Strategies and interventions to strengthen pharmacovigilance systems in low- and middle-income countries: A scoping review

Objectives The slow progress of pharmacovigilance (PV) in
low-and-middle-income countries (LMIC) raises questions about core
challenges on the growth of PV, and the appropriateness of strategies used
so far to develop PV. Therefore, this scoping review aims to describe
strategies and interventions to strengthen PV in LMIC and to propose
recommendations for future investments in PV capacity building.  
Inclusion criteria Publications included were primary studies, articles,
and policy and guideline papers, describing interventions to strengthen PV
in LMIC.    Methods The review was conducted following
the Joanna Briggs Institute (JBI) guidelines on conducting scoping
reviews. Literature searches were performed in MEDLINE, EMBASE, Web of
Science, PDQ-evidence, CINAHL and relevant websites from 1990 to January
2021. Two reviewers independently screened titles, abstracts and
full-texts. One reviewer performed data extraction and descriptive
analysis, which were reviewed by two other reviewers.   Results
10,922 unique titles were screened and 152 were eligible for full text
review. Of these, 57 and an additional 13 reports from grey literature
fulfilled eligibility criteria for inclusion in the review. These were
grouped into two categories: i) Interventions aimed at increasing PV
knowledge and adverse drug reactions (ADR) reporting (45 papers),
primarily education of healthcare professionals (HCP), alone or in
combination with other interventions such as mobile and electronic
reporting; ii) Interventions aimed at strengthening various components of
the national PV system (25 papers), describing strategies or mixed
interventions implemented at the national level, targeting different
components of the national PV system.   Conclusions Results of
this review suggest that educating HCP on ADR reporting is the most common
approach to build PV capacity in LMIC. Though important, education alone
is insufficient and should ideally be organised within the holistic
framework of strengthening national PV systems, with a focus on building
capacity for advanced activities such as signal detection.