Abstract
The Knowledge, Perceptions, and Practice of Pharmacovigilance among Community Pharmacists in Lagos State, Southwest Nigeria
Oreagba, Ibrahim Adekunle (1,3); Ogunleye, Julius Olajide (2); Olayemi, Oluwafemi Sunday (1)
oreagbai@yahoo.com
1: University of Lagos, Nigeria; 2: Faculty of Clinical Pharmacy, West African Postgraduate College of Pharmacists; 3: National
Pharmacovigilance Centre. National Agency for Food and Drug Administration
Problem statement: Adverse drug reactions (ADRs) are significant causes of morbidity and mortality. ADRs may cause many
hospitalizations and lead to large economic burdens to patients and to society. Since pharmacovigilance plays an essential role in the
outcome of therapy, its evolution and its importance as a science are critical for effective clinical practice and public health science.
Spontaneous reporting of ADRs remains the cornerstone of pharmacovigilance and is important in maintaining patient safety. The
success of this activity, however, is dependent on the frequency of reporting by the health care professionals, under-reporting being
the main disadvantage. Community pharmacists both have an important responsibility in monitoring the ongoing safety of medicines
and are widely accessible to do it.
Objectives: To investigate the knowledge, perceptions and practice of pharmacovigilance among community pharmacists in Lagos State,
southwest Nigeria
Design: A descriptive, cross-sectional study
Setting: The study was carried out in private community pharmacies in Lagos, one of the largest metropolitan cities in Nigeria, located in
the southwest.
Study population: A multistage random sampling technique was employed in the selection of 420 community pharmacists in Lagos
Outcome measure(s): Knowledge of pharmacovigilance, practice of pharmacovigilance
Results: About 55% of respondents had ever heard of the word pharmacovigilance out of which less than half (representing only 18% of
all respondents) could define the term. 40% of the respondents stated that patients reported ADRs to them at least once a month, and
20% reported to the relevant authorities, but only 3% of respondents actually reported an ADR to the National Pharmacovigilance
Centre. The most important reason for poor reporting was lack of knowledge about how to report ADRs (44.6%). Meanwhile, 90% of
respondents believed that the role of the pharmacists in ADR reporting was important. Most community pharmacists were willing to
practice pharmacovigilance if they were trained.
•
Conclusions: Community pharmacists in Lagos had poor knowledge about pharmacovigilance. The reporting rate was also poor. There is
an urgent need for educational programs to train pharmacists about pharmacovigilance and ADR reporting. The problem of
underreporting can be considerably reduced by actively involving community pharmacists in the surveillance of drug safety within the
context of the pharmaceutical care they provide. Pharmacovigilance and knowledge about risks of ADRs should be part of the
undergraduate and postgraduate pharmacy education curriculum and ADR reporting, part of a pharmacist's basic tasks
Funding source(s): Self funded
Introduction
The concept of Pharmacovigilance (PVG) i.e. drug safety monitoring is an
old one but is just beginning to generate interest in many developing
countries including Nigeria
Adverse drug reactions (ADRs) are significant causes of morbidity and
mortality. ADRs may cause many hospitalizations and lead to large
economic burdens to patients and to society.2 Since pharmacovigilance
plays an essential role in the outcome of therapy, its evolution and its
importance as a science are critical for effective clinical practice and public
health science.
Spontaneous reporting of ADRs remains the cornerstone of
pharmacovigilance and is important in maintaining patient safety.
However, the success of this activity is dependent on the frequency of
reporting by the health care professionals, underreporting being the main
disadvantage.3
Introduction
In order to boost the performance of the Nigerian Pharmacovigilance
system, it is necessary to assess the practice of pharmacovigilance, and
identify reasons for under-reporting amongst healthcare professionals
Community Pharmacists both have an important responsibility in
monitoring the ongoing safety of medicines and are widely accessible to
do it
Objectives
In Nigeria, there is very scarce information on
the activities of pharmacists in
pharmacovigilance.
This study aims to investigate the knowledge,
perceptions and practice of
Pharmacovigilance amongst community
pharmacists in Lagos State, South west
Nigeria.
Also, their attitude towards ADRs reporting
was investigated.
Method
A cross-sectional observational survey was used in this study.
A multistage random sampling technique was employed in the
selection of the pharmacies. Following the Lagos state association
of community pharmacists zonal coordination list, community
pharmacies in Lagos state fall into 12 zones.
35 pharmacies per zone were randomly selected from each zone
given a total of 420.
The duly registered superintendent pharmacists who are in direct
supervision of the selected pharmacies were included in the study.
Method
The face-to-face questionnaire method was conducted
with the pharmacists after obtaining their consent to
participate in the study.
The data were subjected to frequency analysis and
Pearson’s chi-square tests using Statistical Package for
Social Sciences (SPSS) software version 15.0 for
Windows. Values of p<0.05 were considered as
significant
RESULTS
Table 1. Socio-demographic characteristics of community pharmacists in
Lagos (n=332)
Age
25–34
35–44
45–54
55–64
65þ
Frequency
50
60
106
76
40
(%)
(15.1)
(18.1)
(31.9)
(22.9)
(12.0)
Gender
Men
Women
103
229
(31.0)
(69.0)
Years of experience as
Community Pharmacist
1–5
6–10
10 and above
92
196
44
(27.6)
(59.1)
(13.3)
Post graduate qualifications
M Pharm
MBA
MSc
No response
4
92
56
180
(1.2)
(27.7)
(16.9)
(54.2)
Ownership
Self owned
Employed
120
212
(36.1)
(63.9)
The mean age of the respondents was 49.30 years. SEM¼3.13 (median
48.90). The mean years of practice as a community pharmacist was
6.19 years SEM¼0.335, (median 6.00).
RESULTS
Table 2. Relationship between years of experience as Community
Pharmacist and knowledge of Pharmacovigilance
Years of experience
1–5
6–10
>10
Total
Yes* (%) No (%)
29 (32)
63 (68)
111 (57) 85 (43)
44 (100)
0 (0)
184 (55) 148 (45)
Chi sq - 10.3690 df=2 p<0.005 n=332.
*Knowledge of pharmacovigilance.
Total
92 (100)
196 (100)
44 (100)
332 (100)
RESULTS
Table 3. Knowledge and Practice of Community Pharmacists towards
Adverse Drug Reaction reporting in Lagos (n=332)
Question
Have you ever heard about
Pharmacovigilance
Correct definition of
Pharmacovigilance
Have you reported ADRs in
the last 1 month ?
Have you received reports of ADRs
from patients in the last 1 month?
Do you report ADRs to the
National Pharmacovigilance Centre?
Do you know how to report ADRs?
Do you know where to
obtain the ADR forms?
Yes (%)
No (%)
184 (55)
148 (45)
57 (19)
275 (81)
65 (22)
267 (78)
266(80)
66 (20)
10 (3)
40 (12)
322 (97)
292 (88)
40 (12)
292 (88)
POLICY IMPLICATION
The main findings from this study were the fact that
the knowledge and practice of pharmacovigilance
amongst Nigerian community pharmacists was poor.
In Nigeria, poor knowledge of pharmacovigilance is
not peculiar to pharmacists alone, a study to determine
the extent of pharmacovigilance among resident
doctors in Nigeria9 showed a significant level of
deficiency in their knowledge of pharmacovigilance.
The study revealed that 78.1% of a total of 350 resident
doctors in Nigeria had inadequate knowledge about
pharmacovigilance.
POLICY IMPLICATION
Reasons for poor reporting according to respondents in
this study include lack of awareness about
pharmacovigilance and lack of incentives for ADR
reporting.
One important reason for poor reporting as implied
from this study is inaccessibility to the ADR forms,
as 88% of respondents claimed that they did not have
access to the forms
POLICY IMPLICATION
Majority of respondents believed that community
pharmacists were willing to practice pharmacovigilance
if they are trained just as they agreed that they
needed to update their knowledge of pharmacovigilance.
As a follow up to this study, we plan to carry out an
educational intervention which will consist of a training
program for the community pharmacists who participated
in this study, so that we will be able to evaluate
the influence of the education on all the measured parameters.
Posters and printed educational leaflets will be distributed to
the pharmacies
CONCLUSION
Community pharmacists in Lagos had poor
knowledge about pharmacovigilance.
If trained community pharmacists in Lagos were
willing to practice pharmacovigilance.
Pharmacovigilance and Knowledge
about risks of ADRs should be part of the undergraduate
and postgraduate pharmacy curriculum
and ADR reporting part of a pharmacist’s basic
tasks.