Exposure to anti-malarial drugs and monitoring of adverse drug reactions using toll-free mobile phone calls in private retail sector in Sagamu, Nigeria: implications for pharmacovigilance
Exposure to anti-malarial drugs and monitoring of adverse drug reactions using toll-free mobile phone calls in private retail sector in Sagamu, Nigeria: implications for pharmacovigilance
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DOI：
10.1186/1475-2875-10-230
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发表时间：
2011-08-09
期刊：
影响因子：
3
通讯作者：
Ogundahunsi, Olumide A. T.
中科院分区：
文献类型：
--
作者：
Adedeji, Ahmed A.;Sanusi, Bilqees;Ogundahunsi, Olumide A. T.
背景：药物不良反应（ADRs）在传染病管理过程中会导致健康状况不佳或危及生命的治疗结局。暴露于抗疟疾和使用移动的电话技术报告药物暴露后的不良反应进行了调查，在萨加穆-城郊社区在西南部尼日利亚。方法：购买药品积极监测28天，在三个社区药房（CP）和四个专利和专有药物商店（PPMS）在社区。通过电话从100名购买抗疟药的志愿者那里获得了有关药物不良反应的信息。结果和讨论：在此期间，共记录了12,093次购买。抗生素、止痛剂、维生素和抗疟疾药是最常购买的药品。总共购买了1 500个完整疗程的抗疟疾药物（占购买总量的12.4%）;其中购买量最大的是磺胺乙胺嘧啶和氯喹（分别为39.3%和25.2%）。购买的其他抗疟疾药物为青蒿琥酯单一疗法（AS）-16.1%、蒿甲醚-苯芴醇（AL）-10.0%、阿莫地喹（AQ）-6.6%、奎宁（QNN）-1.9%、卤泛群（HF）- 0.2%和氯胍（PR）-0.2%。CQ最便宜（0.3美元），卤泛群最贵（7.7美元）。AL比CQ贵15.6倍（4.68美元）。在购买后的前24小时（第1天），对移动的电话监测ADR的反应为57%，到第4天下降到33%。在这项监测工作的参与者大多是低教育水平（54%）。结论：这项研究的结果表明，无效的抗疟疾药物，包括单一疗法仍然广泛存在，并经常购买在研究领域。费用可能是继续使用无效单一疗法的一个因素。在资源匮乏的情况下，提供免费电话可促进药物警戒和跟踪药物反应。
Background: Adverse drug reactions (ADRs) contribute to ill-health or life-threatening outcomes of therapy during management of infectious diseases. The exposure to anti-malarial and use of mobile phone technology to report ADRs following drug exposures were investigated in Sagamu - a peri-urban community in Southwest Nigeria.Methods: Purchase of medicines was actively monitored for 28 days in three Community Pharmacies (CP) and four Patent and Proprietary Medicine Stores (PPMS) in the community. Information on experience of ADRs was obtained by telephone from 100 volunteers who purchased anti-malarials during the 28-day period.Results and Discussion: A total of 12,093 purchases were recorded during the period. Antibiotics, analgesics, vitamins and anti-malarials were the most frequently purchased medicines. A total of 1,500 complete courses of anti-malarials were purchased (12.4% of total purchases); of this number, purchases of sulphadoxine-pyrimethamine (SP) and chloroquine (CQ) were highest (39.3 and 25.2% respectiuvely). Other anti-malarials purchased were artesunate monotherapy (AS) - 16.1%, artemether-lumefantrine (AL) 10.0%, amodiaquine (AQ) - 6.6%, quinine (QNN) - 1.9%, halofantrine (HF) - 0.2% and proguanil (PR) - 0.2%. CQ was the cheapest (USD 0.3) and halofantrine the most expensive (USD 7.7). AL was 15.6 times ($4.68) more expensive than CQ. The response to mobile phone monitoring of ADRs was 57% in the first 24 hours (day 1) after purchase and decreased to 33% by day 4. Participants in this monitoring exercise were mostly with low level of education (54%).Conclusion: The findings from this study indicate that ineffective anti-malaria medicines including monotherapies remain widely available and are frequently purchased in the study area. Cost may be a factor in the continued use of ineffective monotherapies. Availability of a toll-free telephone line may facilitate pharmacovigilance and follow up of response to medicines in a resource-poor setting.