Abstract:
Objective: To assess extent and determinants of pastmonth
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.