Reducing the Effects of Adverse Drug Reactions: Assessing Knowledge and Attitudes of Nurses in Tamale, Ghana


  • Evans Paul Kwame Ameade University for Development Studies
  • Anthony Amalba University for Development Studies
  • Alhassan Sibdow Abukari Seventh Day Adventist Hospital, Tamale
  • Baba Sulemana Mohammed University for Development Studies


Nurses, adverse drug reactions, Pharmacovigilance, Steven Johnson Syndrome, Toxic Epidermal Necrosis



Detection and curtailment of probable ADR require decisive, continuous and close monitoring by knowledgeable health workers since ADRs have massive impact on both physical wellbeing and healthcare cost. This study assesses the knowledge and attitude of nurses towards ADRs


Data was collected from 125 nurses from four major hospitals in Tamale, Ghana using a semi-structured questionnaire. Data was analyzed in GraphPad, Version 5.01.


The overall knowledge score was 36.5% and an attitude score of 59.4%. Knowledge however had a positive correlation with attitude (r =  0.15, p = 0.0984).   Knowledge score on the definition of ADR was 21.9%,   but the worst scores were in relation to serious forms of ADR; Steven Johnson’s Syndrome (13.3%) and Toxic Epidermal Necrosis (1.07%) with majority (> 75%) unable to list a single symptom of them.  Male nurses exhibited a significantly higher knowledge (39.26% versus 32.2%,  p = 0.0009) and a better attitude than their female counterparts (62.1% versus 55.1%). General nurses were significantly more knowledgeable than other categories of nurses and also have a better attitude (40.25%, p < 0.0001). A good proportion of nurses (42.4%) attributed their less encouraging attitude towards ADRs to lack of knowledge, with 51.2% suggesting in-service workshops to be the most appropriate strategy to increase their appreciation of ADRs. Nurses who had prior training had a significantly better knowledge than their untrained colleagues (47.11% versus 35.67%, p = 0.0047) and also exhibited a better attitude than those untrained (64.4% versus 59.0%, p= 0.5288).


The knowledge of nurses on ADRs was poor but they exhibited a good attitude. Knowledge had a positive correlation with attitude and therefore giving nurses more training on pharmacovigilance will greatly enhance their contribution towards detecting and reporting observed ADRs.

Author Biographies

Evans Paul Kwame Ameade, University for Development Studies

Department of Human Biology - Lecturer

Anthony Amalba, University for Development Studies

Department of Human  Biology - Lecturer

Alhassan Sibdow Abukari, Seventh Day Adventist Hospital, Tamale

Nursing Department - Senior Nursing Officer

Baba Sulemana Mohammed, University for Development Studies

Department of Human Biology - Lecturer


World Health Organization. Safety of Medicines. A guide to detecting and reporting adverse drug reactions. Geneva, Switzerland: World Health Organization 2002. WHO/EDM/QSM/2002.2

Lazarou J, Pomeranz BH, Corey PN. Incidence of ADR in hospitalized patients: a meta-analysis of prospective studies. JAMA, 1998; 279:1000- 1005

Rodriguez M R, Otero M, Rovira J. Assessing the economic impact of adverse drug effects. Pharmacoeconomics. 2003;21: 623-50.

Bates DW, Cullen DJ, Burdick E, Laird N, Petersen LA, Small SD, Sweitzer GJ, Leape LL. The cost of Adverse Drug Events in hospitalized patients; Adverse Drug Events Prevention Study Group. JAMA 1997: 277 (4) 307-11

Aspden P, Wolcott JA, Bootman JL, Cronenwett LR. Preventing Medication Errors: Quality Chasm Series, The National Academic Press, Washington, DC 2007.

Wasser Fallen JB, Livio F, Buclin T, Tillet L and Yersin B. Rate, type, and cost of adverse drug reactions in emergency department admissions. Eur. J. Intern. Med. (2001) 12: 442-7.

Lazarou J, Pomeranz BM, Corey PN. Incidence of adverse drug reactions in hospitalized patients: A meta-analysis of prospective studies. JAMA (1998) 279: 1200-5.

Pirmohamed M, James S, Meakin S, Green C, Scott AK, Walley TJ, Farrar K, Park BK, Breckenridge AM. Adverse drug reactions as a cause of admission to hospital: Prospective analysis of 18820 patients. BMJ. 2004; 329: 15-9.

Patel KJ, Kedia MS, Bajpai D, Mehta SS, Kshirsagar NA, Gogtay NJ. Evaluation of the prevalence and economic burden of adverse drug reactions presenting to the medical emergency department of a tertiary referral centre: a prospective study. BMC Clin. Pharmacol. 2007; 28:7-8.

Hajebi G, Mortazavi SA, Salamzadeh J, Zian A: A Survey of Knowledge, Attitude and Practice of Nurses towards Pharamacovigilance in Taleqani Hospital. Iranian Journal of Pharmaceutical Research 2010, 9(2):199–206

Lexchin J: Is there a role for spontaneous reporting of adverse drug reactions? CMAJ 2006, 174:191–192.

Lopez-Gonzalez E, Herdeiro MT, Figueiras A: Determinants of under-reporting of adverse drug reactions: a systematic review. Drug Saf 2009, 32:19–31.

Hazell L, Shakir SA: Under-reporting of adverse drug reactions: a systematic review. Drug Saf 2006, 29:385–396.

Inman WH: Attitudes to adverse drug-reaction reporting. Br J Clin Pharmacol 1996, 41:433–435.

Hall M, McCormack P, Arthurs N, Feely J. The spontaneous reporting of adverse drug reactions by nurses. Br J Clin Pharmacol 1995; 40:173–75.

Morrison-Griffiths S, Walley TJ, Park BK, Breckenridge AM, Pirmohamed M. Reporting of adverse drug reaction by Nurses. Lancet 2003; 361: 1347–48

Global Forum for Health Research. The 10/90 report on health and research 2003-2004.2004. 090_report 03 04/1 09004frontmatter. pdf. Accessed on 20/02/14

Eliasson E. Ethnicity and adverse drug reactions. BMJ 2006;332:1163-4

Amrita P, Kharbanda B. Knowledge, Attitude and Skills of Nurses of Delhi towards Adverse Drug Reaction Reporting, Indian Journal of Pharmacy Practice. 2012, 5: 45 – 51

Morrison-Griffiths S and Pirmohamed M. Specialist nurse reporting of adverse drug reactions. Prof. Nurse 2000;15: 300-4.

Hanafi S, Torkamandi H, Hayatshahi A, Kheirollah G, Javadi M: Knowledge, attitudes and practice of nurses regarding adverse drug reaction reporting. IJNMR 2012, 17(1):1–7.

John LJ, Arifulla M, Cheriathu JJ, Sreedharan J. Reporting of adverse drug reactions: an exploratory study among nurses in a teaching hospital, Ajman, United Arab Emirates. DARU Journal of Pharmaceutical Sciences; 2012; 20:44

University for Development Studies: 13th Congregation’s Vice Chancellor’s report. Tamale; 2012.

Palaian S, Ibrahim MI, Mishra P: Health professionals’ knowledge, attitude and practices towards pharmacovigilance in Nepal. Pharmacy Practice (Internet) 2011, 9(4):228–235

McGettigan P, Golden J, Conroy RM, Arthur N, Feely J. Reporting of adverse drug reactions by hospital doctors and the response to intervention. Br J Clin Pharmacol. 1997;44(1):98–100.

Food and Drugs Authority, Ghana: Handing over notes of Evans Paul Kwame Ameade, a Regulatory officer. Tamale; 2010.

Palanisamy S, Arul Kumaran KSG, Rajasekaran A. Knowledge assessment in adverse drug reactions and reporting. Archives of Pharmacy Practice. 2013. 4: 3

Li Q, Zhang SM, Chen HT, Fang SP, Yu X, Liu D,et al: Awareness and attitudes of healthcare professionals in Wuhan, China to the reporting of adverse drug reactions. Chin Med J 2004,117:856–861

Khalili H, Mohebbi N, Hendoiee N, Keshtkar AA, Dashti-Khavidaki S, Khalili H, Mohebbi N, Hendoiee N, Keshtkar AA, Dashti-Khavidaki S. Improvement of knowledge, attitude and perception of healthcare workers about ADR, a pre- and post-clinical pharmacists’ interventional study. BMJ Open 2012, 13(2). doi:10.1130.bmjopen-2011-000367. e000367




How to Cite

Ameade, E. P. K., Amalba, A., Abukari, A. S., & Mohammed, B. S. (2014). Reducing the Effects of Adverse Drug Reactions: Assessing Knowledge and Attitudes of Nurses in Tamale, Ghana. Asian Journal of Pharmacy, Nursing and Medical Sciences, 2(6). Retrieved from