Original Research

Tracking adverse drug reactions and medication errors in the Central Chronic Medicine Dispensing and Distribution (CCMDD) programme in South Africa

Kennedy Otwombe, Maggie Munsamy, Mukesh Dheda, Nishana Ramdas, Corlee Herbst, Merlin Pillay, Tanya van Tonder, Celicia Serenata, Samanta Lalla-Edward
Southern African Journal of HIV Medicine | Vol 23, No 1 | a1366 | DOI: https://doi.org/10.4102/sajhivmed.v23i1.1366 | © 2022 Kennedy Otwombe, Maggie Munsamy, Mukesh Dheda, Nishana Ramdas, Corlee Herbst, Merlin Pillay, Tanya van Tonder, Celicia Serenata, Samanta Lalla-Edward | This work is licensed under CC Attribution 4.0
Submitted: 20 December 2021 | Published: 19 May 2022

About the author(s)

Kennedy Otwombe, Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Maggie Munsamy, Central Chronic Medicines Dispensing and Distribution (CCMDD) Programme, National Department of Health, Pretoria, South Africa
Mukesh Dheda, Pharmacovigilance Programme for Public Health, National Department of Health, Pretoria, South Africa
Nishana Ramdas, Central Chronic Medicines Dispensing and Distribution (CCMDD) Programme, National Department of Health, Pretoria, South Africa
Corlee Herbst, Central Chronic Medicines Dispensing and Distribution (CCMDD) Programme, National Department of Health, Pretoria, South Africa
Merlin Pillay, Central Chronic Medicines Dispensing and Distribution (CCMDD) Programme, National Department of Health, Pretoria, South Africa
Tanya van Tonder, Opinion Solutions, Johannesburg, South Africa
Celicia Serenata, Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Samanta Lalla-Edward, Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa


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Abstract

Background: The South African Central Chronic Medicine Dispensing and Distribution (CCMDD) programme is a National Health Insurance (NHI) initiative that improves access to medicine for patients.

Objectives: To describe the frequency of adverse drug reactions (ADRs) and medication errors reported in stable patients living with HIV.

Method: This descriptive cross-sectional survey was conducted from August 2020 to October 2020, targeting tenofovir disoproxil fumarate/lamivudine/dolutegravir (TLD) and tenofovir disoproxil fumarate/emtricitabine/efavirenz (TEE) patients. The distribution of ADRs and medication errors is presented.

Results: Of 9621 patients, 30.8% (n = 2967) were interviewed, 40.2% (n = 1192) on TLD and 59.8% (n = 1775) on TEE regimens. The majority were women (TLD: 55.8%, n = 665; TEE: 75.4%, n = 1338); 15% (179/1192) reported ADRs on TLD. Medication errors were low on TLD (1.6%, n = 19) and TEE (1.2%, n = 22). Receipt of incorrect medication (eight each in TLD and TEE) and associated hospitalisations (one vs two, respectively) were low. Common TLD-associated ADRs were weight gain (47.5%, n = 85), headaches (44.7%, n = 80), insomnia (39.7%, n = 71), restlessness (36.9%, n = 66), dizziness (29.6%, n = 53), brain fog (27.9%, n = 50), nervousness (27.4%, n = 49), rash on the skin (24.6%, n = 44) and poor concentration (21.2%, n = 38).

Conclusion: About one in seven patients reported ADRs under TLD. Medication errors were low, possibly due to effective quality control measures and stable patients being on the programme. Knowing the frequency of ADRs and medication errors is critical for enhancing the CCMDD programme.


Keywords

CCMDD; National Health Insurance; ADRs; Medication errors; HIV

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