Adverse drug reactions : assessment and relevance to patient care in Nigeria
This review article defines and classifies adverse drug reaction (ADR). It then emphasizes the importance of Pharmacovigilance (PV) which is the practice of monitoring the effects of drugs after they have been already licensed for use especially in order to identify and evaluate previously unreported ADR. A general review of International and Nigerian PV is given. There is emphasis on assessment of PV to ensure it is related to patient care. Outcome measures to look out for in the practice of PV should include effect on mortality, effect on morbidity and quality of life and the potential return on public investment in detecting adverse drug effects. The characteristics and weaknesses associated with drug use and adverse reactions in Nigeria are outlined. This includes the few available experts trained in PV; lack of enabling environment for these experts to transmit their knowledge to other health care team to facilitate the achievement of the goals of PV; lack of general knowledge on PV, absence of equipped and functional PV clinics, inadequate funding of PV programme, substandard falsified medical products, adulteration of medicines, faulty drug distributions systems previously, inability to enact and enforce adequate laws to regulate the use of drugs in Nigeria and lack of political will to enforce the National drug use policy. In conclusion, some action points for a successful PV in Nigeria include establishment of PV clinics in all Teaching/Specialist hospitals as well as all General hospitals in the country, recruitment of all pharmaceutical manufacturing and or distributing companies, traditional herbal practitioners, the patent medicine dealers and all patients in the practice of PV in Nigeria.