Prescription errors, drug resistance mar Nigeria’s HIV treatment programme

on   /   in Health 6:48 pm   /   Comments

By SOLA OGUNDIPE

A high incidence of major medication errors related to prescription of incorrect antiretroviral therapy, ART, protocols, potential drug-drug interaction or contraindication and inappropriate duration and/or frequency of medication are being recorded in Nigeria’s HIV treatment programme.

File photo: Surgeons at work

File photo: Surgeons at work

The result of a recent comprehensive  study on patients on antiretroviral therapy, ART, in 14 selected HIV treatment centres in Nigeria, chronicles the high incidence of medical errors related to prescription of incorrect antiretroviral drug treatment plans and potentially hazardous drug-drug interactions.

The  study, entitled “Incidence and Types of Medication Errors in Patients Receiving Antiretroviral Therapy in Resource-Constrained Settings” published in  the January 2014, Volume 9, Issue 1, e87338  edition of the open access journal PLoS ONE,  was a prospective cohort assessment of patients receiving antiretroviral therapy  between February 2009 and March 2011 in outpatient pharmacy, who were screened for medication errors based on the provisions of the national HIV care and treatment guideline.

Resolution

In their resolution, the researchers, who were all affiliated with  the Howard University Pharmacists & Continuing Education (PACE) Center, Abuja & Washington DC, USA, reported how  the  incidence and rate of medication errors  which they described as “somewhat high” in antiretroviral prescription, potentially threaten the nation’s treatment programme.

“Majority of identified errors were related to prescription of incorrect ART regimens and potential drug-drug interactions; the prescriber was contacted and the errors were resolved in majority of cases. Active screening for medication errors is feasible in resource-limited settings following a capacity building intervention,” the researchers noted.

Based on the nation’s multi-sectoral response to HIV/AIDS, led by the National Agency for the Control of AIDS, NACA, which remarkably lowered the national HIV prevalence from 5.8 percent in 2001 to 3.6 percent in 2012 , Nigeria is widely expected to have one of the most ambitious HIV treatment programmes in the world.

But with a vast population of 3.8 million  People Living With HIV/AIDS (10 per cent of  the global HIV burden) and an estimated 520,000 People Living With HIV/AIDS, PLWA, on ARV treatment out of about 900,000 that qualify, much remains to be desired,according to the  Global Fund to Fight AIDS, Tuberculosis and Malaria.

NigeriaHIVinfo.com reacts

In a reaction to the report, Coordinator of Nigeria’s No.1 HIV/AIDS information portal, NigeriaHIVinfo.com, Mr. Steve Aborishade, said the result of the research  graphically details the grave implications to treatment outcomes in HIV patients.

“An important concern to us will be the infringement that this could represent to the right to health of Nigerians who are on HIV medications and on the government programmes.

The insights which the report provides represent a dull blight on an already contentious treatment programme dangerously buoyed by marked integrity deficits.

“To us at NigeriaHIVinfo.com, the findings become worrisome as it raises serious concerns around the integrity of our ART regime, especially from the research conclusion which suggests that active screening for medication errors is feasible even in resource-limited settings like ours if only we would build the capacity of those manning our facilities.”

Aborishade linked concerns about the PLoS study report to findings of the 2010 Global Burden of Disease, GBD, Study which identifies  HIV/AIDS as the worst health problem in Gabon and Equatorial Guinea, and number two in  Nigeria, Ghana and Cameroon.

The GBD study, he recalled, ranks   HIV is the number one cause of Disability-Adjusted Life-Years, DALYs, lost worldwide.

“Whereas most other conditions disproportionately affect the old and the very young, DALYs lost for women aged 25 to 45 and men aged 30 to 45. Nigeria’s predominantly youthful population to us constitutes a peculiar catchment bracket here, and cause of worry.”

Concerns

Aborishade said the findings constitute serious grounds for concerns considering the gale of recent controversy around the supply and dispensing of substandard  ARV medication to Federal government treatment centres across the country, coupled with the failure to extend ARV treatment to all who require it and failure to halt new infections in children and adults.

“This gross shortcoming represents likely factors capable of collapsing the foundation of our ART regime with the modest gains recorded overtime in the light of revelations which question the capability, sincerity and indeed clarity of our policy direction and of our programme implementation.

“It sadly also makes mockery of our President’s avowed commitment which fuelled his declaring last year that no Nigerian life would be lost to HIV/AIDS again.”

Calling for immediate attention to redress the malady, Aborishade expressed hope that those directing the intervention process will see the urgent need to respond with more clarity of purpose.

“We demand that they entrench a new regime driven by accountability and openness even in the midst of constraints to available resources.

The Nigerian people deserve an explanation as to how we remain at this junction having in mind the huge investments in tax payers’ money and foreign donor’s grants that the Hiv intervention continues to consume,” he stated.

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