|Year : 2018 | Volume
| Issue : 2 | Page : 45-47
Knowledge and practice about adverse drug reactions among pharmacists in Nadiad City
Anand Bharatkumar Pithadia1, Ahuti A Patel2, Arun K Soni1, Bhanubhai N Suhagia3, Tejal Soni4, Sanjeeth B Peter5, Niraj B Pandit6
1 Department of Pharmacology, Faculty of Pharmacy, Dharmsinh Desai University, Nadiad, Gujarat, India
2 Undergraduate Student, Faculty of Pharmacy, Dharmsinh Desai University, Nadiad, Gujarat, India
3 Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Dharmsinh Desai University, Nadiad, Gujarat, India
4 Department of Pharmaceutics, Faculty of Pharmacy, Dharmsinh Desai University, Nadiad, Gujarat, India
5 Director, DDMM Heart Hospital, DDMM Heart Institute, Nadiad, Gujarat, India
6 Department of Community Medicine, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
|Date of Web Publication||26-Feb-2019|
Anand Bharatkumar Pithadia
Department of Pharmacology, Faculty of Pharmacy, Dharmsinh Desai University, Nadiad - 387 001, Gujarat
Source of Support: None, Conflict of Interest: None
Objective: The objective of the study was to evaluate the knowledge and practice about adverse drug reactions (ADRs) among community pharmacists. Methods: A cross-sectional study was conducted with a questionnaire provided to 47 community pharmacists in Nadiad, Gujarat, India. Results: Nearly 75% response rate was noted as 35 pharmacists participated in the survey. Respondents were evaluated for their knowledge and practice of ADR reporting. For ADR reporting process, only 2.85% of pharmacists were familiar with Pharmacovigilance Programme of India (PvPI). Nearly 57% of participants reported ADR to physicians and 40% reported ADR to nonspecified sources. Around 51% of pharmacists replied that ADR reporting is professional obligation of pharmacists. Around 15% of pharmacists replied that ADRs do not require to be reported. Around 91.42% of pharmacists suggested advice to patients regarding the side effects of the drugs that may occur with the prescribed medicines. Conclusion: It may be concluded that community pharmacists have lower awareness regarding ADR reporting and importance of PvPI. This would reflect that the pharmacists have lack of knowledge about ADRs and their reporting. Therefore, government agencies and private institutes should develop strategies to spread the awareness regarding ADR reporting and its importance, which will be helpful to reduce the rate of underreporting.
Keywords: Adverse drug reaction, community pharmacist, knowledge
|How to cite this article:|
Pithadia AB, Patel AA, Soni AK, Suhagia BN, Soni T, Peter SB, Pandit NB. Knowledge and practice about adverse drug reactions among pharmacists in Nadiad City. J Integr Health Sci 2018;6:45-7
|How to cite this URL:|
Pithadia AB, Patel AA, Soni AK, Suhagia BN, Soni T, Peter SB, Pandit NB. Knowledge and practice about adverse drug reactions among pharmacists in Nadiad City. J Integr Health Sci [serial online] 2018 [cited 2019 Jul 23];6:45-7. Available from: http://www.jihs.in/text.asp?2018/6/2/45/252873
| Introduction|| |
As per WHO, adverse drug reaction (ADR) is an unwanted reaction along with therapeutic use of drug. Monitoring ADRs through pharmacovigilance program by the WHO was started in the 1960s. A number of countries throughout the world have started to report ADRs as they are one of the causes for mortality and morbidity., It contributes to 5.3% inpatients in hospitals and affects 2.2 million people throughout the world, causing around 100,000 death annually. The cost of treatment associated with ADRs is around $136 billion. Hence, ADR detection and prevention may be beneficial to reduce the cost of treatment associated with it.
As pharmacists know about drugs in detail, they may be able to identify ADRs of drugs. Pharmacist can identify ADR in hospitals as well as at pharmacy stores. However, practice for ADR reporting by pharmacists is very poor and ADR underreporting is a major problem faced by health-care system. Common reasons linked with ADR underreporting are insufficient knowledge about pharmacovigilance systems, personnel attitude for reporting, and workload at center. In one of the studies conducted in Saudi Arabia, only 23% of participated pharmacists were aware of ADR reporting. It is, therefore, essential to encourage health-care professionals to report ADRs, and such scenario in India is the same as in other countries. Therefore, we evaluated pharmacist practice about ADRs in Nadiad city.
| Methods|| |
A questionnaire related to ADRs was prepared to conduct this cross-sectional study among community pharmacists of Nadiad city, Gujarat, India. It was given (English language) to the community pharmacists to evaluate their knowledge about ADR reporting process. Pharmacy students visited pharmacy store, explaining the aims of the study to the pharmacist and invited them to participate in the study with their prior consent.
Descriptive statistics were used to analyze the frequency and percentage using Microsoft Excels.
| Results|| |
Of 47 pharmacists, 35 pharmacists participated in the study (75% response rate). Their demographic detail is summarized in [Table 1]. Nearly 48% of pharmacists were governing the pharmacy store with the qualification of bachelor's degree, 48% with diploma degree, and 3% with master in pharmacy education. Regarding the service at pharmacy store, 68% of pharmacists had 10–20 years, 17% of pharmacists had 20–30 years, 11% of pharmacists had <10 years, and 3% had 30–40 years of experience [Table 1].
Nearly 91.42% of pharmacists were aware with ADRs and their types. However, 9% of pharmacists did not know about it. It was observed that about 74% of pharmacists reported the cases of ADRs if seen in any patient and 51% of them knew about Pharmacovigilance Programme of India (PvPI). However, 57% of participants replied that they had reported ADRs to physicians and 40% of them had reported to nonspecified sources. Only 2.85% of pharmacist had reported ADRs to Indian Pharmacopeia Commission (IPC, PvPI). Further, 86.48% of pharmacists agreed that systemic monitoring and reporting of ADR is very important, and it should made compulsory by the government to report ADRs by pharmacists with prior consultation with physicians [Table 2].
|Table 2: Community pharmacist knowledge about adverse drug reaction reporting and adverse drug reaction patient counseling|
Click here to view
Around half of the pharmacists replied that ADR reporting is the duty of either clinicians or of hospital. Further, it was observed that 91.42% of pharmacists suggested advice to patients regarding the side effects of the drugs that may occur with the prescribed medicines and sent them to physician if such side effects occurred with treatment. They also said that patients should consult physician whenever there is an incidence of ADR. Further, all pharmacists agreed to compulsorily report ADRs [Table 2].
| Discussion|| |
We evaluated knowledge and actions taken by pharmacists about ADR reporting through a cross-sectional study in Nadiad, Gujarat, India. Compared to South Asian countries, ADR reporting rate remained high in the UK and European countries. The results of our study showed that practice about ADRs by community pharmacists was not up to the mark. Majority of them were not aware of ADR reporting process. We identified some of the reasons through this study, and most common was the lack of awareness about how to report ADRs.
Previous studies also showed that community pharmacists can make major contribution to ADR reporting., We identified that pharmacists are not actively involved in ADR reporting and they consider that it is the duty of either physicians or hospital administration. It is further supported by previous finding in one of the studies in India. As per the present study, 64.4% of physicians and 15.1% of pharmacists reported ADR. Thus, compared to physicians, lower rate of ADR reporting by pharmacists might be due to the duties assigned to pharmacists in health-care system. Another possible reason would be lesser pharmacist–patient interaction. In India, most of the community and hospital pharmacists dispense prescribed drugs (by physicians) to patients and are not involved in patient counseling. On the other side, most of the supportive health-care staff such as nursing staff remained in contact with patients for longer duration as compared to pharmacists.
Other reasons for the same in India may also include financial inducements, legal policies, and anxiety about already documented ADRs that single report would make no difference, lack of time, and over load of work at pharmacy., However, our study has several limitations as it included only one city from India, which limits its generalizability. Further, to improve the underreporting of ADR, the National Coordination Centre for PvPI placed the format for reporting suspected ADRs on the website of IPC. These forms can be filled by pharmacists, nursing staff, and physicians. Separate format (in regional languages) is also available for patients or consumers who can also submit to IPC. Currently, helpline number 1800-180-3024 is also made available by PvPI. This number is working on weekdays (9:00 AM to 17:30 PM). Therefore, these measures may help minimize the rate of underreporting.
| Conclusion|| |
It may be concluded that community pharmacists have less awareness regarding ADR reporting and importance of PvPI. This would reflect that the pharmacists have lack of knowledge about ADRs and their reporting. Therefore, government agencies and private institutes should develop strategies to spread the awareness regarding ADR reporting and its importance, which will be helpful to maximize ADR reporting.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Karch FE, Lasagna L. Adverse drug reactions. A critical review. JAMA 1975;234:1236-41.
Sriram S, Ghasemi A, Ramasamy R, Devi M, Balasubramanian R, Ravi TK, et al.
Prevalence of adverse drug reactions at a private tertiary care hospital in South India. J Res Med Sci 2011;16:16-25.
Dormann H, Muth-Selbach U, Krebs S, Criegee-Rieck M, Tegeder I, Schneider HT, et al.
Incidence and costs of adverse drug reactions during hospitalisation: Computerised monitoring versus stimulated spontaneous reporting. Drug Saf 2000;22:161-8.
Patel H, Bell D, Molokhia M, Srishanmuganathan J, Patel M, Car J, et al.
Trends in hospital admissions for adverse drug reactions in England: Analysis of national hospital episode statistics 1998-2005. BMC Clin Pharmacol 2007;7:9.
Pirmohamed M, James S, Meakin S, Green C, Scott AK, Walley TJ, et al.
Adverse drug reactions as cause of admission to hospital: Prospective analysis of 18 820 patients. BMJ 2004;329:15-9.
Gedde-Dahl A, Harg P, Stenberg-Nilsen H, Buajordet M, Granas AG, Horn AM, et al.
Characteristics and quality of adverse drug reaction reports by pharmacists in Norway. Pharmacoepidemiol Drug Saf 2007;16:999-1005.
Rishi RK, Patel RK, Bhandari A. Under reporting of ADRs by medical practitioners in India – Results of pilot study. Pharmacoepidemiol Drug Saf 2012;1:1-3.
Mahmoud MA, Alswaida Y, Alshammari T, Khan TM, Alrasheedy A, Hassali MA, et al.
Community pharmacists' knowledge, behaviors and experiences about adverse drug reaction reporting in Saudi Arabia. Saudi Pharm J 2014;22:411-8.
Rao PG, Archana B, Jose J. Implementation and results of an adverse drug reaction reporting programme at an Indian teaching hospital. Indian J Pharmacol 2006;38:293-4. [Full text]
Rawlins MD. Pharmacovigilance: Paradise lost, regained or postponed? The William Withering Lecture 1994. J R Coll Physicians Lond 1995;29:41-9.
Oreagba IA, Ogunleye OJ, Olayemi SO. The knowledge, perceptions and practice of pharmacovigilance amongst community pharmacists in Lagos state, South West Nigeria. Pharmacoepidemiol Drug Saf 2011;20:30-5.
Granas AG, Buajordet M, Stenberg-Nilsen H, Harg P, Horn AM. Pharmacists' attitudes towards the reporting of suspected adverse drug reactions in Norway. Pharmacoepidemiol Drug Saf 2007;16:429-34.
Kalaiselvan V, Prasad T, Bisht A, Singh S, Singh GN. Adverse drug reactions reporting culture in pharmacovigilance programme of India. Indian J Med Res 2014;140:563-4.
] [Full text]
Şencan N, Altınkaynak M, Ferah I, Özyıldırım A, Ceylan E, Clark P. The knowledge and attitudes of physicians and nurses towards adverse event reporting and the effect of pharmacovigilance training: A hospital experience. Hacettepe Univ J Fac Pharm 2010;30:25-40.
Muraraiah S, Rajarathna K, Sreedhar D, Basavalingu D, Jayanthi CR. A questionnaire study to assess the knowledge, attitude and practice of pharmacovigilance in a paediatric tertiary care centre. J Chem Pharm Res 2011;3:416-22.
Kalaiselvan V, Kumar P, Mishra P, Singh GN. System of adverse drug reactions reporting: What, where, how, and whom to report? Indian J Crit Care Med 2015;19:564-6.
] [Full text]
Phalke VD, Phalke DB, Durgawale PM. Self-medication practices in rural Maharashtra. Indian J Community Med 2006;1:31-4.
[Table 1], [Table 2]