Perceptions and barriers of adverse drug reaction reporting within inpatient state psychiatric facilities

Abstract

Introduction Adverse drug reactions (ADRs) are a leading cause of morbidity and mortality for hospitalized patients. Health care organizations track ADRs to reduce patient mortality, reduce hospital readmissions, decrease costs, and improve patient care. Differing definitions of ADRs cause confusion among providers, leading to hesitation with ADR reporting. The objective of this study was to understand health care professionals' perspectives of ADR reporting within inpatient state psychiatric facilities. Methods A survey was sent to 143 health care professionals throughout 25 inpatient state psychiatric facilities within 1 state. The survey assessed the definition of an ADR, confidence in reporting, barriers to reporting, the role of reporting, who should report and review ADRs, and strategies for process improvement. Results The survey had a 75.5% response rate with 108 respondents. Most respondents could identify the definition of an ADR, were moderately confident in reporting ADRs, and understood the importance of ADR reporting. Barriers to ADR reporting included the reaction not being serious, a lack of information about the ADR, or not enough clarity on how to report an ADR. Fear of retaliation was an additional barrier to ADR reporting. Training and direction on ADR reporting, education on real versus perceived consequences, a designated point person to aid in reporting, and better access to reporting technology were suggested improvements for ADR reporting. Discussion From this survey, it is evident that respondents believe improved education and training, improved communication regarding reporting consequences, and consensus on the definition of an ADR would encourage reporting.

The case of a geriatric female experiencing frequent falls and epileptic seizures during long-term low-dose clozapine and extended-release bupropion treatment

“…Bupropion and clozapine likely contributed to an adverse drug reaction of seizures in this patient, and for this reason, bupropion should be used cautiously in patients treated with clozapine, especially those with a history of head trauma, including those with a history of frequent falls. In addition, this case provokes consideration of how a prescriber's perception or definition of an ADR can influence and alter the course of both clinical and academic investigation of the actual event [15]. There are numerous definitions of adverse drug reactions; however, most in the medication safety community would agree that a previously reported adverse effect of a known drug-drug interaction, regardless of the timeline in which it occurred, is an undesirable but preventable adverse drug reaction.…”

Pharmacovigilance and Adverse Drug Reactions Reporting: Healthcare Providers’ Experiences from Southern Highland Tanzania

“…Medical doctors, nurses, and pharmacists are the HCPs in charge of identifying, documenting, reporting, and preventing ADR in routine clinical practice [ 13 ]. According to the literature, some ADRs can be prevented if HCPs align their prescribing with current medical guidelines and most ADRs can be avoided if HCPs explore and reconcile probable ADR contributing factors [ 14 ]. ADR reporting in Tanzania has been improved through the implementation of several strategies by the Ministry of Health through TMDA, including the introduction of PV regulations in 2018 and guidelines in 2020 and the appointment of a PV focal person in each country zone to ensure regular training of HCPs and patients' sensitization.…”