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ADVERSE DRUG REACTION REPORTING SYSTEM AT DIFFERENT HOSPITALS OF LAHORE, PAKISTAN - AN EVALUATION AND PATIENT OUTCOME ANALYSIS

Ghulam Mustafa, Saeed-ur-Rasheed, Muhammad Tahir Aziz

Adverse drugs reactions (ADRs) are known to be a major cause of morbidity and mortality. However, only a very little proportion is reported. ADRs contribute to the incidence of adverse events, resulting in increased health care costs. An increase in the number and quality of reports by improving ADR reporting system in hospitals, highlight the importance of ADR including general awareness could improve patient outcome and save healthcare costs. Ministry of Health has done some work but still major requirements are needed to run a proper ADR program. The first part of this project was to review the ADR reporting system in Pakistan hospitals, to determine the factors contributing to the ADR reporting rate and benchmark with developed countries. Data were collected by self-administered questionnaire. The response rate was 83.3%. 24 (80%) hospitals have no proper ADR system; five (16.7%) hospitals are targeting few of the drugs for ADR reporting while only one (3.3%) hospital has a proper ADR policy including online reporting system as well. Only seven (23.3%) hospitals have a policy of ADR reporting which is running under Pharmacy Department. The next part of the project was a survey of 84doctors and 52 Pharmacist selected from Lahore city, Pakistan to evaluate their involvement, understanding and reasons for reporting ADRs. A self-administered questionnaire was used to collect the data. Response rate obtained for the doctors was (39.3% n=33) and (67.3% n=35) for hospital pharmacists. Thirty three (39.3%) doctors and thirty four (65.4%) pharmacists knew how to report ADR within the hospital while 9 (10.7%) doctors and 13 (25%) Pharmacists knew about the ADR reporting to MOH. Factors that would encourage respondents to report ADRs included seriousness of reaction (75.8%), unusual reaction (63.6%), reaction to a new product (66.6%) and confidence in the diagnosis of ADR (31.5%). Similarly, the discouraging factors are uncertain association (65.7%), awareness (57.6%), and concern about legal liability (51.4%). It is observed that awareness of ADRs program need special attention with some concrete steps should be taken for the improvement of ADRs system in Pakistan. Continuous medical education, training and integration of ADR reporting into the clinical activities would definitely improve the patient outcome.