Factors that influence reporting of adverse drug reactions in private retail pharmacies: A cross-sectional study in Wakiso District

Abstract

Background: Adverse Drug reactions are a significant public health concern, and their reporting is crucial for ensuring drug safety. Health workers in private retail pharmacies are essential sources of ADR reports as they interact with a considerable proportion of the population seeking medication from these settings. However, there is limited literature on the factors influencing ADR reporting practice in pharmacies, particularly in Wakiso district, Uganda. Study Objectives: This study aimed to identify the factors influencing ADR reporting among health workers in private retail pharmacies in Wakiso district, Uganda. Materials and methods: This study employed a mixed-methods cross-sectional design. One health worker from each of the 143 surveyed pharmacies in Wakiso district was interviewed using an interviewer-administered questionnaire. Additionally, semi-structured interviews were conducted with five key informants to gather in-depth insights. ADR reporting practice was assessed using three indicators: detection, documentation, and submission of suspected ADR cases to the National PV Centre (NPC) in the past six months, based on which the ADR reporting practice was classified as good or poor. Prevalence ratios (PR) obtained from a multivariate Poisson regression model were used to measure the association between ADR reporting practice and associated factors. At the same time, thematic analysis was performed for qualitative data. Results: The study found that overall, ADR reporting practice was poor. Among the respondents, 83.9% had encountered suspected ADR cases in the previous six months, but only 15 (12.5%) exhibited good ADR reporting practice by documenting and reporting the suspected cases to the NPC. Less than half (47.5%) of respondents had adequate knowledge of ADR reporting, and a similar proportion (48.3%) had a favourable attitude toward ADR reporting. Good ADR reporting practices were significantly associated with adequate knowledge (aPR = 4.5, 95% CI: 2.3–9.8, P =0.0001), in-service training (aPR = 2.1, 95% CI: 1.4–3.6, P = 0.028), and the existence of ADR data collection forms in the pharmacy (aPR = 1.8, 95% CI: 1.3–3.1, P = 0.022). Qualitative interviews further confirmed the underreporting of ADRs by healthcare workers despite encountering them.Conclusions. Adverse drug reaction reporting practice among health workers in private retail pharmacies was found to be poor. Staff knowledge, in-service training, and the presence of ADR reporting forms in the pharmacy were significantly associated with good reporting practice. The NPC should implement strategies to enhance health worker knowledge, such as awareness campaigns and incorporating pharmacovigilance into undergraduate curricula. Additionally, facilitating access to ADR reporting forms and strengthening in-service training programs are essential for improving ADR reporting practice in this setting.