Effect of educational intervention on healthcare providers knowledge and perception towards pharmacovigilance: A tertiary teaching hospital experience

Drug regulatory affairs under focus: Knowledge and perceptions among pharmacists and pharmacy students

OBJECTIVES

Pharmaceutical product development, registration, and post-marketing surveillance are the main concerns of the Regulatory Affairs (RA) profession in regulated pharmaceutical industries. The RA assumes a pivotal role in ensuring product quality, patient safety, and drug efficacy and constitutes a vital part of the pharmaceutical industry. The current study aims to evaluate the knowledge and understanding of the concept of RA and Drug Registration (DR) among pharmacists and pharmacy students in Jordan.

METHODS

A cross-sectional study was conducted targeting pharmacists in different sectors and pharmacy students to assess knowledge and perceptions of RA and DR in Jordan. The participants were invited to participate by sending the survey link through social media platforms (WhatsApp).

RESULTS

A total of 411 participants completed the study survey. Among the study participants, 193 were pharmacists (47.0%), while the rest were pharmacy students. The majority indicated that they had never taken a course related to RA during their undergraduate studies (77.4%). About half of the participants lacked awareness of RA personnel responsibilities with most of the participants agreeing that workshops, lectures, and training are required.

INTERPRETATION OF RESULTS AND CONCLUSION

This study aims to elevate Jordanian pharmacists' awareness by focusing the efforts on young pharmacists and pharmacy students. This can be achieved by implementing RA courses within the pharmacy curricula and upholding the role of the regulatory bodies in Jordan.

Improving ADR reporting in Jordan: a qualitative exploration of pharmacists' perspectives

Background

Community pharmacists are most accessible to patients. Hence, they have a crucial role in ensuring drug safety by detecting and reporting adverse drug reactions (ADRs). However, there may be gaps in their knowledge of ADR reporting systems and barriers they face in reporting.

Objective

This study aims to assess community pharmacists' knowledge of ADR reporting systems in the Kingdom of Jordan, identify the barriers they face in reporting ADRs, and explore the broader factors that influence their involvement in pharmacovigilance activities.

Methods

In-depth, semi-structured, face-to-face interviews were held with 20 community pharmacists from different regions of Jordan to evaluate their understanding of ADR reporting, the obstacles they encountered, and the elements that could motivate them to report ADRs. The interviews were transcribed and subjected to thematic analysis to find recurrent themes and insights. The thematic analysis highlighted opportunities for continuing education and an absence of formal training as the main barriers to ADR reporting.

Results

Pharmacists reported dissatisfaction with time limits in their hectic work situations and the complexity of reporting procedures, especially the length and information demanded by ADR reporting forms. Another factor influencing low reporting rates was a perceived lack of acknowledgment and feedback. Participants proposed that encouraging ADR reporting with professional recognition or compensation and improving and digitizing the reporting process would promote increased participation.

Conclusion

ADR reporting presents considerable difficulties for community pharmacists in Jordan, mostly because of administrative obstacles and an absence of official support and training. Enhancing pharmacovigilance efforts in Jordan could be achieved by providing incentives, simplifying the reporting procedure, and incorporating reporting into the current pharmacy management software.

A retrospective analysis of the pharmacovigilance data registry in a tertiary teaching hospital in Jordan

Objectives

The study aims to analyse adverse drug reaction (ADR) reporting patterns at Jordan University Hospital to enhance pharmacovigilance practices.

Methods

Retrospective analysis of ADR data from February to August 2023 was conducted. Data included patient demographics, drugs implicated, seriousness criteria, and system organ classes affected.

Results

Among 1340 ADR reports analysed, females accounted for 67.4% of cases, with adults aged 18 to less than 65 years comprising 95.3% of reports. The majority of ADRs were non-serious, with only 2.1% resulting in hospitalisation or prolonged hospital stay. The most frequently reported ADRs included abdominal pain (8.3%), nausea (6.9%), headache (4.7%), and dizziness (4.7%). Notably, cardiovascular system drugs (16.4%) and alimentary tract and metabolism drugs (16.2%) were commonly associated with ADRs, followed by musculoskeletal system drugs (9.0%). Additionally, among all reported drugs, 99.9% were considered suspects, (suspected ADR cases include patient treatment cases for which a likelihood of being related to a drug therapy was scored as 'possible', 'probable', or 'certain' after causality assessment (by the WHO-UMC system in 2017), with oral administration being the predominant route (89.5%).

Conclusion

The study highlights a notable increase in ADR reporting during the study period compared to historical data, indicating heightened awareness and understanding among healthcare providers. Enhanced pharmacovigilance practices, particularly involving pharmacists, are essential for detecting and reporting ADRs effectively. Further investigation into factors contributing to prevalent serious ADRs is warranted to improve patient safety and health outcomes.

Pharmacovigilance teaching and learning: a mixed cross-sectional analysis of the Portuguese public higher education system

Pharmacovigilance stands out for its importance in obtaining existing knowledge about medicine and patient safety and should be recognized as a continuous line of study. It constitutes a highly relevant component in the activities of health professionals, with spontaneous notification of suspected adverse drug reactions being its main emphasis. The underreporting that persists can be overcome through continuous professional development programs, reinforcing theoretical and practical knowledge in the curricular plans of health courses. As a result, more educated professionals will also allow citizens to recognize the importance of pharmacovigilance. The main objective of this study was to describe and characterize the teaching-learning process of pharmacovigilance in Portugal, analyzing the knowledge, perceptions and attitudes of students and health professionals. In total, ninety-three curricular unit forms of the seventeen healthcare courses included were analyzed, among which only three referred to pharmacovigilance as mandatory and thirty-nine did not address any keywords. The questionnaire applied was answered by 650 participants, both students (62%) and professionals (38%). Approximately 84.4% of the students and 54.7% of the professionals affirmed that they had never spontaneously reported an adverse drug reaction. Only 24.6% of the students and 17.8% of professionals referred to the existence of specific course content dedicated to pharmacovigilance in their coursework. In view of these results, it is evident that there is a need for a wider reflection regarding the further training and constant update of practicing professionals as well as in diverse health institutions, investing in the creation of an academic curriculum that integrates pharmacovigilance in healthcare courses.

An Awareness of Pharmacovigilance Among Healthcare Professionals Due to an Underreporting of Adverse Drug Reactions Issue: A Systematic Review of the Current State, Obstacles, and Strategy

BACKGROUND

Healthcare professionals play an essential role in reporting adverse drug reactions as part of pharmacovigilance activities. However, adverse drug reactions reported by healthcare professionals remain low.

OBJECTIVE

The aim of this systematic review was to investigate healthcare professionals' knowledge, awareness, attitude, and practice on pharmacovigilance and adverse drug reaction reporting, explore the causes of the underreporting issue, and provide improvement strategies.

METHODS

This systematic review was conducted using four electronic databases for original papers, including PubMed, Scopus, Google Scholar, and Scholar ID. Recent publications from 1st January 2012 to 31st December 2022 were selected. The following terms were used in the search: "awareness", "knowledge", "adverse drug reaction", "pharmacovigilance", "healthcare professional", and "underreporting factor". Articles were chosen, extracted, and reviewed by the two authors.

RESULTS

Twenty-five studies were selected for systematic review. This review found that 24.8%-73.33% of healthcare professionals were unaware of the National Pharmacovigilance Center. Around 20%-95.7% of healthcare professionals have a positive attitude toward pharmacovigilance and adverse drug reaction reporting, while 12%-60.8% of healthcare professionals have experience reporting any adverse drug reaction in their practice. The most frequently highlighted barriers to pharmacovigilance were a lack of awareness and knowledge regarding what, when, and to whom to report.

CONCLUSION

Underreporting issues require immediate attention among healthcare professionals due to a lack of awareness and knowledge of pharmacovigilance and adverse drug reaction reporting. Educational and training program interventions have been suggested by most studies to address these issues.

Pharmacovigilance practice among pediatric neurologists from Poland and Germany

OBJECTIVES

To compare the pediatric neurologists' knowledge, practice, and barriers to the pharmacovigilance (PV) process in Poland and Germany.

METHODS

The research tool was an online anonymous questionnaire on Google Forms e-mailed to pediatric neurologists from Poland and Germany.

RESULTS

The questionnaires were handed out to 830 pediatric neurologists and 371 expressed their consent to participate in the study. Most of the neurologists were familiar with the definition of PV and adverse drug reactions (ADRs). Only 34.10% of pediatric neurologists from Poland, and 38.88% from Germany believe that many ADRs are preventable and almost most of them believe it is necessary to report ADRs from children with epilepsy. Unfortunately, in opposite to this knowledge, only 37.79% of respondents from Poland and 40.32% from Germany felt co-responsible for reporting ADRs. The main reason for the neurologists not to report ADRs was a conviction that reporting ADRs would be an additional burden generating extra work.

CONCLUSION

There is no big difference between the practice of PV by pediatric neurologists in Poland and Germany. System-regulated PV stabilization in the country translates into the practice of maintaining PV. Monitoring the safety of pharmacotherapy and knowledge of risks associated with ADRs should be included in the curricula of academic neurologics courses.

Patterns of adverse drug reactions in Jordan: a retrospective analysis of the National Pharmacovigilance Data Registry (2015-2021)

BACKGROUND

Post-marketing surveillance of drugs is a cornerstone of pharmacovigilance. This study was conducted to characterize patterns of adverse drug reactions (ADRs) reported in Jordan.

RESEARCH DESIGN AND METHODS

ADR reports submitted to the pharmacovigilance database of the Jordan Food and Drug Administration during 2015-2021 were retrospectively analyzed. The most commonly reported drugs, drug classes, ADRs, and ADRs consequences were explored. Logistic regression identified possible predictors of reporting serious ADRs.

RESULTS

A total of 2744 ADR reports were included, among which 28.4% were classified as serious. An annual increase in ADR reporting was observed. The most commonly implicated drug classes were antineoplastic and immunomodulating agents (24.0%), anti-infectives for systemic use (14.2%), and alimentary tract and metabolism (12.1%). Covid-19 vaccination was the most reported drug (22.8%). Fatigue (6.3%), injection site pain (6.1%), and headache (6.0%) were the top three common ADRs. Among ADRs with outcome information, 4.7% were fatal. Patient's age and intravenous medication use largely predicted reporting serious ADRs.

CONCLUSIONS

This study provides contemporary insights into the post-marketing surveillance of drugs in Jordan. The findings are foundational for future studies exploring drug-ADRs causality relationships. Efforts that promote pharmacovigilance concepts should be sustained and enhanced at the national level.

Jordanians' knowledge, attitude and practice regarding adverse drug reactions reporting

Objectives

The purpose of the current study was to evaluate the general public knowledge, attitudes, and practice regarding Adverse Drug Reactions (ADRs) reporting and pharmacovigilance in Jordan.

Methods

A cross-sectional study was conducted between July 16, 2022, and July 30, 2022, in Jordan. During the study period, an electronic survey consisting of 4 sections was administered to a convenience sample of Jordanians (aged 18 or above) using 2 social media platforms (Facebook and WhatsApp). Logistic regression analysis was used to screen the predictors of ADRs reporting by the participants.

Results

A total of 441 participants completed the survey. The majority of the participants (67.6%) were females, 53.1% between 26 and 45 years old. Almost all participants (96.3%) were always aware of the indication of the medications they take, the time and frequency (87.8%), and the duration of medications (84.4%). Nearly one-third of the participants (37.4%) asked about their medications' ADRs. However, the drug information leaflet was the most frequently used source of ADR information (33.3%). The majority of responders believed that both healthcare providers and consumers should report ADRs (93.4% and 80.3%, respectively). Only one-quarter of respondents (27.2%) believed that consumers could directly report ADRs through the Jordan pharmacovigilance program. The majority of patients who had experienced ADRs (70.3%) were aware that ADRs should be reported, and among them, 91.9% had reported the ADRs to healthcare providers. Furthermore, few participants (8.1%) reported it to the Jordan National Pharmacovigilance Centre (JNCP). Linear regression revealed that none of the demographic characteristics (age, gender, education, job, and social status) were affecting public reporting practice of the ADRs (P > 0.05 for all).

Conclusion

Respondents showed fair knowledge about adverse drug reactions and their reporting. However, there is a need to initiate educational activities and intervention programs to raise awareness about the JNPC, which will have a positive impact on public health and ensure safe medication use in Jordan.

Impact of the Role of the Clinical Pharmacist on the Underreporting of Adverse Drug Reactions at a Peruvian hospital

Background: The clinical pharmacists play a key role in the Pharmacovigilance System. They are integrated to the health team performing pharmacotherapeutic follow-up (PF), drug information, at third level care hospital. The objective of this study was to assess the impact of the clinical pharmacists' role in increasing the reporting of suspected adverse drug reactions (SADRs) after including in-service training (IST) in their role, as well as to characterize the reported ADRs. Methods: A longitudinal study was performed, reports of SADRs received through medical interconsultations were evaluated, before and after applying IST, in 2 periods: January 2017 to June 2018 and July 2018 to December 2019. Results: Interconsultations after IST were increased by 168,4%; of these, 75 were ADRs reported to the Dirección General de Medicamentos, Insumos y Drogas (DIGEMID). Internal Medicine and Pneumology services reported more SADR in both periods. There was significant statistical difference in ADRs' causality (P = .001) and type (P = .009). Severe ADRs highlighted after IST (4 vs 12). The most affected organ and system in both periods was skin and appendages. Conclusion: The reporting of SADRs augmented, reflected in an increase in medical interconsultations as a modality of SADR notification, after including IST to the role of the clinical pharmacist, allowing the development of convenient FP, which led to the evaluation of SARs. A higher number of serious ADRs were reported.

The impact of educational interventional session on healthcare providers knowledge about pharmacovigilance at a tertiary Jordanian teaching hospital

OBJECTIVE

A limited number of educational interventions among health care providers and students have been made in Jordan concerning the pharmacovigilance. Therefore, the main aim of this study was to evaluate how an educational workshop affected the understanding of and attitudes toward pharmacovigilance among healthcare students and professionals in a Jordanian institution.

METHODS

A questionnaire was used before and after an educational event to evaluate the pre- and post-knowledge and perception of pharmacovigilance and reporting of adverse drug reactions (ADRs) among a variety of students and healthcare professionals at Jordan University Hospital.

RESULTS

The educational workshop was attended by 85 of the 120 invited healthcare professionals and students (a response rate of 70.8%). The majority of respondents were capable of defining ADRs (n = 78, 91.8%) and pharmacovigilance accurately (n = 74, 87.1%) in terms of their prior understanding of the topic. Around 54.1% of the participants (n = 46) knew the definition of type A ADRs while 48.2% of them (n = 41) knew the definition of type B ADRs. Additionally, around 72% of the participants' believed that only serious and unexpected ADRs should be reported (n = 61, 71.8%), also, 43.5% of them (n = 37) believed that ADRs should not be reported until the specific medication that caused it is known. The majority of them (n = 73, 85.9%) agreed that reporting of ADRs was their responsibility. The interventional educational session has significantly and positively impacted participants' perceptions (p value ≤ 0.05). The most reason for not reporting ADRs as stated by the study participants was the lack of information provided by patients (n = 52, 61.2%) and the lack of enough time to report (n = 10, 11.8%).

CONCLUSION

Participants' perspectives have been greatly and favorably impacted by the interventional educational session. Thus, ongoing efforts and suitable training programs are required to assess the effect of bettering knowledge and perception on the practice of ADRs reporting.

Knowledge, attitudes and practice regarding pharmacovigilance and adverse drug reaction reporting among physicians and pharmacists in Egypt: a step toward personalized medicine implementation

Aim: To assess the knowledge, attitudes, and practices of the healthcare professionals working at Children's Cancer Hospital Egypt regarding pharmacovigilance (PV) and adverse drug reaction (ADR) reporting, in addition to the ADR reporting barriers. Materials & methods: A cross-sectional study was conducted at Children's Cancer Hospital Egypt from July to September 2021 using a validated questionnaire. Results: About 37 physicians (20.3%) and 145 pharmacists (79.7%) responded to the survey. Overall, the knowledge (median: 40%) and practice (median: 50%) of PV and the reporting of ADRs were low; however, attitudes were mostly positive. The main barrier to reporting ADRs was The difficulty of determining whether or not ADRs occurred (42.3%). Conclusion: Understanding of PV and ADR reporting could improve the huge gap between ADRs experienced and ADRs reported. In order to be able to assess the impact of personalized medicine implementation, adequate ADR reporting should be well established.

Knowledge, attitude and practice of hospital pharmacists towards Pharmacovigilance and adverse drug reaction reporting in Najran, Saudi Arabia

Introduction

 Pharmacovigilance (PV) is critical in determining the risk–benefit ratio of medicines and encouraging their safe, rational, and effective use, hence enhancing patient safety and care. Pharmacists, as drug experts, share responsibility for ensuring that medicines remain safe.

Objective

 The study aimed to assess the knowledge, attitude, and practice of hospital pharmacists towards PV and adverse drug reaction (ADR) reporting and to know factors that discourage them from reporting ADRs in Najran, Saudi Arabia.

Methods

A pre-tested self-administered questionnaire was distributed to all the pharmacists working in government hospitals who consented to participate in the study. Data was collected over three months, from 01 June 2018 to 31 Aug 2018. Data were analyzed using Statistical Package for Social Science (SPSS) software for Windows, version 23. Descriptive statistics such as frequency and percentages, mean ± standard deviation (SD) were calculated, and the Pearson's Chi-square test was used to examine the relationship between different variables.

Results

A total of 145 questionnaires were distributed, and the response rate obtained was 70.3%. The definition of PV and ADR were correctly identified by 42% and 68.3% of participants, respectively. A noteworthy finding is that 95% of participants were aware of the existence of the ADR reporting system, and 88.9% knew the responsible regulatory agency. Participants showed a positive attitude towards PV and ADR reporting; 90.1% considered ADR reporting a part of professional obligation, and 94.1% believed that there should be collaboration between pharmacists and other healthcare professionals. A majority of participants (86.1%) had identified an ADR during their practice, and 71.3% had reported an ADR. The unavailability of a professional environment to discuss ADR and insufficient pharmacotherapy/clinical knowledge was cited as the main factors discouraging from reporting ADRs.

Conclusions

Overall, the pharmacists had an average to good knowledge of and positive attitude towards PV and ADR reporting and a good ADR reporting practice. The concept of PV and ADR reporting should be further strengthened, and there is a vast potential for the same.

Neurologists' Knowledge, Practice, and Attitudes towards Pharmacovigilance and Adverse Drug Reactions Reporting Process in Epileptic Patients-Comparative Analysis from Poland and Egypt

Objectives: To compare neurologists’ knowledge, practice, and barriers of pharmacovigilance (PV) process among patients with epilepsy in Poland and Egypt. Methods: It was an international study that used an online questionnaire e-mailed to neurologists registered to practice in Poland and Egypt. Results: Most of the neurologists were familiar with the definition of PV and adverse drug reactions (ADRs), but relatively few neurologists knew where to report ADRs, especially the Egyptian neurologists. Only 31.11% of the neurologists from Egypt and 39.90% neurologists from Poland declared that they had reported ADRs at least once during their professional practice, and few of them declared the regular reporting of such incidents. The main reason for the neurologists not reporting ADRs was the lack of time and a conviction that reporting ADRs would be an additional burden that would generate extra work. Conclusion: The standards of pharmacovigilance process, safety control, and quality are not the same throughout the world. System-regulated PV stabilization in a country translates into the practice of maintaining PV. Monitoring the safety of pharmacotherapy and knowledge of risks associated with ADRs should be included in the academic curricula of physician courses.

Adverse drug reactions reporting practice and associated factors among community health extension workers in public health facilities, Southwest, Nigeria

Introduction

timely adverse drug reactions (ADRs) reporting has contributed immensely towards public health safety. Community health extension workers (CHEWs) provides basic medical care in rural areas. This study assessed the knowledge, attitude, practice, and determinants of ADRs reporting among CHEWs in public health institutions, Southwest, Nigeria.

Methods

a cross-sectional survey of 333 CHEWs randomly selected from public health facilities using self-administered questionnaires. The questionnaire sought information on the knowledge, attitude and practice of CHEWs towards ADRs reporting. The knowledge and attitude questions were scored and categorized. The association between dependent and independent variables assessed with bivariate and multivariate logistic regressions, and p < 0.05 considered statistically significant.

Results

among 333 respondents, 205 (61.6%) had encountered patients with ADRs but only 26 (12.6%) had reported it with yellow forms. About half, 169 (50.8%), and 191 (57.4%) respondents had a positive attitude and inadequate knowledge of ADRs reporting respectively. Sex (aOR: 2.84, 95% CI: 2.10-7.10; p < 0.0001), working in Ogbomoso area (aOR: 3.3, 95% CI: 1.34-8.21; p=0.01), and training (aOR: 2.01, 95% CI: 1.20-3.42; p = 0.01) were factors associated with adequate knowledge. The determinant of ADRs reporting was training (aOR: 3.63, 95% CI: 1.13-11.63; p = 0.03).

Conclusion

though CHEWs had a slightly positive attitude, they had inadequate knowledge and poor ADRs reporting. The determinant of inadequate ADRs reporting knowledge and under reporting was lack of training. There is an urgent need for educational intervention programmes towards improving knowledge and practices of ADRs reporting among CHEWs.

Traditional Lectures Actually Improve the Body of Knowledge, Skills, and Attitudes of Health Care Professional for Health Incident Reporting System

Introduction: A solid patient safety culture lies at the core of an effective event reporting system in a health care setting requiring a professional commitment for event reporting identification. Therefore, health care settings should provide strategies in which continuous health care education comes up as a good alternative. Traditional lectures are usually more convenient in terms of costs, and they allow us to disseminate data, information, and knowledge through a large number of people in the same room. Taking in consideration the tight money budgets in Brazil and other countries, it is relevant to investigate the impact of traditional lectures on the knowledge, skills, and attitudes to incident reporting system and patient safety culture. Objective: The study aim was to assess the traditional lecture impact on the improvement of health care professional competency dimensions (knowledge, skills, and attitudes) and on the number of health care incident reports for better patient safety culture. Participants and Methods: An open-label, nonrandomized trial was conducted in ninety-nine health care professionals who were assessed in terms of their competencies (knowledge, skills, and attitudes) related to the health incident reporting system, before and after education intervention (traditional lectures given over 3 months). Results: All dimensions of professional competencies were improved after traditional lectures (P < .05, 95% confidence interval). Conclusions: traditional lectures are helpful strategy for the improvement of the competencies for health care incident reporting system and patient safety.

Pharmacovigilance education to healthcare professionals: Will it affect their performance in reporting adverse drug reactions?

AIM

To assess impact of pharmacovigilance (PV) educational program on knowledge, attitude and practice (KAP) of healthcare professionals (HCPs).

METHODS

a prospective study was conducted on HCPs at an Egyptian hospital. The study included: pre-education phase; where KAP questionnaire was administered by HCPs to obtain baseline data, intervention phase; where educational sessions were held by clinical pharmacists and Egyptian PV centre, and post-education phase; where the questionnaire was re-administered by participants 9 months post-receiving educational sessions. The questionnaire comprised five sections: participants' demographics, knowledge, attitude and practice sections and two multiple choice questions asking about the importance of establishment of ADRs monitoring centre, and factors hindering ADRs reporting. Pre-education and post-education data were compared.

RESULTS

From 221 HCPs invited to participate, only 153 filled the pre-education and post-education questionnaires. At baseline, the median (range) of the total KAP score were 1 (0-7), 1 (0-4) and 4 (0-14) for physicians, nurses and pharmacists, respectively. All KAP scores were low for all HCPs at baseline with the pharmacists having significantly higher knowledge and attitude scores compared with physicians, and nurses (P < .001). After education, all scores significantly increased and 13 ADRs were reported by HCPs compared with only 2 at baseline.

CONCLUSION

It was concluded that educational program had a significant impact on enhancing KAP of HCPs towards PV and ADRs reporting.

Teaching Pharmacovigilance to Healthcare Students: Identifying Gaps and Opportunities for Improvement

The literature indicates that the limited pharmacovigilance knowledge demonstrated by healthcare professionals is the main reason for the underreporting of adverse drug reactions. Therefore, the main objective of this study was to investigate pharmacy, dental and medical students' knowledge and attitudes to pharmacovigilance and pharmacovigilance education. The cross-sectional questionnaire study was conducted at the University of Split School of Medicine in November 2020. In total, 350 students participated in the study. The results have shown that pharmacy students showed a significantly higher knowledge score compared to dental and medical students (P < 0.001). In total 92.2% of pharmacy, 21.8% of dental and 70.8% of medical students had knowledge of patients' involvement in adverse drug reactions, reporting (P < 0.001). Interestingly, only 44.3% of all students knew that adverse drug reactions could be reported using a mobile application. Moreover, significantly more pharmacy students (74.4%) were aware of the adverse drug reactions monitoring center in Croatia, with 47.5% of dental and 39.2% of medical students correctly identifying it (P < 0.001). The results showed that most students felt that pharmacovigilance was not adequately covered in curricula; therefore, there is a great need to increase the knowledge and awareness of pharmacovigilance among students aspiring to become future healthcare professionals, and improve their reporting practice in clinical future.

Pharmacist-led educational interventions provided to healthcare providers to reduce medication errors: A systematic review and meta-analysis

INTRODUCTION

Medication errors are avoidable events that can occur at any stage of the medication use process. They are widespread in healthcare systems and are linked to an increased risk of morbidity and mortality. Several strategies have been studied to reduce their occurrence including different types of pharmacy-based interventions. One of the main pharmacist-led interventions is educational programs, which seem to have promising benefits.

OBJECTIVE

To describe and compare various pharmacist-led educational interventions delivered to healthcare providers and to evaluate their impact qualitatively and quantitatively on medication error rates.

METHODS

A systematic review and meta-analysis was conducted through searching Cochrane Library, EBSCO, EMBASE, Medline and Google Scholar from inception to June 2020. Only interventional studies that reported medication error rate change after the intervention were included. Two independent authors worked through the data extraction and quality assessment using Crowe Critical Appraisal Tool (CCAT). Summary odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model for rates of medication errors. Research protocol is available in The International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42019116465.

RESULTS

Twelve studies involving 115058 participants were included. The two main recipients of the educational interventions were nurses and resident physicians. Educational programs involved lectures, posters, practical teaching sessions, audit and feedback method and flash cards of high-risk abbreviations. All studies included educational sessions as part of their program, either alone or in combination with other approaches, and most studies used errors encountered before implementing the intervention to inform the content of these sessions. Educational programs led by a pharmacist were associated with significant reductions in the overall rate of medication errors occurrence (OR, 0.38; 95% CI, 0.22 to 0.65).

CONCLUSION

Pharmacist-led educational interventions directed to healthcare providers are effective at reducing medication error rates. This review supports the implementation of pharmacist-led educational intervention aimed at reducing medication errors.

Nurses' Knowledge on Sepsis Related to Mechanical Ventilation: An Intervention Study

BACKGROUND

Sepsis is a leading cause of mortality and morbidity worldwide. South African adult public critical care units experience incidences of sepsis on an ongoing basis. Nurses caring for mechanically ventilated adult patients in intensive care units (ICUs) need to base their nursing care on "surviving sepsis campaign" (SSC) guidelines to properly manage sepsis. Adequate knowledge on sepsis guidelines remains crucially indicated for nurses as they endeavor to maintain asepsis in critically ill patients.

PURPOSE

This study was conducted to assess the effect of an educational intervention on nurses' knowledge and practices of sepsis in mechanically ventilated adult patients in public ICUs.

METHODS

An intervention study, with quasi-intervention two-group, pretest-posttest design, was used to collect data using a self-administered, structured, pretest and posttest questionnaire designed to measure nurses' knowledge and practices on sepsis related to mechanical ventilation. The study was conducted between June and October 2018. An educational intervention was developed and validated. Five purposively selected public ICUs in the Eastern Cape, South Africa, were selected and assigned to three groups: Intervention Group 1 (ICUs 1 and 2), which received the full intervention (containing a 20-minute PowerPoint presentation, printed materials based on sections of the SSC guidelines, and monitoring visits bimonthly for 3 months); Intervention Group 2 (ICUs 3 and 4; receiving the same as Intervention Group 1 but with no monitoring visits); and the control group (ICU 5; receiving no intervention).

RESULTS

One hundred seventeen nurses completed the questionnaires at pretest, and 94 completed the questionnaires at posttest, producing a response rate of 79% and 80%, respectively. The results revealed a significant knowledge score increase between pretest and posttest for both Intervention Group 2 (53.28 ± 14.39 and 62.18 ± 13.60, respectively; p = .004) and the control group (56.72 ± 13.72 and 70.05 ± 12.40, respectively; p = .001). Similarly, a recommended practice score increase was shown for Intervention Group 2 (58.8 ± 9.63 and 62.80 ± 9.52, respectively), and a significant increase was shown for the control group (56.72 ± 7.54 and 63.29 ± 5.89, respectively; p = .002). Intervention Group 1 showed a detectable but not significant decline in knowledge (57.72 ± 13.99 and 54.61 ± 12.15, respectively) and recommended practice (61.22 ± 8.66 and 60.33 ± 7.83, respectively) scores.

CONCLUSIONS

The availability of SSC guidelines was found to have increased knowledge on sepsis related to mechanical ventilation, although including monitoring visits as part of the educational intervention was not found to have a positive effect on increasing knowledge and practices. Further studies are required to explore factors contributing to improving knowledge and practices on sepsis related to mechanical ventilation and the effect that various educational interventions have in this context.

[Moroccan pharmacy students' knowledge and perceptions about pharmacovigilance]

OBJECTIVE

The aim of this study was to evaluate the impact of an educational work groups on the knowledge and perception of 2nd year pharmacist students towards pharmacovigilance in a moroccan faculty of medicine and pharmacy.

METHOD

A descriptive study conducted in pharmacology laboratory of the faculty of medicine and pharmacy of Rabat on 2nd year pharmacist students, to assess their knowledge and perception towards PV via questionnaire before and after an educational work groups.

RESULTS

Among the 122 invited students, 108 responded to the questionnaire distributed before working group with a participation rate of 88,5 %. This rate increased to 95,9 % (n=117) after work groups sessions. Pre-work groups, students showed an overall low knowledge, where only 27.7 % knew the ADRs reporting sheet. In addition, most students were not well prepared to report ADR in their future practice (n=82, 75.92 %). Work groups partially offsetting this deficit, and helped to better explain to the students the reporting system. Resulting in only 28 participants maintained their declaration of inability to report ADR in their future practice (25.92 %). On the other hand, students showed a favorable perception.

CONCLUSION

In this study, students expressed the desire to learn more about PV during their university education. This result led to the introduction of a system of PV working groups for 3rd and 4th year pharmacy students for the 2018-2019 academic year.

Physicians' Understanding and Practices of Pharmacovigilance: Qualitative Experience from A Lower Middle-Income Country

Developed countries have established pharmacovigilance systems to monitor the safety of medicines. However, in the developing world, drug monitoring and reporting are facing enormous challenges. The current study was designed to explore the challenges related to the understanding and practices of physicians in reporting adverse drug reactions in Lahore, Pakistan. Through the purposive sampling technique, 13 physicians were interviewed. All interviews were audio-recorded, transcribed verbatim, and analyzed for a thematic content analysis. The thematic content analysis yielded six major themes: (1) Familiarity with medication safety and adverse drug reaction (ADR) concept, (2) Knowledge about pharmacovigilance activities, (3) Practices related to ADR reporting, (4) Barriers impeding ADR reporting, (5) Acknowledgement of the pharmacist’s role, and (6) System change needs. The majority of the physicians were unaware of the ADR reporting system; however, they were ready to accept practice changes if provided with the required skills and training. A lack of knowledge, time, and interest, a fear of legal liability, poor training, inadequate physicians’ and other healthcare professionals’ communication, and most importantly lack of a proper reporting system were reported as barriers. The findings based on emerging themes can be used to establish an effective pharmacovigilance system in Pakistan. Overall, physicians reported a positive attitude towards practice changes, provided the concerned authorities support and take interest in this poorly acknowledged but most needed component of the healthcare system.

Current knowledge regarding medication-related osteonecrosis of the jaw among different health professionals

PURPOSE

To assess the current knowledge regarding medication-related osteonecrosis of the jaw (MRONJ); the adverse effects of anti-resorptive (AR) and anti-angiogenic (AA) drugs; strategies for MRONJ prevention and treatment; and perception of the dentist's role in assisting patients who use these drugs among physicians, dentists, and nurses.

METHODS

Using questionnaires, the current knowledge of MRONJ was assessed among dentists, physicians, and nurses, who were divided into group I, which included specialties that directly assist cancer patients, and group II, which included other specialties. The questionnaires assessed the characteristics of the health professionals, training time, and specialties; their knowledge of AR and AA drugs; and their knowledge of MRONJ.

RESULTS

A total of 1370 health professionals participated in the study, including 1032 dentists, 239 physicians, and 99 nurses. Among dentists and physicians, the training time (p = 0.036 and p < 0.001, respectively) and specialization in group I domains (p < 0.001 and p < 0.001, respectively) had a significant impact on MRONJ knowledge, while nurses showed no significant impact regardless of the training time and specialty. Less than 10% of the physicians and dentists could correlate the signs and symptoms of all stages of MRONJ.

CONCLUSION

The findings indicated a notable lack of knowledge regarding MRONJ among dental surgeons and physicians, and especially among nurses. More experienced professionals and specialists in the areas that assist cancer patients usually have a greater understanding of the dentist's role in MRONJ prevention, diagnosis, treatment, and patient care and will introduce or are already using AR and AA drugs.

The Efficiency of Multi-Faceted Educational Intervention on Knowledge, Perceived Behavior, and Practice Skills towards Pharmacovigilance among Undergraduate Pharmacy Students of India

BACKGROUND

The primary reason for poor adverse drug reaction (ADR) signal detection worldwide is the under-reporting of ADRs by healthcare professionals. Multidisciplinary teams, including pharmacists, may play an essential role in targeting this issue.

AIM

The purpose of the study was to evaluate the impact of a multi-faceted educational intervention (MEI) on the knowledge, perception, and practice skills of pharmacovigilance among undergraduate pharmacy students.

METHODS

A longitudinal, prospective study using a single group before-and-after intervention design was conducted among 100 undergraduate pharmacy students at Togari Veeramallappa Memorial College of Pharmacy, Ballari, India (TVMCP), affiliated to Vijayanagara Institute of Medical Sciences (VIMS), Ballari, India. The questionnaire was structured using previous studies and standardized. It had three groups of questions. Group 1 questions evaluated the knowledge (K1-K8), group 2 tested perceptions (A1-A6), and group 3 tested the practice skills of pharmacovigilance (P1-P5) of the participant. The participants were graded in 3 categories as poor, unsatisfactory, and satisfactory, depending upon the mean score. Matched pairs student t-test and The Wilcoxon Signed rank statistical test was used to assess the impact of the MEI on the participants' knowledge, perception, and practice skills score, along with recording different factors preventing them from being actively involved in the pharmacovigilance program.

RESULTS

The educational intervention improved the pharmacovigilance knowledge, perception, and practice skills scores of our pharmacy students.

CONCLUSION

Our study showed that knowledge, perception, and practice skills scores increased after MEI highlighting the need for regular educational campaigns to healthcare professions.

Analysis of spontaneous reporting of suspected adverse drug reactions for non-analgesic over-the-counter drugs from 2008 to 2017

BACKGROUND

Adverse drug reaction (ADR) reporting practices by health care professionals remain poor. Over-the-counter (OTC) drugs are perceived as safe; however, they can also cause ADRs. The objective of this study was to analyze ADR reporting for OTC drugs in a 10-year period, in order to evaluate frequency of ADRs, population that ADRs most affect and reporters of ADRs of OTC drugs in Croatia.

METHODS

Spontaneously reported ADRs of non-analgesic OTC drugs, collected from January 2008 to December 2017 were analyzed. Data was obtained from Agency for Medicinal Products and Medical Devices of Croatia (HALMED).

RESULTS

There were 547 ADRs of OTC drugs reported in total and an increase in number of reports through the years was observed. Pharmacists reported 45.4% of all ADRs, and were most frequent reporters (p < 0.001). In 2017 majority of reports, 62 (49.2%), were obtained from consumers. ADRs were most frequently observed in patients aged 70 years and older (15% of ADRs). Five percent of all reports were accidental exposures among children.

CONCLUSIONS

Pharmacists most frequently reported ADRs of OTC drugs and consumers' awareness of ADR reporting has risen. Other health care professionals (e.g., nurses and dentists) must be offered proper education in order to improve reporting practice of ADRs. Health care professionals should address concerns about OTC drug safety in elderly and children.

Pharmacists' knowledge and perceptions about pharmacovigilance and barriers towards adverse drug reactions reporting in Yemen

Objective

The current study aims to assess Yemeni pharmacists’ knowledge, attitude and practice of adverse drug reactions (ADRs) reporting systems and to determine barriers hindering them from reporting.

Methods

A cross-sectional descriptive study was conducted between August and October 2017. One hundred sixty-two pharmacists practicing in both community and hospital settings were recruited from five governorates using a convenient sampling technique. A validated self-administered questionnaire was used to collect data and to achieve the study objectives. Descriptive analysis was done using Statistical Package for Social Science version 20.

Key findings

Out of 260 questionnaires distributed, 162 pharmacists responded (Response rate of 62.3%). In terms of knowledge, 156 (96.3%) were not aware of the existence of ADRs reporting system in Yemen. The overall average knowledge score among pharmacists was 1.2 (SD = 1.2) out of 7. Concerning practice, about (140, 87.0%) of pharmacists disclosed that patients reported at least one ADRs annually. Insufficient clinical knowledge of pharmacist, unavailability of ADRs reporting form and unawareness of existence of the national ADRs reporting system were noticed to be the main barriers towards ADRs reporting.

Conclusions

Most of pharmacists were unaware of the ADRs reporting system in Yemen. However, advertising, education and intensive training are needed to improve awareness and to ensure an effective ADRs reporting process.

Educational intervention to improve the knowledge, attitude and practice of healthcare professionals regarding pharmacovigilance in South-South Nigeria

Background

Our aim in this study was to evaluate the effect of a combined educational intervention and year-long monthly text message reinforcements via the Short Messaging System (SMS) on the knowledge, attitude and practice (KAP) of healthcare professionals (HCPs) towards pharmacovigilance.

Methods

Six randomly selected teaching hospitals in the South-South zone of Nigeria were randomized in 1:1 ratio into intervention and control groups. The educational intervention consisted of delivering a seminar followed by sending monthly texts message reinforcements via SMS over 12 months. Then a semi-structured questionnaire regarding the KAP of pharmacovigilance was completed by HCPs working in the hospitals after the intervention. Data was analysed descriptively and inferentially.

Results

A total of 931 HCPs participated in the post intervention study (596 in the intervention and 335 in the control). The M:F ratio was 1:1.5. According to the KAP questionnaire, a significant difference was observed between the intervention and control groups, regarding knowledge of the types of adverse drug reactions (ADRs). ADR resulting from pharmacological action of the drug (85.6% versus 77%, p = 0.001), the fact that ADRs can persist for a long time; (60.1% versus 53.4%, p = 0.024) and a higher awareness of the ADR reporting form (48.7% versus 18.8%, p < 0.001). Most respondents in the intervention group (68.5% versus 60.6%, p = 0.001) believed they should report ADRs even if they were unsure an ADR has occurred, a greater proportion of HCPs from the intervention group had significantly observed an ADR (82% versus 73.4%, p = 0.001). Furthermore, of the 188 who had ever reported an ADR, 41% from the intervention group used the national ADR reporting form compared with 19.8% from the controls (p < 0.001).

Conclusion

This educational intervention and the use of SMS as a reinforcement tool appeared to have positively impacted on the knowledge and practice of pharmacovigilance in South-South Nigeria with a less-than-impressive change in attitude. Continuous medical education may be required to effect long-lasting changes.