Adequacy of Pharmacovigilance Training in the Health Professional Training Institutions in Uganda: Training Gaps and Opportunities for Improvement

Abstract

Background Despite efforts to improve pharmacovigilance systems, Uganda’s reporting rate remains below the WHO effective reporting criteria of 200 reports per a million inhabitants annually. Adequate education of health science students on pharmacovigilance is one of the core sustainable interventions to improve pharmacovigilance systems. This study assessed the adequacy of pharmacovigilance training in health professional training institutions in Uganda in order to identify the current needs and improvement opportunities. Methods Data was collected from allied health professional training institutions offering courses in clinical medicine and community health and diploma in pharmacy; universities offering bachelor’s degrees in medicine and surgery, pharmacy, nursing and dental surgery; and nursing training institutions offering certificate and diploma courses in nursing and midwifery. The study involved review of 16 curricula and 18 interviews with the heads of the programs of the different institutions. Data on pharmacovigilance content covered in the training curricula, challenges in pharmacovigilance training, pharmacovigilance competencies, knowledge, and skills gaps were collected. The study also included 13 key informants from policy and regulatory bodies, pharmaceutical industry, importers, and distributors of pharmaceuticals, professional councils/societies, examination boards, and hospitals to get perspectives on training gaps and opportunities for improvement. Quantitative data were analysed using Microsoft Excel 2017. Qualitative data were transcribed and reported verbatim. Results Most of the curricula 15 (88%) had content on medication use problems though inadequate, and only 1 (6%) had content on causality assessment. Majority of the respondents from the training institutions 12 (67%) reported having no staff with subject specific training background on pharmacovigilance. Other challenges reported include the lack of instructional materials and time on their already packed curricular to teach pharmacovigilance. All the respondents from training institutions 18 (100%) and key informants 13 (100%) recommended incorporation of pharmacovigilance into pre-service training curricula as a means of improving pharmacovigilance training and competencies among graduates. According to the key informants, there is need to strengthen pharmacovigilance training in the pre-service curriculum 9 (100%). The knowledge and skills that should be strengthened included detection, management and causality assessment 4 (44%), and spontaneous safety reporting 3 (33%). Conclusions The curricula for health professional training institutions do not adequately cover content on pharmacovigilance. The key areas that should be strengthened are detection, management and reporting of medication use problems, and causality assessment. Pharmacovigilance content should be introduced and/or strengthened in the existing curricula of all health professional training institutions to meet the growing need for pharmacovigilance experts, create culture of medicine safety and vigilance, and improve patient safety.