Use of Mobile Phones for Monitoring Adverse Drug Reaction in Pharmacy and Drug Stores in Ishaka, Uganda - a Pilot Assessment of Willingness to Report

Aim: We investigated reporting of Adverse Drug Reaction (ADR) following use of drugs purchased from open system pharmacy (OSP) and drug stores, and the effectiveness of mobile phones for reporting drug reactions and detection of drug interactions.
Study Design: The study was descriptive and inceptional.
Place and Duration of Study: Selected Pharmacies and drug stores in Ishaka Municipality, Bushenyi, Uganda, between January and April 2012.
Methodology: A total of 190 participants purchasing prescription and non prescription drugs in the drug outlets were enrolled and drug purchases documented. Structured interviews were used to assess any existing system of ADR tracking. Possible interactions were assessed using electronic checkers software on drug combinations prescribed or purchased. Mobile phone calls were used to monitor the reporting potential, use of medication and events or reactions following drug use for ADRs.
Results: No formalized pre-study system was found for tracking ADR in the OSP and drug stores studied. Participants purchased 420 different medications with 55.8% without prescription. Antibiotics, analgesics and antimalarials ranked most purchased medications. All participants carried at least a functional mobile phone and demonstrated interest to report ADRs. Mean Effective Mobile Phone Contact Ratio (MEMPCR) for ADR monitoring was 0.91+0.2 and follow-up was 96% (n=183) and 89.5% on days 0 and 4 respectively. Interactions predicted were in 24.8% (31). Significant reporting of at least one of 404 reactions occurred within 72hr compared to 96-120hr (P=0.003). Two participants had reaction leading to discontinued use of Cotrimoxazole.
Conclusion: Use of mobile phones and drug interaction checker software may avail early detection of ADR and reporting. Facilitated toll free- call service may be an effective means of extending the scope of ADR tracking in addition to Yellow Card scheme, and augment involvement of pharmacists and consumers in safe use of drugs.