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 Chi squared (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.