Knowledge and Awareness of Pharmacovigilance among Ayurveda Physicians in Himachal Pradesh.

Sir,

Pharmacovigilance (PV) is a serious concern in India due to frequently observed cases of adverse drug reactions (ADRs),[1] Ayurveda is also facing a dearth of systematic documentation apropos ADRs and safety of its medicines. The possible reasons could be poor awareness of PV and misconception that Ayurveda medicines are devoid of adverse reactions.[2] However it is noteworthy that classical Ayurveda prescribes purely herbal, herbo-mineral (e.g. Tribhuvanakīrti rasa) and bhasma preparations (callcined metal/minerals), the ADRs may occur if precautions are not taken while manufacturing or administering these medicines.[34] Furthermore, doubts regarding long-term safety of Ayurvedic medicines come up as they may contain metals, minerals or poisonous drugs of Schedule E-1,[5] and there are reports related to ADRs.[67]

Ayurveda practitioners (APs) could be reliable scientific resources in PV reporting mechanism, but are not contributing significantly in ADR reporting due to poor knowledge, attitude and practices in this regard.[8910] No report is available so far on the level of knowledge and awareness on PV among Ayurveda practitioners of any northern Indian state. Considering this, we undertook a questionnaire (validated and consisted of fifteen items) based survey, during July-November 2016, of 277 Ayurveda physicians, selected using simple random sampling, working in rural and urban regions of Himachal Pradesh, after obtaining their consent to participate and informing that the participation was voluntary and assuring that confidentiality will be maintained. The questionnaire was communicated through WhatsApp to participants and they were asked to resend it after answering. The collected data were analyzed using MS Excel 2007 and expressed in percentage (%). General data on characteristics of 277 physicians is as follows: Age group (years): 25-35 = 163 (59%), 35-45 = 67 (24%), >45 = 47 (17%); Gender: Male = 192 (69%), Female = 85 (31%); Professional qualification: graduates = 266 (96%), post-graduates = 11 (4%); Working experience as physician: <5 years = 109 (39%), >5 years = 168 (61%); Type of clinical posting: Posted in government Ayurvedic Health Centres (AHCs)/sub-divisional AHCs/district/state-level Ayurvedic hospitals = 103 (37%), Posted in mobile health units under NRHM = 43 (16%), Others (Pvt. practitioners/working in NGOs) = 131 (47%). The obtained information on knowledge, attitude and practice of PV among them is detailed in Table 1.

Table 1

Knowledge, attitude and practice of pharmacovigilance among Ayurveda physicians

Though the study was of limited sample size, the findings reflect the poor knowledge and awareness of PV among Ayurveda practitioners of Himachal. The present report is expected to wake up the concerned authorities and Ayurveda stakeholders for successful implementation of NPP. Better understanding of PV among practitioners can not only assist in early detection, assessment and prevention of adverse drug reactions but also is imperative for prompt re-evaluation of marketed drugs, risk management and rational drug use.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.