Diffusion of Pharmacovigilance in the Eritrean Healthcare System: A Cross-sectional Study

Abstract

Background: Taking the overstretched healthcare system, inappropriate prescribing, self-medication seeking behavior, infiltration of substandard and counterfeit medicines in the resource-constrained countries into, having a well-functioning Pharmacovigilance system has paramount importance to ensure patient safety. The aim of this study is therefore to assess the degree and pattern of Pharmacovigilance system diffusion and its barriers in Eritrean healthcare system. Methods: This is an exploratory cross-sectional study among healthcare professionals from representative health facilities in all administrative regions in Eritrea. Participants were selected using systematic random sampling method. Assisted self-administered questionnaire was used for data collection between June 27 and September 8, 2017. Association among demographic variables, knowledge, attitude and practice of Pharmacovigilance were analyzed. Two-tailed p-value <0.05 was considered statistically significant. Results: A total of 390 healthcare professionals from 141 health facilities across the country were enrolled in the study. Of the respondents, 90% know what Pharmacovigilance is about and 89% know how to report adverse drug reactions (ADRs). There was a significant difference in knowledge among the professional categories (p<0.001) and their level of education (p=0.002). As the level of education increases, so does the positive attitude towards reporting ADRs in professional practice (p=0.009). About three-fourth (73%) reported that they transfer Pharmacovigilance knowledge to their colleagues. Physicians and Pharmacists were found to be the main players in diffusing the system. Majority of the respondents (72%) encountered patients with ADRs and 64% of them claimed they have reported ADRs. Inadequate knowledge, unavailability of suitable reporting channels and inadequate motivation were the main barriers for those unable to report adverse drugs reactions. Conclusion: Pharmacovigilance as innovation is highly adopted and diffused in Eritrea with an impressive Knowledge, attitude and practice of healthcare professionals in reporting adverse drug reactions and other related problems. Limited knowledge on how to report ADRs, unavailability of suitable reporting channels and inadequate motivation were, however, the top three ADR reporting barriers identified which could negatively impact the progress of the diffusion process.