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Documentation of ADRs – PST06211 Monitoring and Evaluation of Medicine Use

NTA Level 6 • Semester 2 • PST06211

Documentation of ADRs

Monitoring and Evaluation of Medicine Use • Source Session/Topic 13
Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability.

Session 13: Documentation of ADRs

Total Session Time: 120 minutes

Prerequisites

• None

Learning Tasks

By the end of this session students are expected to be able to:

• List necessary information for documentation in ADRs
• Explain types of ADR reporting forms
• Explain handling of ADR data

Resources Needed:

• Flip charts, marker pens, and masking tape
• Black/white board and chalk/whiteboard markers
• Computer and LCD Projector

SESSION OVERVIEW

Activity/

Step Time Content

Method

1 05 minutes Presentation Introduction, Learning Tasks

30 minutes Presentation Necessary Information for Documentation of

2

Brainstorming ADRs

30 minutes Presentation

3 Types of ADR Reporting Forms

Buzzing

5 40 minutes Presentation Handling of ADR Data

6 10 minutes Presentation Key Points

7 05 minutes Presentation Evaluation

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SESSION CONTENTS

STEP 1: Presentation of Session Title and Learning Tasks (5 minutes)

READ or ASK students to read the learning tasks and clarify

ASK students if they have any questions before continuing.

STEP 2: Necessary Information for Documentation of ADRs (30 minutes)

Activity: Brainstorming (5 minutes)

Ask students to brainstorm on the following question:

• What are the necessary information for documentation of ADRs?

ALLOW few students to respond?

WRITE their responses on the flip chart/ board

CLARIFY and SUMMARISE by using the content below

• Properly charting a patient‘s ADR can protect him/her from further harm and shield you and

your facility from legal problems.

• Because a significant part of the evaluation for any drug's long-term safety occurs after it's

on the market, serious ADRs should be reported to TFDA.

• Document the patient's clinical condition, your interventions, and the patient's response.
• Fill out an incident report and internal ADR report, which should contain all the information

that will be needed.

• To properly document an ADR, first document the clinical facts in the patient's medical

record. Then complete an incident report.

• Your documentation in the patient's chart and incident report should include:

o Patient information, such as date of birth, sex, race, and weight; pre-existing or

coexisting medical conditions; other medications taken, allergies; and relevant

diagnostic and lab results

o The date of the event

o Specific patient outcomes attributed to the ADR, such as prolonged hospitalization

o A clear, factual, objective and chronologic description of the problem or event.

o Document your assessment findings and interventions, all persons notified and their

responses, the dates and times of these notifications, and the actions taken by those

you've informed and the patient's response to interventions.

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o The name of the drug, the manufacturer, the lot number and expiration date on the

packaging (if available), dosage, frequency, duration, route, and times of administration.

Returning any packaging or containers to the pharmacy or retaining them as evidence.

o Your name, title, and credentials as a reporter.

STEP 3: Types of ADR Reporting Forms (30 minutes)

Activity: Buzzing (5 minutes)

ASK students to pair up and buzz on the following question

What are types of documents used to report ADRs?

ALLOW few pairs to respond and let other pairs to add on points not mentioned

WRITE their response on the flip chart/board

CLARIFY and SUMMARIZE by using the content below

• The following forms/tool are used to document and report ADRs;

o Yellow form -for reporting ADRs to medicines or vaccines

 The Yellow card system for collecting information on suspected adverse drug

reactions (ADRs) to medicines.

 The system allows the safety of the medicines and vaccines that are on the market to

be monitored.The system was founded in 1964 after the thalidomide disaster.

 Yellow Cards are available from TFDA and a few are presented near the back of the

BNF as tear-off pages.

 Blue form -for reporting poor quality products. This can be used to report

substandard and counterfeit drugs

o Pharmacovigillance Register – For recording details on filled forms

o Green form -for reporting ADRs by patients themselves

o Pink card -Patient ADR alert card. The criteria for issue of alert card to patient include

 Patients who are hypersensitive/allergic/intolerance to particular drug

 Patient who develop near fatal reaction to any particular drug

 Patient who had a drug induce morbidity to any drug

 Patient who had hospital admission due to an ADR to any drug

• Apart from ADR reporting tools other documents may help obtaining information for

patients such as

• Personal Medication Record

PST 06211 Monitoring and Evaluation of Medicines Use NTA Level 6 Semester 2 Facilitator Guide

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o The personal medication record (PMR) is a comprehensive record of the patient‘s

medications (prescription and non-prescription medications, herbal products, and other

dietary supplements).

o Pharmaceutical personnel in their carrier may use personal medication record to include

category which will need the patient to report other medication-related problems (e.g.,

what medication caused the problem? What was the problem?)

o This will help to trace signal

STEP 5: Handling of ADR Data(40 minutes)

• An acknowledgement letter or note will be sent to the reporter for every ADR report

received with an additional reporting form.

• The ADR reports shall be stored in a confidential database at TFDA and analysed report

sent to the WHO database of International Programme on safety monitoring of drugs to

which all case reports received by the National centres are sent.

• The names of reporter and the patient will be removed before any details about a specific

adverse drug reaction are used or communicated to others.

• Publications will not disclose trade name of products unless regulatory actions have been

taken.

• In this regard information obtained from spontaneous ADR monitoring system will not be

used for commercial purposes.

• The information is only meant to improve our understanding on use of medicinal products

by reducing the risks associated with drug prescribing and administration and to ultimately

improve patient care, safety and treatment outcome.

• In the same way suspected ADR reports cannot be used in a court of law under any

circumstances.

• TFDA is responsible for providing reporting forms, collecting, analysing and

communicating the findings and evaluation reports.

• Data collected will be used for provision of timely advice to health-care professionals and

consumers on drug safety issues at facility level, national and international level.

• Who helps in gathering data relating to ADR occurrence?

o Researchers in clinical trials, patients using medicines, Pharmaceutical companies,

database, pharmacovigillance personnel, Regulatory managers, health practitioners in

general e.g. pharmacists, physicians.

• Utilisation of ADRs Data

o Data collected will be used for provision of timely advice to health-care professionals

and consumers on drug safety issues at facility level, national and international level. A

well-documented adverse drug reaction case could result in one or more of the

following;

o Further investigation of signals. For example, identifying `at risk‘ group, a dose range

which might be more suspected, suggesting a pharmaceutical group effect,

PST 06211 Monitoring and Evaluation of Medicines Use NTA Level 6 Semester 2 Facilitator Guide

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pharmacological mechanisms, lack of effect by a particular drug or investigation into the

use of a drug in the country

o Drug regulation and dissemination of information of current importance

o Education and training initiatives to improve the safe use of the medication and other

health promotion interventions as the situation may warrant including change in supply

status or withdrawal

STEP 6: Key Points(10 minutes)

• Yellow form is used for reporting ADRs to medicines or vaccines
• Documentation in the patient's chart and incident report should include,patient information,

date of the event and name of the drug

• The ADR reports shall be stored in a confidential database at TFDA and analysed report

sent to the WHO database.

• In handling of ADR datathe names of reporter and the patient will be removed before any

details about a specific adverse drug reaction are used or communicated to others.

• Researchers in clinical trials, patients using medicines, Pharmaceutical companies, database,

pharmacovigillance personnel, Regulatory managers, health practitioners in general e.g.

pharmacists, physicians helps in gathering data relating to ADRs occurrences

STEP 7: Evaluation (5 minutes)

• What is the necessary information required in documentation of ADRs?
• Mention types of ADRs reporting forms?
• Who help in gathering data in ADRs occurrences?

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References

Quick, J. D. (1997). Managing drug supply the selection, procurement, distribution and use of

pharmaceuticals. West Hartford, CT: KumarianPress.Bartsch, S. (2007).

The Global Fund to Fight AIDS, Tuberculosis and Malaria. Global Health Governance and the

Fight Against HIV/AIDS,146-171. doi:10.1057/9780230591349

WHO Operational package for assessing, monitoring and evaluating country pharmaceutical

situations. (2015, November 20). Retrieved from

https://www.who.int/medicines/publications/WHO_TCM_2007.2/en/

PST 06211 Monitoring and Evaluation of Medicines Use NTA Level 6 Semester 2 Facilitator Guide

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