Hospital Pharmacy - May 2017 - 363

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Said and Hussain

these issues (37.4%), ensuring confidentiality (26.4%), and
providing financial compensation for report submission
(9.9%).

Discussion

Figure 1. The frequency percent of the NO response of
health care workers to knowledge assessed questions of ADRs
reporting by professional class.
Note. ADR = adverse drug reaction; UAE = United Arab Emirates.

only 19%, 14%, and 12.1% of medical doctors, community
pharmacists, and hospital pharmacists reported ADRs. Our
results have shown a high frequency percent of encountered
ADRs in practice per week in all professional groups. The
results were 81%, 79%, and 83% for medical doctors, community pharmacists, and hospital pharmacists, respectively,
during weeks 0 to 5. The frequency percent of response for
questions assessing attitude and practice adopted by each
professional class are summarized in Table 2. As shown in
Table 2, the attitude and practice strategies adopted by each
professional class were found to be not significant. Regarding
the most qualified person to report an ADR (where more than
one answer was allowed), the response rates were highest for
the pharmacists (87.9%) followed by medical practitioners
(68.1%) and nurses (32.9%).
The seriousness of the ADR was the most important factor for reporting an ADR, whereas confidence in ADR diagnosis was the least important issue to consider. The necessary
actions taken by health care professionals to deal with an
ADR showed great variation. The majority of responders
(40%) would stop the medicine, while 26% and 20% would
prescribe medicine to control the ADR and would tell the
patient not to worry if the ADR is known, respectively. Only
a small sector of responders would record all details and
report to the ministry of health or the manufacturer of the
medicine.
Suggestions made by responders to improve ADR reporting are summarized in Figure 2. Increasing reporting system
awareness and easier report submission were suggested by
73.6% and 64.8%, respectively. Other suggestions were
making reporting mandatory (31%), electronic submission
of the reports (37.4%), increasing awareness of health care
personnel reporting (47.3%), increasing public awareness of

According to our knowledge, this is the first study in the
UAE to investigate KAP responses of different health care
professionals, including medical doctors, community pharmacists, and hospital pharmacists in different health care settings. A previous UAE study by Qassim et al16 investigated
KAP of ADR reporting; however, its findings were restricted
to community pharmacists working in 2 cities in the UAE:
Sharjah and Ajman.
Our results showed that 81% and 56% of medical doctors,
83% and 60% of community pharmacists, and 83.3% and
60% of hospital pharmacists did not know how or where to
report an ADR, respectively. This was consistent with a previous UAE study reporting 83.4% and 55.9% of UAE community pharmacists were unaware of how to or where to
report an ADR, respectively.17 Most health care professionals were unaware of the existence of the Health Authority of
Abu Dhabi (HAAD) pharmacovigilance program for ADR
detection and monitoring. These results suggest that the lack
of ADR reporting is a major issue in the health care industry
of UAE.18,19
Underreporting in UAE is not an isolated phenomenon.
Other areas of the world such as China,17 India,20 Malaysia,7
Nigeria,21 and Saudi Arabia21 also face similar issues.
Countries, such as the United Kingdom, with well-established pharmacovigilance programs report a high level of
underreporting.22,23
It is interesting to note that in this study, the poor ADR
reporting practices did not match the high frequency percentage of ADRs encountered in practice per week in all professional groups. Results showed that 81%, 79%, and 83% of
medical doctors, community pharmacists, and hospital pharmacists encountered ADRs in practice during weeks 0 to 5.
In this study, responders were not even sure which ADR
should be reported. Although 60% agreed that all ADRs
should be reported, 18.8% found that only reporting serious
ADRs was important, while 6.3% and 12.5% would report
ADRs to new drugs and new ADRs to old drugs only. In
addition, 31.3% of responders reported that their confidence
in the ADR identification would encourage their reporting.
This clearly does not match the HAAD pharmacovigilance policy of mandating all health care providers to report
any suspected ADRs despite the uncertainty about causal
relationship. This is also not in line with the HAAD pharmacovigilance policy that mandates all ADRs be reported by
health care providers. Emphasis lies on reporting ADRs of a
serious nature, those that are unexpected with product, or
ADRs to new drugs.
Consequently, inadequate knowledge has led to poor
practices by all professional groups sampled in the present

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