Oct-Dec, 2011 - Indian Journal of Pharmacy Practice

Amrita P - Scenario of Pharmacovigilance and ADR Reporting among Pharmacists in DelhiFig. 3: Intra-profession correlation regardingPharmacovigilance skillsJ- Inform patients about therapeutic effects, K- Inform patientsabout side effects, L- Do patient inform you about side effects,M- Do you report ADR, N- Have set procedure of reporting ADRin their organization, O- Have ADR reporting form.interaction between hospital pharmacists and patients wasfound to be best among the three. This is indicated from theresponse that, 57.44 % of hospital pharmacists, 46.15% ofcommunity pharmacists and 33.87% of medicalrepresentatives were informed by the patients/physicianabout the side effects experienced by patients. Involvement ofhospital pharmacists (44.68%) in reporting ADR was greaterthan the medical representatives (14.51%) and communitypharmacists (10.25%). The study of van Grootheest AC et al,reported that contribution of hospital pharmacists to ADR22reporting in Canada and United States is by far the largest. Incontrary the study of Su C et al showed that hospitalpharmacists in a northern region of China had a reasonableknowledge of and positive attitudes towardspharmacovigilance, however the majority of pharmacists had23never reported an ADR in their career.In our study involvement of community pharmacists in ADRreporting is lowest. This may be due to sub-optimal level ofknowledge about the drugs, lack of confidence and inaptprofessional approach. Our community pharmacists restrictthemselves to mere dispensing of marketed preparations.Contrary to our observation, van Grootheest AC et al reportedthat in Netherlands, community pharmacists play asignificant role in ADR reporting. They contributesubstantially, both in numbers and in quality of ADR reports.In Netherlands the contribution of community pharmacists to24professional ADR reports is 40.02%. In Japan and Spain39% and 25.9% professional ADR reports originate from22community pharmacists.Hospital pharmacists (19.14%) and medical representatives(16.12%) reported that they have set channel for reportingADR, while 97.44% of community pharmacists said they donot have any channel for reporting ADR. Establishing achannel for reporting ADR and informing about the same tothe practicing pharmacists, would promote the reporting bypharmacists. Though 44.68% of hospital pharmacists,14.51% of medical representatives and 10.25% ofcommunity pharmacists reported observed ADRs, only2.56% of community pharmacists, 2.12% of hospitalpharmacists and 3.22% of medical representatives had ADRreporting form. From this data, it is once again very clear thathospital pharmacists, community pharmacists and medicalrepresentatives report the ADR verbally to chief pharmacist,physician, purchasing department of hospital, manufacturingindustry, department in-charge, product management teamand not to the NMC, RMC or peripheral monitoring center.This kind of reporting is not of much help in ensuring patientsafety.In a Malaysian study, community pharmacists claimed tohave some knowledge of a reporting system but the actualreporting was insignificant. Further all of them agreed that it25was part of their professional obligation to report an ADR.Survey by Toklu Hz et al shows that Turkish communitypharmacists have poor knowledge about pharmacovigilance16with just 7% ADR reporting by them.Attitude of pharmacists:One hundred sixteen (78.38%) pharmacists felt that the ADRmonitoring is essential. Four (2.70%) pharmacists felt ADRmonitoring is not essential while 28 (18.92%) pharmacistsdid not respond. It may be possible that these pharmacists didnot understand the meaning of ADR monitoring. The studyof Granas AG et al conducted in Norway also shows that26pharmacists had positive attitudes towards ADR monitoringwhile study of Vessal G et al conducted in Iran shows thatmore than half of the responding pharmacists felt that ADRreporting should be voluntary, while 26% felt it to be a18professional obligationNineteen (12.84%) pharmacists felt that there is no need toreport the ADR as it is well known. But as per the CDSCOGuidelines even the minor ADRs should be reported as it may27throw light on prescribing patterns. Ninety five (64.19%)pharmacists felt that pharmacists are not trained enough fordetecting and reporting ADR. Out of 148 participatingpharmacists only 56 (37.84%) pharmacists said they undergocontinuing education program. One hundred eleven (75%)pharmacists were of the opinion that education and training inpharmacovigilance would play a pivotal role in improvingADR reporting. The study of Sweis et al and Green et alconducted in UK and study of I. Ribeiro Vaz et al in PortugalIndian Journal of Pharmacy Practice Volume 4 Issue 4 Oct - Dec, 2011 34