n African Journal for Physical Health Education, Recreation and Dance - Improving patient safety with antiretroviral treatment by actively soliciting adverse drug reaction reports : patient centered treatment and care

Supplement 2
  • ISSN : 1117-4315


Adverse drug reactions (ADRs) contribute to patient morbidity, hospitalisation and increased costs for the health care system. The burden of ADR reporting is a responsibility often overlooked by health care professionals. A decentralised pharmacovigilance programme for HIV, AIDS and TB was implemented in Mpumalanga Province in 2012. Spontaneous ADR reporting from outpatient settings subsequently increased, but lack of reporting of ADRs for hospital inpatients remained a concern. This study aimed to determine the outcome of a pharmacist's participation in the management of patients on antiretroviral treatment (ART) for the identification, management and reporting of ADRs. An active pharmacovigilance (PV) system through pharmaceutical care provided by a pharmacist was implemented as an operational project as part of routine practice, in two medical wards at Ermelo Provincial Hospital. Baseline data on ADR-reporting were collected retrospectively for a 12-week period prior to the implementation of the PV system. The implementation phase (12 weeks) consisted of daily monitoring of prescription charts, laboratory results and progress notes of patients by a pharmacist, actively seeking to identify and report ADRs or events related to ART. Suspected ADRs were discussed and pharmaceutical care interventions implemented, based on shared decision-making between the prescriber and the pharmacist. In total, 107 patients received pharmaceutical care over a period of 12 weeks, from which 72 ADRs (67.3%) were reported. General ADR reports accounted for 21% (38), IRIS-type reports for 36% (23) and reports of virological failure for 10% (11) of the suspected ADRs identified. The ADR reporting rate from the two medical wards for inpatients on ART, increased from 0.5% for the 12-week period prior to the operational project to 51.1% during the implementation phase. The pharmacovigilance activities of a pharmacist in the wards evidently improved reporting of ADRs related to ART, contributing to patient safety. Hospital management and policy makers should consider the role that a pharmacist can play in improving rational and safe use of medicines in the inpatient setting.

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