Skip to main content

Advertisement

Log in

Direct reporting of adverse drug reactions by healthcare consumers in Africa: a narrative review

  • Review Article
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Background The challenges of under-reporting of adverse drug reactions have been identified as a major setback for the pharmacovigilance system worldwide. Direct reporting by health care consumers has been adopted in some developed and developing countries with a positive impact in improving pharmacovigilance activities through increased reporting rate. There are limited reports on direct reporting and its outcome in Africa. Aim of the review The study aimed to identify and present the available evidence on direct reporting of adverse drug reactions by healthcare consumers in Africa. Methods A review guided by Cochrane handbook was conducted. Electronic scientific databases such as PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase and Cochrane Library were searched. Google scholar, general Google search engine, the website for the regulatory resources for Africa and World Health Organisation—Uppsala Monitoring were also searched for available guidelines, documents and publications. The review period was January 1992 to October 2019. The results were analysed descriptively. Results This study identified 16 African countries that have included healthcare consumers as eligible to report adverse drug reactions in their policy/guidelines. There is low awareness of healthcare consumers on pharmacovigilance system. Eight (8) out of thirty-six (36) African countries that are members of the World Health Organisation Programme for International Drug Monitoring have formally launched direct reporting by healthcare consumers which are 14.2% of African countries. There is a wide range of difference between the rate of adverse drug reactions report submitted by health care consumers as compared with healthcare workers. Paper form, text messages, telephone and web application-based reporting system have been used by different countries that have launched direct reporting. Poor infrastructure, low awareness and lack of a reporting culture are major challenges while the availability of common reporting methods is a potential opportunity of promoting direct reporting in African countries. Conclusions Few African countries have adopted and launched direct reporting. Reporting rate through direct methods is still relatively low when compared with reporting by healthcare workers. Published legal framework, policies, guidelines and studies on direct reporting are limited. Availability of a system and reporting method are opportunities to improve and overcome probable challenges.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Edwards IR, Aronson JK. Adverse drug reactions: definitions, diagnosis, and management. Lancet. 2000;356(9237):1255–9.

    CAS  PubMed  Google Scholar 

  2. Mudhaliar MR, Ghouse ISM, Gollapalli M, Bendala S, Pasumarthy R, Chinnakotla V. Responses of healthcare professionals to a standard self-administered questionnaire on pharmacovigilance and adverse drug reactions in South India. J Basic Clin Pharm. 2017;8(3):173–7.

    Google Scholar 

  3. Sultana J, Cutroneo P, Trifirò G. Clinical and economic burden of adverse drug reactions. J Pharmacol Pharmacother. 2013;4(Suppl1):73.

    Google Scholar 

  4. Davies EC, Green CF, Taylor S, Williamson PR, Mottram DR, Pirmohamed M. Adverse drug reactions in hospital in-patients: a prospective analysis of 3695 patient-episodes. PLoS One. 2009;4(2):e4439.

    PubMed  PubMed Central  Google Scholar 

  5. Tan K, Petrie KJ, Faasse K, Bolland MJ, Grey A. Unhelpful information about adverse drug reactions. BMJ Br Med J. 2014;349.g5019. https://doi.org/10.1136/bmj.g5019

  6. World Health Organization. The importance of pharmacovigilance. Safety monitoring of medicinal products. Geneva, Switzerland: World Health Organization. 2002. ISBN: 92-4-159015-7. http://archives.who.int/tbs/safety/s4893e.pdf. Accessed 1 Oct 2019.

  7. World Health Organization. Pharmacovigilance: ensuring the safe use of medicines. Geneva, Switzerland: World Health Organization, 2004. ISBN: 9789352707034. http://whqlibdoc.who.int/hq/2004/WHO_EDM_2004.8.pdf. Accessed 1 Oct 2019.

  8. Al Dweik R, Yaya S, Stacey D, Kohen D. Spontaneous adverse drug reaction reporting by patients in Canada: a multi-method study—study protocol. SpringerPlus. 2016;5(1):213.

    Google Scholar 

  9. Aagaard L, Nielsen LH, Hansen EH. Consumer reporting of adverse drug reactions. Drug Saf. 2009;32(11):1067–74.

    PubMed  Google Scholar 

  10. Amin MN, Khan TM, Dewan SMR, Islam MS, Moghal MR, Ming LC. Cross-sectional study exploring barriers to adverse drug reactions reporting in community pharmacy settings in Dhaka, Bangladesh. BMJ Open. 2016;6(8):e010912.

    PubMed  PubMed Central  Google Scholar 

  11. John LJ, Arifulla M, Cheriathu J, Sreedharan J. Reporting of adverse drug reactions: a study among cinicians. J Appl Pharm Sci 2012;2(6):135–39.

    Google Scholar 

  12. Lopez-Gonzalez E, Herdeiro MT, Figueiras A. Determinants of under-reporting of adverse drug reactions. Drug Saf. 2009;32(1):19–31.

    CAS  PubMed  Google Scholar 

  13. Hazell L, Shakir SA. Under-reporting of adverse drug reactions. Drug Saf. 2006;29(5):385–96.

    PubMed  Google Scholar 

  14. Ampadu HH, Hoekman J, de Bruin ML, Pal SN, Olsson S, Sartori D, et al. Adverse drug reaction reporting in Africa and a comparison of individual case safety report characteristics between Africa and the rest of the world: analyses of spontaneous reports in VigiBase®. Drug Saf. 2016;39(4):335–45.

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Gurmesa LT, Dedefo MG. Factors affecting adverse drug reaction reporting of healthcare professionals and their knowledge, attitude, and practice towards ADR reporting in Nekemte Town, West Ethiopia. BioMed Research International. 2016.

  16. Robertson J, Newby DA. Low awareness of adverse drug reaction reporting systems: a consumer survey. Med J Aust. 2013;199(10):684–6.

    PubMed  Google Scholar 

  17. Isah AO, Pal SN, Olsson S, Dodoo A, Bencheikh RS. Specific features of medicines safety and pharmacovigilance in Africa. Ther Adv Drug Saf. 2012;3(1):25–34.

    PubMed  PubMed Central  Google Scholar 

  18. Ndagije HB, Nambasa V, Manirakiza L, Kusemererwa D, Kajungu D, Olsson S, et al. The burden of adverse drug reactions due to artemisinin-based antimalarial treatment in selected Ugandan health facilities: an active follow-up study. Drug Saf. 2018;41(8):753–65.

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Aagaard L, Hansen EH. Consumers’ reports of suspected adverse drug reactions volunteered to a consumer magazine. Br J Clin Pharmacol. 2010;69(3):317–8.

    PubMed  PubMed Central  Google Scholar 

  20. Blenkinsopp A, Wilkie P, Wang M, Routledge PA. Patient reporting of suspected adverse drug reactions: a review of published literature and international experience. Br J Clin Pharmacol. 2007;63(2):148–56.

    CAS  PubMed  Google Scholar 

  21. Wilson V, Amma V. Prospects of consumer-initiated adverse drug reaction reporting in cardiovascular pharmacovigilance. J Pract Cardiovasc Sci. 2015;1(1):54.

    Google Scholar 

  22. Jha N, Rathore DS, Shankar PR, Thapa BB, Bhuju G, Alshakka M. Need for involving consumers in Nepal’s pharmacovigilance system. Aust Med J. 2014;7(4):191.

    Google Scholar 

  23. Anderson C, Krska J, Murphy E, Avery A. The importance of direct patient reporting of suspected adverse drug reactions: a patient perspective. Br J Clin Pharmacol. 2011;72(5):806–22.

    PubMed  PubMed Central  Google Scholar 

  24. Basch E, Jia X, Heller G, Barz A, Sit L, Fruscione M, et al. Adverse symptom event reporting by patients vs clinicians: relationships with clinical outcomes. JNCI J Natl Cancer Inst. 2009;101(23):1624–32.

    PubMed  Google Scholar 

  25. Hammond IW, Rich DS, Gibbs TG. Effect of consumer reporting on signal detection: using disproportionality analysis. Exp Opin Drug Saf. 2007;6(6):705–12.

    Google Scholar 

  26. Van Grootheest K, de Graaf L. Consumer adverse drug reaction reporting. Drug Saf. 2003;26(4):211–7.

    PubMed  Google Scholar 

  27. Van Hunsel F, Passier A, Van Grootheest K. Comparing patients’ and healthcare professionals’ ADR reports after media attention: the broadcast of a Dutch television programme about the benefits and risks of statins as an example. Br J Clin Pharmacol. 2009;67(5):558–64.

    PubMed  PubMed Central  Google Scholar 

  28. Bencheikh R, Squalli M, Ouled Errkhis R, Skalli S, Benkirane R, Khattabi A. Pharmacovigilance in Africa and contributing factors of its development. Conference paper. Rabat, Morocco. First African congress of Pharmacovigilance, 2013.

  29. Ogar CK, Ibrahim A, Osakwe AI, Jajere F, Kigbu-Adekunle AA, Alonge K, et al. Pharmacovigilance rapid alert system for consumer reporting (PRASCOR): a look at its quantitative contribution to spontaneous reporting in Nigeria from August 2012 to February 2017. Pharm Med. 2018;32(2):131–41.

    Google Scholar 

  30. Margraff F, Bertram DJDS. Adverse drug reaction reporting by patients: an overview of fifty countries. Drug Saf. 2014;37(6):409–19.

    CAS  PubMed  Google Scholar 

  31. Avery T, Anderson C, Bond C, Fortnum H, Gifford A, Hannaford PC et al. Evaluation of patient reporting of adverse drug reactions to the UK 'Yellow Card Scheme': literature review, descriptive and qualitative analyses, and questionnaire surveys. Health Technol Assess. 2011;15(20):1–234.

  32. Inacio P, Cavaco A, Airaksinen M. The value of patient reporting to the pharmacovigilance system: a systematic review. Br J Clin Pharmacol. 2017;83(2):227–46.

    PubMed  Google Scholar 

  33. Saleh HA, Fourrier-Réglat A, Diogène E. Patient-centered pharmacovigilance: a review. Trop J Pharm Res. 2018;17(1):179–88.

    Google Scholar 

  34. Inacio P, Gomes JJ, Airaksinen M, Cavaco A. Exploring sociodemographic and economic factors that promote adverse drug reactions reporting by patients. Health Policy. 2018;122(3):263–8.

    PubMed  Google Scholar 

  35. Watson S, Chandler RE, Taavola H, Härmark L, Grundmark B, Zekarias A, et al. Safety concerns reported by patients identified in a collaborative signal detection workshop using VigiBase: results and reflections from Lareb and Uppsala Monitoring Centre. Drug Saf. 2018;41(2):203–12.

    PubMed  Google Scholar 

  36. Jumo C. Health workers and hospital patients knowledge of pharmacovigilance in Sokoto, north-west Nigeria. Nigerian J Pharm Sci. 2012;11:31–40.

    Google Scholar 

  37. Sabblah GT, Darko DM, Mogtari H, Harmark L, van Puijenbroek E. Patients’ perspectives on adverse drug reaction reporting in a developing country: a case study from Ghana. Drug Saf. 2017;40(10):911–21.

    CAS  PubMed  Google Scholar 

  38. Jacobs TG, Ampadu HH, Hoekman J, Dodoo AN, Mantel-Teeuwisse AK. The contribution of Ghanaian patients to the reporting of adverse drug reactions: a quantitative and qualitative study. BMC Public Health. 2018;18(1):1384.

    PubMed  PubMed Central  Google Scholar 

  39. Adisa R, Adeniyi OR, Fakeye TO. Knowledge, awareness, perception and reporting of experienced adverse drug reactions among outpatients in Nigeria. Int J Clin Pharm. 2019;41:1062–1073.

    PubMed  Google Scholar 

  40. Agoro OO, Kibira SW, Freeman JV, Fraser HSF. Barriers to the success of an electronic pharmacovigilance reporting system in Kenya: an evaluation three years post implementation. J Am Med Inform Assoc. 2018;25(6):627–34.

    PubMed  Google Scholar 

  41. Darko DMaSG. Implementing patient reporting of adverse reactions in Africa WHO pharmaceuticals newsletter. 2016.

  42. Zimbabwe MCAo. Zimbabwe National Pharmacovigilance Policy Handbook. In: Care MoHaC, editor. 2nd ed. Zimbabwe2016. p. 139.

  43. Pierce CE, de Vries ST, Bodin-Parssinen S, Härmark L, Tregunno P, Lewis DJ, et al. Recommendations on the Use of mobile applications for the collection and communication of pharmaceutical product safety information: lessons from IMI WEB-RADR. Drug Saf. 2019;42(4):477–89.

    PubMed  PubMed Central  Google Scholar 

  44. Pharmacy Boardof SierraLeone. Guideline For detecting and reporting adverse drug reactions. In: Sanitation MoHa, editor. Freetown: Pharmacy Board of SierraLeone; 2019.

  45. Egyptian Pharmaceutical Vigilance Center. Safety information form (cards). The Egyptian Pharmaceutical Vigilance Centre (EPVC), Egypt. http://www.epvc.gov.eg/adr/. Accessed 1st July 2019.

  46. Kiberu VM, Mars M, Scott RE. Barriers and opportunities to implementation of sustainable e-Health programmes in Uganda: a literature review. Afr J Prim Health Care Fam Med. 2017;9(1):e1–10.

    PubMed  Google Scholar 

  47. Isabalija SR, Mbarika V, Kituyi GM. A framework for sustainable implementation of e-medicine in transitioning countries. Int J Telemed Appl. 2013;2013:8.

    Google Scholar 

  48. Fernandopulle RBM, Weerasuriya K. What can consumer adverse drug reaction reporting add to existing health professional-based systems? Drug Saf. 2003;26(4):219–25. doi:https://doi.org/10.2165/00002018-200326040-00002.

    Article  PubMed  Google Scholar 

  49. Elshafie S, Zaghloul I, Roberti AM. Pharmacovigilance in developing countries (part I): importance and challenges. 2018;40(4):758–763.

    PubMed  Google Scholar 

  50. Bukirwa H, Nayiga S, Lubanga R, Mwebaza N, Chandler C, Hopkins H, et al. Pharmacovigilance of antimalarial treatment in Uganda: community perceptions and suggestions for reporting adverse events. Trop Med Int Health. 2008;13(9):1143–52.

    PubMed  Google Scholar 

  51. MedicinesControlCouncil. reporting of post-marketing adverse drug reactions to human medicinal products in South Africa. In: Health, Do, editors South Africa 2014. p. 20.

  52. Jha N, Rathore DS, Shankar PR, Thapa BB, Bhuju G, Alshakka M. Need for involving consumers in Nepal’s pharmacovigilance system. Aust Med J. 2014;7(4):191–5.

    Google Scholar 

  53. Alshakka M, Jha N, Algefri S, Ibrahim MIM, Hassali MA, Abdorabbo A, et al. Problems and challenges faced in consumer reporting of adverse drug reactions in developing countries—a case study of Yemen, Nepal and Malaysia. Indian J Pharm Biol Res. 2014;2(3):37.

    CAS  Google Scholar 

  54. Santos A. Direct patient reporting in the european union—a snapshot of reporting systems in seven member states. 2015. http://haiweb.org/publications-page/. Accessed 1 Oct 2019.

  55. WEBRADR. Mobile App pilot in African countries. 2017. Accessed 28 Sept 2018.

  56. de Langen J, van Hunsel F, Passier A, de Jong-van den Berg L, van Grootheest K. Adverse drug reaction reporting by patients in The Netherlands three years of experience. Drug Saf. 2008;31(6):515–24.

    PubMed  Google Scholar 

  57. Li H, Guo X-J, Ye X-F, Jiang H, Du W-M, Xu J-F, et al. Adverse drug reactions of spontaneous reports in shanghai pediatric population. PLoS One. 2014;9(2):e89829.

    PubMed  PubMed Central  Google Scholar 

  58. Härmark L, van Hunsel F, Grundmark B. ADR reporting by the general public: lessons learnt from the Dutch and Swedish systems. Drug Saf. 2015;38(4):337–47.

    PubMed  Google Scholar 

  59. Service MoHaS. Namibia-national-guidelines-for-medicine-safety-surveillance. National Guidelines for Medicine Safety Surveillance. Therapeutics Information and Pharmacovigilance Center, TIPC; 2011. p. 22.

  60. van Hunsel F, Härmark L, Pal S, Olsson S van, Grootheest KJDs. Experiences with adverse drug reaction reporting by patients. Drug Saf. 2012;35(1):45–60.

    PubMed  Google Scholar 

  61. Yamamoto M, Kubota K, Okazaki M, Dobashi A, Hashiguchi M, Doi H, et al. Patients views and experiences in online reporting adverse drug reactions: findings of a national pilot study in Japan. Patient Prefer Adherence. 2015;9:173–84.

    PubMed  PubMed Central  Google Scholar 

  62. Dodoo AN. Active safety surveillance in Africa: pragmatism and agility. Drug Saf. 2018;41(8):731–3.

    PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to thank the health science librarian of the University of KwaZulu-Natal, Pravina D Laljeeth for assisting in the development of search strategy for this study. Acknowledgement is also addressed to Prof Ibrahim A. Oreagba, Dr Muyideen A Adenola and Dr Monsurat Lawal for proofreading this article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Halimat Adedeji-Adenola.

Ethics declarations

Funding

During the writing of this paper, HAA received running cost from the College of Health Sciences, University of KwaZulu-Natal, South Africa.

Conflicts of interest

The authors declare that they have no competing interests. There are no activities that may influence the submitted work.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Adedeji-Adenola, H., Nlooto, M. Direct reporting of adverse drug reactions by healthcare consumers in Africa: a narrative review. Int J Clin Pharm 43, 11–24 (2021). https://doi.org/10.1007/s11096-020-01141-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-020-01141-x

Keywords

Navigation