Abstract
Background:
Adverse drug reactions (ADRs) constitute a significant global healthcare challenge associated with increased morbidity, mortality and healthcare costs; however, there are concerns that ADRs are grossly under-reported by different categories of healthcare professionals (HCPs) in many countries. The main objective of this study was to assess the knowledge, attitude and practice of ADR reporting of HCPs working at the primary, secondary and tertiary levels of care in Ekiti State, Nigeria.
Methodology:
This was a self-administered questionnaire-based study conducted among HCPs working in Ekiti State, South-west Nigeria. The questionnaire which was adapted from ones used in similar studies was reviewed for content validity by experts in the field. Healthcare professionals (medical doctors, pharmacists, nurses, community health extension workers, and other allied HCPs) working in the 3 tiers of healthcare participated in the study. The questionnaire consisted of sections on the demographics of respondents, their knowledge, attitude and practice of ADR reporting. Data analysis was done using SPSS (version 25) employing t test, ANOVA and chi-square as appropriate with P-value < .05 accepted as being statistically significant.
Results:
Three hundred HCPs comprising of nurses (112; 37.3%), physicians (75; 25.0%), pharmacists (53; 17.7%), community health extension workers (40; 13.3%) and others (20; 6.7%) completed the questionnaire with 166 (55.3%) of them working in tertiary healthcare facilities. Male respondents (6.3 ± 1.7; P = .003), pharmacists (7.0 ± 1.6; P < .0001), HCPs and those from tertiary centers (6.2 ± 1.7; P = .028) had higher knowledge scores. While 228 (76%) respondents had observed incidents of ADR during their professional practice, only 75 (25%) have ever reported it. Only 113 (37.7%) of respondents had seen the adverse drug reaction reporting form with only 53 (17.7%) ever using it. The reporting methods preferred by respondents were through email/internet (102; 34.0%), phone/SMS (78; 26.0%) and using the hard copy of the forms (95; 31.7%). The attitude of respondents towards ADR reporting was mainly positive.
Conclusion:
There was significant variation in the knowledge of different categories of HCPs and facility levels about ADR reporting. Encouragingly, the overall attitude of respondents towards ADR reporting was positive. Based on the above, strategies are needed to build capacity of HCPs in the area of on adverse drug reaction and its’ reporting.
Keywords: adverse drug reactions, pharmacovigilance, healthcare professionals, knowledge, attitude, practice
Introduction
Adverse drug reactions (ADRs) have been shown to constitute a significant health challenge in both developed and developing nations by being associated with increased morbidity and mortality, prolonged hospital stays, increased utilization of healthcare resources and increased cost of healthcare.1-4 Prevalence studies in various settings showed that approximately 5% to 35% of many preventable hospital admissions are due to ADRs with a huge financial burden. 5 In a study of 18 820 patients in the United Kingdom, Pirmohamed et al reported that 7% of admissions were due to ADRs. 6 Similarly, a review of observational studies conducted in Europe found that 3.5% of ADRs outside the hospital led to hospitalization and 10.1% of ADRs during hospitalizations led to longer hospital stays. 7 Reports from a study conducted in 4 hospitals in South Africa revealed that 8.4% of admissions were due to ADRs. 8 In the same vein, a review of studies from India reported incidence rates of 2.9% and 6.3% for ADRs leading to admissions and ADRs developed during admissions respectively. 9 The incidence rate of adverse drug reactions occurring during admission from studies conducted in Nigeria among adult and pediatric inpatients was 10.7% and 1.2% respectively.10,11 Pharmacovigilance is defined by the World Health Organization (WHO) as the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other possible drug-related problems. 12 The randomized controlled trials (RCTs) used as the pre-marketing methods to detect and quantify ADRs have several drawbacks, such as limited study sample size and limited heterogeneity due to the exclusion of older patients.13,14 Therefore, post-marketing drug safety monitoring through PV activities helps to detect potential ADRs not captured during RCTs. 15 Methods employed to detect ADRs include: spontaneous reporting, carrying out observational prospective cohort or retrospective database studies, prescription event monitoring and case control studies.16,17 Causality assessment of suspected ADRs is important in the reporting of ADRs; this is usually done using the World Health Organization-Uppsala Monitoring Center (WHO-UMC), Naranjo and other assessment scales.18,19 Spontaneous reporting remains the most common method used by healthcare professionals (HCPs) worldwide. 20 Healthcare professionals contribute significantly to ADR reporting worldwide leading to detection of rare and sometimes life-threatening ADRs. Hence adequate knowledge and positive attitude of HCPs towards ADRs reporting are important in this regard. There are concerns, however, that ADRs are grossly under-reported by HCPs in many countries. A systematic review on the determinants of under-reporting of ADRs identified the following factors: ignorance, lack of interest, unavailability of reporting forms, lack of time and not being sure whether the report will make any difference. 21 Other reasons enumerated in studies conducted in LMICs include lack of training in ADR reporting, not being aware of the appropriate authority to report to, poor feedback from national reporting centers and lack of incentives.22-25 In Nigeria, the procedure for reporting of ADRs starts from the HPCs who document the observed or reported ADR using the yellow card. The yellow card is an ADR reporting form which was developed in the United Kingdom and is used widely for ADR reporting worldwide. The report is then submitted to the hospital pharmacovigilance committee from where it is forwarded to the regional pharmacovigilance center. The National Pharmacovigilance Center which is a unit under the National Agency for Food Drug Administration Control and Administration (NAFDAC) collates and analyzes reports from regional pharmacovigilance centers in the whole country. The collated reports of ADRs are then submitted to the WHO Global Individual Case Safety Report database, VigiBase. Many studies have been conducted in Nigeria to assess the knowledge, attitude and practice of different categories of HCPs about ADR reporting.26-31 These studies portrayed high level of under-reporting with between 1.5% and 42.7% of respondents ever reporting ADRs. Additional findings from the Nigerian studies showed that 32.3% to 95.0% of participants were not aware of the national ADR reporting scheme.26-31 Most of these studies were conducted in single healthcare facilities, among specific professional categories and mostly in tertiary healthcare facilities; hence, its findings may not adequately inform about the knowledge and practice of HCPs in Nigeria, especially those practicing in secondary and primary-level healthcare facilities. We are aware that a substantial part of the Nigerian population access healthcare at primary and secondary healthcare facilities, therefore, the need to investigate the level of knowledge, attitude and practice of ADR reporting among HCPs in these settings. To the knowledge of the authors, this is the first study from Nigeria looking at the subject matter simultaneously across the 3 tiers of healthcare. The findings from this study will be used as a template for appropriate interventions towards improved reporting of adverse drug reactions by different categories of HCPs in Ekiti State and other parts of Nigeria.
Thus, the current study was proposed to assess the knowledge, attitude and practice of HCPs on ADR reporting. We also sought to compare the knowledge about ADR reporting among different categories of HCPs (medical doctors, pharmacists, nurses, community health extension workers, laboratory scientists and pharmacy technicians). We also investigated the factors responsible for under-reporting of the ADRs by HPCs in the selected healthcare facilities.
Methodology
This was a self-administered questionnaire-based study conducted among different categories of HCPs in Ekiti State, South-west Nigeria.
Study Setting: The study was conducted in facilities from all 3 tiers of healthcare in Ekiti State, South-west Nigeria. The state is divided into 3 senatorial districts consisting of 16 local government areas with each of the senatorial districts having its own share of the healthcare facilities. 32 The public healthcare system has 3 level: primary, secondary, and tertiary. The primary level comprises basic and comprehensive health centers usually manned by nurses, community health extension workers (CHEW) and sometimes medical doctors. Community health extension workers are trained to provide appropriate, relevant healthcare services at the PHCs as well as community health education and outreach services. The secondary level of healthcare comprises general hospitals with a complement of medical doctors, nurses, pharmacists, and other allied healthcare workers. The tertiary healthcare level comprises mainly of University Teaching Hospitals, Federal Medical Centers and other specialized hospitals with consultants in various medical specialties, nursing professionals, pharmacists and other allied healthcare workers. These facilities also serve as training centers for undergraduate and postgraduate medical, nursing and other allied healthcare disciplines. At the time of the study, there were 30 primary comprehensive health care centers, 20 secondary-level general hospitals and 6 tertiary level hospitals. 33
Sampling and Sample Size
The study was carried out in randomly selected healthcare facilities: comprehensive health centers (one in each of the 3 senatorial districts of Ekiti-State), 1 general hospital in each senatorial district and 3 tertiary facilities: Ekiti-State University Teaching Hospital, Ado-Ekiti, State Specialist Hospital, Ikere-Ekiti and Federal Teaching Hospital, Ido-Ekiti.
An online statistical software (Raosoft®) was used to estimate the sample size using a sampling frame of 1250 and the following assumptions: 95% confidence interval (CI), 5% margin of error, prevalence rate set at 50%.
An estimated sample size of 295 was arrived based on the above. A total of 350 questionnaires were then distributed to participating healthcare facilities factoring in their respective staff population. A stratified random sampling technique was use to select participants from different tiers of healthcare facility and professional categories. Table 1 shows the sampling distribution per type of facility and professional category.
Table 1.
Sampling Table Showing Details of Size According to Facility Type and Professional Category.
| Professional category | Primary | Secondary | Tertiary | Total |
|---|---|---|---|---|
| Medical doctors | 5 | 15 | 70 | 90 |
| Nurses | 20 | 40 | 70 | 130 |
| Pharmacists | 0 | 15 | 45 | 60 |
| Community health extension workers | 40 | 5 | 0 | 45 |
| Others (Pharmacy technicians, laboratory technologists) | 15 | 10 | 0 | 25 |
| Total | 80 | 85 | 185 | 350 |
Study Instrument
The questionnaire, drafted in English, was adapted from ones used in similar studies with modifications to suit our context.26,34 The questionnaire, which was pre-tested, was also reviewed for content validity by experts in the field of clinical pharmacology and therapeutics and pharmacy. The items in the questionnaire had a good internal consistency with a calculated Cronbach’s alpha of .85. Apart from the demographic characteristics of respondents, the questionnaire had sections about knowledge, attitudes and practices of pharmacovigilance. The section on knowledge of pharmacovigilance had 10 questions/statements with a weight of 1 point each making a total attainable score of 10 points. A score of < 4, 4 to 6 and > 6 was classified as poor, average and good knowledge, respectively. The duration of professional practice was dichotomized into < 10 years and greater than 10 years. The attitude and practice sections which were qualitative in nature consisted of 7 and 8 statements/questions respectively and were not combined into a cumulative score.
Study Procedure
The principal investigator visited each facility, interacted with staff informing them about the aims and objectives of the study and invited them to participate. The principal investigator then left the questionnaires assigned to each participating facility in the care of a focal person (dedicated staff interested in pharmacovigilance) to coordinate the distribution and collection of the questionnaires. The questionnaires were distributed during departmental activities by the focal persons and collected after 1 week.
Ethical approval for the study was obtained from the Research and Ethics Committee of Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria before the commencement of the study. Completion of the questionnaire by respondents was taken as implicit consent.
Data analysis: Collected data was screened for accuracy, completeness, and consistency and those found incomplete or missing in addressing important variables were discarded. Data analysis was performed with IBM SPSS version 25 (Armonk, NY: IBM Corp). Categorical variables (sex, cadre of physicians, facility level, and knowledge level) were summarized using frequencies and percentages while the normally distributed continuous variables (pharmacovigilance knowledge score) were summarized using mean and standard deviation. Normality of data was determined using Kolmogorov-Smirnov test. Comparison of means (pharmacovigilance knowledge score) of the variables (professional category, facility level and duration of practice) was done using ANOVA and Student t test as appropriate. Association between categorical variables (duration of practice, professional category, facility level and knowledge level) was assessed using Chi-square test. A P-value less than.05 was accepted as statistically significant association.
Results
Background Information
Three hundred completed questionnaires were returned giving an overall response rate of 85.7%. The response rate for HCPs in primary, secondary and tertiary healthcare facilities was 91.3%, 71.3%, and 89.7% respectively. Similarly, the response rate for medical doctors, nurses, pharmacists and CHEWs was 83.3%, 86.2%, 88.3%, and 88.9% respectively. Female respondents (182; 60.7%) were the majority. Nurses (112; 37.3%) had the highest number of respondents followed by medical doctors (75; 25%), pharmacists (53; 17.7%), CHEWs (40; 13.3%) and other categories (20; 6.7%). A majority (166; 55.3%) of respondents worked in tertiary healthcare facilities while 61 (20.4%) and 73 (24.3%) were from secondary and primary healthcare facilities.
Knowledge of Pharmacovigilance
The mean knowledge score was 5.90 ± 1.80 with 65 (21.7%), 119 (39.7%) and 116 (38.7%) respondents having poor, average and good knowledge respectively. Male respondents (6.3 ± 1.7), pharmacists (7.0 ± 1.6), workers from tertiary facilities (6.2 ± 1.7) and those with >10 years work experience (5.9 ± 1.8) had higher knowledge scores. There were statistically significant differences in knowledge scores based on sex, facility level and professional category (P value of .012, .003, and <.0001 respectively). Details of these associations can be seen in Table 2. Comparison of means of the knowledge score among the different grouped variables revealed statistically significant differences among professional categories, facility levels and sex (P value of <.0001, .028, and .003 respectively). Details are shown in Table 3. The results of additional sub-analysis (comparison) of mean knowledge score for various professional groups within the professional category is shown in Table 4.
Table 2.
Association Between Knowledge Class and Other Variables.
| Variable | Good knowledge n (%) | Average knowledge n (%) | Poor knowledge n (%) | Total | X2 | P value |
|---|---|---|---|---|---|---|
| Sex | 8.875 | .012* | ||||
| Male | 57 (48.3) | 43(36.4) | 18 (15.3) | 118 | ||
| Female | 59 (32.4) | 76 (41.8) | 47 (25.8) | 182 | ||
| Age group | 3.197 | .525 | ||||
| <25 years | 10 (40.0) | 11 (44.0) | 4 (16.0) | 25 | ||
| 25 to 45 years | 74 (35.9) | 83 (40.3) | 49 (23.8) | 206 | ||
| >45 years | 32 (46.4) | 25 (36.2) | 12 (17.4) | 69 | ||
| Professional cadre | 38.501 | <.0001* | ||||
| Medical doctor | 35 (46.7) | 30 (40.0) | 10 (13.3) | 75 | ||
| Pharmacist | 34 (64.2) | 14 (26.4) | 5 (9.4) | 53 | ||
| Nurse | 37 (33.0) | 46 (41.1) | 29 (25.9) | 112 | ||
| Community health extension workers | 7 (17.5) | 22 (55.0) | 11 (27.5) | 40 | ||
| Others | 3 (15.0) | 7 (35.0) | 10 (50) | 20 | ||
| Facility level | 15.833 | .003* | ||||
| Primary | 17 (23.3) | 33 (45.2) | 23 (31.5) | 73 | ||
| Secondary | 26 (42.6) | 18 (29.5) | 17 (27.9) | 61 | ||
| Tertiary | 73 (44.0) | 68 (41.0) | 25 (15.0) | 166 | ||
| Duration of practice | 1.986 | .370 | ||||
| 1 to 10 years | 62 (39.7) | 58 (37.2) | 36 (23.1) | 156 | ||
| >10 years | 49 (38.6) | 56 (44.1) | 22 (17.3) | 127 |
Note. *Some missing values (17) in variable “duration of practice.”
Table 3.
Comparison of Mean Knowledge Scores of Categorical Variables.
| Variable | Number of respondents | Mean knowledge score (SD) | F | P value |
|---|---|---|---|---|
| Sex | 1.061 | .003* | ||
| Male | 118 | 6.29 (1.65) | ||
| Female | 182 | 5.65 (1.85) | ||
| Age group | 2.098 | .025* | ||
| <25 years | 25 | 6.36 (1.98) | ||
| 25 to 45 years | 206 | 5.79 (1.76) | ||
| >45 years | 69 | 6.06 (1.85) | ||
| Professional cadre | 3.357 | <.001* | ||
| Medical doctor | 75 | 6.23 (1.48) | ||
| Pharmacist | 53 | 7.10 (1.49) | ||
| Nurse | 112 | 5.65 (1.76) | ||
| CHEW | 40 | 5.22 (1.62) | ||
| Others | 20 | 4.45 (2.16) | ||
| Facility level | 2.054 | .028* | ||
| Primary | 73 | 5.21 (1.85) | ||
| Secondary | 61 | 5.94 (1.89) | ||
| Tertiary | 166 | 6.20 (1.67) | ||
| Duration of practice | 2.403 | .854 | ||
| 1 to 10 years | 156 | 5.90 (1.85) | ||
| > 10 years | 127 | 5.94 (1.80) |
Note. *Some missing values (17) in variable “duration of practice.”
Table 4.
Post- hoc (ANOVA) Comparison of Different Professional Groups in the Professional Category.
| Professional category | Medical doctor P value | Pharmacist P value | Nurses P value | CHEW P value | Other HCPs P value |
|---|---|---|---|---|---|
| Medical doctor | – | .001* | .02* | .001* | <.0001* |
| Pharmacist | .001* | – | <.0001* | <.0001* | <.0001* |
| Nurses | .02* | <.0001* | – | .18 | .008* |
| CHEW | .001* | <.0001* | .18 | – | .130 |
| Other HCPs | <.0001* | <.0001* | .008* | .130 | – |
Note. *Statistical significance at P < .05.
Practice of Pharmacovigilance
A majority (228; 76%) of respondents have seen patients with ADRs during their practice but only 75 (25%) have ever reported. Only 118 (38.3%) of respondents have seen the adverse drug reaction reporting (yellow) form while 53 (17.7%) have reported ADRs using the form. One hundred and ninety-four respondents knew about the national pharmacovigilance center while 57 (19%) were aware of the existence of a pharmacovigilance unit in their facility. The reporting methods preferred by respondents are email/web format (102; 34%), telephone/SMS (78 (26%), completed hard copy of reporting forms (95; 31.7%) and by post (7; 2.5%).
Attitude Towards Pharmacovigilance
The attitude of respondents towards ADR reporting was mainly positive; ADR reporting was viewed as a necessity by 255 (85.0%) respondents, 260 (86.4%) of them advocated for the establishment of pharmacovigilance centers in their facilities and 287 (95.7%) expressed the need for pharmacovigilance to be taught to HPCs. Cross-tabulation of the attitude of respondents and sex, professional category and facility level did not yield statistically significant associations.
Barriers Towards ADR Reporting and Suggestions for Improvement
The factors discouraging respondents from reporting ADRs are shown in Table 5.
Table 5.
Factors Discouraging ADR Reporting by Respondents.
| Factors discouraging ADR reporting | n (%) |
|---|---|
| Lack of renumeration | 59 (24.7) |
| Lack of time | 76 (31.8) |
| Difficulty in diagnosing ADRs | 79 (33.0) |
| Lack of effect whether report is made or not | 25 (10.5) |
Training of HPCs, increasing sensitization about ADRs, establishment of pharmacovigilance centers in facilities, making available reporting forms, promoting patient reporting of ADRs and provision of remuneration are suggestions made by respondents towards improving reporting of ADRs.
Discussion
This study assessed mainly the knowledge, attitude and practice of HPCs from several Nigerian healthcare facilities about adverse drug reporting and factors that may affect it. Overall, less than 40% of respondents had good knowledge about ADR reporting while their attitude towards it was largely positive.
Female respondents, nurses and those working in tertiary healthcare facilities predominated among respondents. This is not surprising as majority of the nursing staff in most healthcare facilities in Nigeria are women and nurses are more in number than any other category of HPCs. Tertiary healthcare facilities have more HPCs than primary and secondary healthcare facilities as shown in the sampling table. This explains why more respondents were from the tertiary healthcare facilities. The existence of some sort of research culture in tertiary healthcare facilities may also reflect in the response rate of participants.
Pharmacists ranked first in the knowledge of ADR reporting followed by medical doctors, nurses, and other HCPs. The difference in the mean scores were also statistically significant. Findings from studies conducted in Ethiopia and Bhutan also found that doctors and nurses were less knowledgeable about ADR reporting than pharmacists.35,36 The relatively better knowledge exhibited by pharmacists is likely due to more emphasis being put on issues related to adverse drug reactions and its reporting in under-graduate pharmacy curriculum. Pharmacists are also usually in charge of pharmacovigilance units of their facilities and as such may be more familiar with issues relating to pharmacovigilance than other HPCs. There were statistically significant associations between knowledge level, sex, facility level, and professional category in our study. In contrast to findings from our study, nurses were found to know more than medical doctors about ADR reporting in a study conducted in Jordan. 22 Healthcare professionals from tertiary facilities also had a higher knowledge score than those working in other tiers. This is likely due to the fact that HCPs working in this setting enjoy various capacity building programmes and have completed some form of specialization or post-graduate training. Healthcare professionals at the primary care level are mostly community health extension workers with basic training; this may account for the relatively wide gap in knowledge. Majority of our respondents were females working as nurses or CHEWs; hence, the observed significant lower knowledge scores among them. Based on our findings, there is a need for continuing medical education in the area of ADR and it’s reporting for HCPs, especially nurses and CHEWs.
Reports from similar studies showed that while a large proportion of HCPs had observed ADRs in daily clinical practice, only a few ever reported such cases.23,26,37-39 The same trend was observed in this study. Training about ADR reporting has been shown to improve HCPs’ knowledge and practice of ADR reporting.40,41 Only 95 (31.7%) respondents in this study had some form of training on ADR reporting similar to reports from South Africa and Saudi Arabia with 76.2% and 76.3% of the respondents had no training.24,38 Adverse drug reaction reports are usually collated and processed at the national pharmacovigilance center for each country. Majority (194; 64.7%) of participants in our study knew of the national pharmacovigilance center in Nigeria, an outcome similar to reports from studies conducted among HCPs in Nepal and Ethiopia.42,43 The preferred format for ADR reporting by respondents were internet/web format, hard copy of reporting form and using telephone/SMS. This is not surprising because of the availability of affordable smartphones and internet services in Nigeria. The importance of online reporting of ADRs have been demonstrated in studies conducted in many developed nations.44-47 The attitudes of HCPs in this study was overwhelmingly positive, a finding in keeping with results from studies conducted in other LMICs.35,48,49
Lack of time, uncertainty about nature of reactions to report, not knowing where to report to, non-availability of reporting forms and lack of training are some of the factors identified from literature that may contribute to under-reporting of ADRs.28,50-52 Another contributory factor to ADR under-reporting identified in our study was the lack of incentives for HCPs. The use of incentives was also suggested by HCPs in recent studies conducted in Pakistan and China.53-55 Addressing this issue of incentives may be an approach to consider by healthcare authorities in Nigeria and other LMICs.
Study Limitations
The study was conducted in healthcare facilities within Ekiti State, Nigeria and hence there was no geographical spread across the whole country. Also, being a self-reporting study, response bias and accuracy of recall by participants may have some impact on the study results.
Conclusion
There was significant variation in the knowledge of different categories of HPCs and facility levels about ADR reporting. This was on a background of predominantly positive attitude towards ADR reporting by respondents. Based on the above, strategies are needed to build capacity of HPCs, especially nurses and CHEW in the area of pharmacovigilance particularly at primary and secondary health care facilities. Additional intervention that can be considered include constant monitoring and evaluation of ADR reporting in facilities with a reward mechanism for performers. Also, a simplified method of ADR reporting (ie, online or SMS reporting) should be considered.
Supplemental Material
Supplemental material, Questionaire_ADR_Revised for Assessment of Knowledge, Attitude and Practice of Adverse Drug Reaction Reporting Among Healthcare Professionals working in Primary, Secondary and Tertiary Healthcare Facilities in Ekiti State, South-West Nigeria by Theophilus A. Adegbuyi, Joseph O. Fadare, Ebisola J. Araromi, Abayomi O. Sijuade, Iyanu Bankole, Ilesanmi K. Fasuba and Rachel A. Alabi in Hospital Pharmacy
Acknowledgments
The authors are grateful to all healthcare workers who participated in the study. Our gratitude also goes to the research assistants and the head of the participating institutions for allowing the study to be conducted in their facilities.
Footnotes
Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article.
ORCID iD: Joseph O. Fadare 
https://orcid.org/0000-0002-5641-1402
Supplemental Material: Supplemental material for this article is available online.
This study evaluated the knowledge, attitude and practice of ADR reporting among HPCs working in the 3 tiers of healthcare in Ekiti State, Nigeria. We found a wide variability in the knowledge of respondents about ADR and it’s reporting with pharmacists, scoring highest followed by medical doctors, nurses and community health extension workers. This is the first study objectively assessing the knowledge of different categories of HCPs about ADR and it’s reporting in Nigeria.
Next steps: We hope to conduct follow-up trainings for HCPs in the sites where this study was conducted as a form of intervention. This will be followed up by monitoring and evaluation of their performance after a specific time frame to be determined. We also hope to pilot the use of SMS for ADR reporting in some of our healthcare facilities in the near future.
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Supplementary Materials
Supplemental material, Questionaire_ADR_Revised for Assessment of Knowledge, Attitude and Practice of Adverse Drug Reaction Reporting Among Healthcare Professionals working in Primary, Secondary and Tertiary Healthcare Facilities in Ekiti State, South-West Nigeria by Theophilus A. Adegbuyi, Joseph O. Fadare, Ebisola J. Araromi, Abayomi O. Sijuade, Iyanu Bankole, Ilesanmi K. Fasuba and Rachel A. Alabi in Hospital Pharmacy