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The effectiveness of pictogram intervention in the identification and reporting of adverse drug reactions in naïve HIV patients in Ethiopia: a cross-sectional study

Authors Gebreyohannes EA, Bhagavathula AS, Abegaz TM, Abebe TB, Belachew SA, Tegegn HG, Mansoor SM

Received 10 September 2018

Accepted for publication 12 December 2018

Published 14 January 2019 Volume 2019:11 Pages 9—16

DOI https://doi.org/10.2147/HIV.S186797

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Professor Bassel Sawaya


Eyob Alemayehu Gebreyohannes,1 Akshaya Srikanth Bhagavathula,1,2 Tadesse Melaku Abegaz,1 Tamrat Befekadu Abebe,1 Sewunet Admasu Belachew,1 Henok Getachew Tegegn,1 Sarab M Mansoor3

1Department of Clinical Pharmacy, School of Pharmacy, University of Gondar-College of Medicine and Health Sciences, Gondar, Ethiopia; 2Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates; 3School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, NSW, Australia

Purpose: In health communication, pictogram has a comprehensive place to aid attention, memory recall, and promote adherence. This study was conducted to assess whether pictorial intervention would help to identify and improve adverse drug reactions (ADRs) reporting in an antiretroviral therapy (ART) clinic in Northwest Ethiopia.
Patients and methods: A cross-sectional study on ART-naïve HIV-positive patients was conducted from July 2015 to January 2016. The patients were randomly categorized into two groups. Group A was subjected to receive pictorial medication information and a pictogram-enhanced tool to identify and report ADRs, while group B did not receive any pictogram-enhanced tool.
Results: A total of 207 ART-naïve HIV-positive patients who were registered for the ART treatment attending Gondar University Hospital ART clinic were included. Bivariate analysis showed that sociodemographic characteristics, such as age, sex, education, employment, and marital status were the main predictors of identifying and reporting ADRs. Males were twice more likely to identify ADRs than females. Univariate analysis revealed that patients assigned to group A showed a significant association with the ability to identify ART medications using pictograms. Patients assigned to group A were more likely to identify lamivudine (OR [95% CI] =7.536 [4.042–14.021], P≤0.001), tenofovir (OR [95% CI] =6.250 [2.855–13.682], P≤0.001), nevirapine (OR [95% CI] =5.320 [1.954–14.484], P=0.001), efavirenz (OR [95% CI] =3.929 [1.876–8.228], P≤0.001), and zidovudine (OR [95% CI] =3.570 [1.602–7.960], P=0.002) using pictograms. Patients in group A were 4.3 times more likely to identify diarrhea as an ADR using pictogram compared with group B.
Conclusion: The use of pictorial representation resulted in only slight improvement in identification and reporting of ADRs among naïve HIV-positive patients with limited literacy in Northwest Ethiopia. This representation of ADRs merits further investigation with regard to ADR identification and promoting patients’ safety, particularly for HIV-positive patients with limited educational levels.

Keywords: HIV, AIDS, ADR, pictogram, Gondar, Ethiopia, HAART

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