A Preliminary Study of Knowledge, Attitude and Practice of Adverse Drug Reaction Reporting in a Teaching Hospital in Lusaka, Zambia

Abstract

Objectives of the Study: The study was aimed at examining ADR reporting practices and barriers among medical doctors, pharmacists, nurses, clinical officers, and medical residents at the University Teaching Hospital, Lusaka, Zambia. The specific objectives were: a) to assess the knowledge of ADR reporting among health professionals, b) to assess attitudes of health professionals towards ADR reporting, and c) to assess the practice of ADR reporting among health professionals. Materials and Methods: The study adopted a questionnaire-based cross-sectional method. One hundred and forty questionnaires were administered to health professionals working at the University Teaching Hospital, Lusaka. Statistical Analysis Used: The Statistical Package for the Social Sciences (SPSS) version 20 was used to run various descriptive statistics and to draw charts. Pearson's Chi-square test was used to observe the association of knowledge and attitude with experience and position, at significance level of 0.05. Results: One hundred and twenty-eight questionnaires were successfully filled in and returned, giving a response rate of 91.4%. Knowledge of ADR reporting among the professionals was extremely very low. Only one respondent obtained 50% of the total scores, i.e. 19 marks out of 34 marks; and no respondent got above 50%. The minimum score obtained was 0, the maximum score was 19, and the average score was 12.6 with a standard deviation of 3.555. There was no association between knowledge level of ADR reporting and age of the respondent (r=0.003 (n=123); p=0.973). Furthermore, there was no association between knowledge levels of ADR reporting and length of respondents' practice at UTH (r=0.013 [n=120]; p=0.886). Low knowledge levels of ADR reporting were attributed to lack of training. Only 17.7% of respondents had been trained in ADR reporting. The major factors that encouraged ADR reporting included: if the reaction was serious (84.7%); if the reaction was unusual (77.4%); if the reaction was to a new product (73.4%); if the reaction was well recognized for a particular drug (60.5%); and confidence in diagnosis of an ADR (46.0%). Factors that discouraged ADR reporting included: lack of feedback (73.5%); the level of clinical knowledge to decide whether an ADR had occurred (49.0%); lack of time to actively look for ADRs (46.9%); the information reported may be wrong (37.8%); lack of time to fill in a report (36.7%); and lack of need to report a recognized ADR because it will make little difference to knowledge (30.6%). Very few (12.7%) respondents had reported an ADR case. The major factors found to be responsible for under reporting of ADR include ignorant of reporting procedures (52.0%), lack of reporting forms (31.8%), and lack of appreciation of the importance of ADR reporting. Conclusion: This study observed that knowledge of ADR reporting was very low among health professionals at UTH. These deficiencies in knowledge and attitudes require urgent attention not only to improve the rate of ADR reporting, but also in order to improve the safety of the patients. Furthermore, the hospital management should improve awareness and training on ADR reporting