Factors Influencing Adverse Drug Reaction Reporting among Patients and Healthcare Providers in Selected Hospitals in Kirinyaga County, Kenya

Abstract

In 2020, Kirinyaga County accounted for 5% of adverse drug reaction (ADR) reports submitted to the Pharmacy and Poisons Board (PPB). Despite landing at no. 5 out of 47 in the Counties ADR reporting ranks, the ADR reporting rate could be improved. The study aimed to establish factors influencing ADR reporting among patients and healthcare providers in selected hospitals in Kirinyaga County. This mixed-method study comprised interviewer-administered, self-administered questionnaires and key informant interviews with 360 patients, 224 healthcare providers and 12 section heads. Stratified and purposive sampling methods sampled respondents. Statistical Package for Social Sciences (SPSS) version 27 analyzed quantitative data. The Chisquared (χ2 ) test determined the association between predictor and outcome variables. Binary logistic regression assessed the strength of the association. Fisher's exact test determined significance. P values of <0.05 were considered significant. NVivo version 12 coded qualitative data. Deductive thematic analysis analyzed qualitative data. In total, 166 (46.1%) patients experienced ADRs from medicines they were using. Of this, 145 (87.3%) reported ADRs to healthcare providers within the last three months. Besides, 265 (73.6%) patients were not aware of the patient alert card. Among patients, men were 46.2% less likely to experience ADRs compared to females (odds ratio (OR) 0.538, 95% confidence interval (CI) 0.340– 0.852, p=0.008). In total, 159 (74%) healthcare providers never reported ADRs to the PPB within the last three months. The study associated ADR reporting among healthcare providers with increasing age (p=0.001) and education (p=0.023). Additionally, Nurses had an 88.0% lower likelihood of reporting ADRs than Pharmacists (OR 0.120, 95% CI 0.041–0.351, p<0.001). Moreover, health professionals aware of the National PV Center were more likely to report ADRs (OR 3.818, 95% CI 1.995–7.307, p<0.001). Sensitized healthcare workers on ADR reporting were more likely to report ADRs (OR 3.642, 95% CI 1.453–9.130, p=0.006). Each of the hospitals lacked pharmacovigilance (PV) centers. Barriers of ADR reporting identified were: not knowing where to report, fear due to unfriendly healthcare staff and inadequate training. In conclusion, most patients reported ADRs to healthcare providers and patients' gender significantly influenced experiencing ADRs. Healthcare providers' age, level of education, PV training, knowledge of ADR reporting tools and PV center were significantly associated with ADR reporting. Inadequate training and feedback hindered ADR reporting at the facility level. Active involvement of patients and healthcare providers in spontaneous ADR reporting, training of stakeholders in PV activities, providing prompt feedback, establishing a PV center beside the promotion of reporting tools and up-to-date guidelines are highly recommended to enhance ADR reporting in Kirinyaga County