analyzed, and with local feed-back, voluntary ADR reports by
HCPs could be an essential alerting tool for identifying rare and serious suspected ADRs in
Uganda.
