PhD defence G.T. (George) Sabblah

Exploring patients’ role in medication safety in Africa

Patient engagement in pharmacovigilance (PEP) is important because it offers unique insights into the safety of medical products, potentially leading to new safety signals.

This thesis explores patients' contributions to medication safety in Africa, focusing on their perspectives on adverse drug reaction (ADR) reporting, barriers and facilitators to reporting medication errors (MEs), incidence of MEs following hospital discharge, and systems for reporting by patients.

Our questionnaire study showed that patients in Ghana had good knowledge of the pharmacovigilance system but preferred to report ADRs through their healthcare professionals and expected feedback on their reports.

A mixed-methods sequential explanatory study revealed a limited number of ME reports from Africa in VigiBase (the WHO global database of individual case safety reports) due to absence of reporting systems. The study also showed that PEP is interconnected with broader societal issues such as religious, socio-cultural beliefs and political situations. Of concern is that our cross-sectional survey in Ghana showed high incidence of MEs following hospital discharge.

In order to understand PEP in high-income countries (HICs) compared to Africa, we discussed its impact in HICs and incorporated two case studies from Africa: a scoping review on ME reporting in Africa and a case study on PEP in Ghana. The analysis highlighted paucity of literature on PEP and ME reporting in Africa.

We recommended future research on the impact of ADRs and MEs, securing sustainable funding for pharmacovigilance, leveraging technology to enhance PEP, and educating patients to address sociocultural issues.