Knowledge, attitudes and practices of community pharmacists in Harare regarding the reporting of adverse drug reactions.

Abstract

Adverse drug reactions (ADRs) cause considerable morbidity which contributes significantly to health expenditure. Worldwide, there is under-reporting of ADRs by healthcare workers and Zimbabwe is no exception. In Zimbabwe, ADRs are mainly detected by use of a spontaneous reporting system. There is a greater need for enhanced pharmacovigilance (PCV) in Africa, where weak health systems are likely to contribute to medicine-related harm. The aim of the study was to contribute to the safe use of medicines by strengthening reporting of adverse drug reactions by pharmacists in Harare, by identifying knowledge, attitudes and practices that hinder their involvement at present. The objectives of the study are to determine if pharmacists practicing in private community pharmacies in Harare, Zimbabwe, know how to identify and when to report ADRs and whether they are reporting ADRs to the relevant authorities. In addition, the study seeks to determine their attitudes towards identification and reporting of ADRs and finally, to make recommendations for interventions to improve the knowledge, attitudes and practices of pharmacists in relation to the identification and reporting of ADRs. The study was designed as an observational, cross-sectional, analytical study. This design was used since it offered a cost-effective way of gathering information from many people in a relatively short period. Study Population and sampling: The study took place in Harare, Zimbabwe, where over 44% of the country’s private community pharmacies are located. A census approach was used as little is known about the subject locally. A self-administered questionnaire was designed to establish the socio-demographics of the respondents, their knowledge on ADR reporting and their attitudes and practices regarding ADR reporting. The questionnaires were distributed via electronic mail and at a continuing professional development session to a combined total of 129 community pharmacists. Data were analysed using Statistical Package for the Social Sciences (SPSS) version 16 and Microsoft Excel 2007. The respondents displayed poor knowledge of ADR reporting and hence there is under-reporting of ADRs. Factors such as post-graduate training and years of experience post- graduation have no bearing on the knowledge possessed by the respondents regarding ADR reporting. Although the respondents showed an appreciation of the importance of ADR reporting, there are barriers such as lack of knowledge and fear of legal liability that prevent pharmacists from reporting ADRs. Discussion: Lack of knowledge is the main barrier to reporting of ADRs by community pharmacist in Zimbabwe. To address this gap, interventions such as education for community pharmacists are required for both undergraduate pharmacist students and qualified pharmacists. There is a low level of knowledge and poor attitudes and practices amongst Zimbabwean pharmacists with respect to ADR reporting. Multi-sectoral interventions are required to overcome the barriers that community pharmacists encounter in reporting ADRs.