Evidence map›Paper›PMID 40975083›Full record

Trial reportThe Lancet. Global health2025

Adverse drug reaction reporting with the Med Safety app in Uganda: a cluster-randomised, controlled trial.

Ronald Kiguba, Helen B Ndagije, Norah Mwebaza, Ronald Ssenyonga, Lilian Giibwa, Gerald Isabirye, Jonathan Owiny, Victoria Nambasa, Ismail Ntale, Joanitah Atuhaire and 8 more

Abstract readMulticenter StudyRandomized Controlled TrialPragmatic Clinical Trial
In one paragraph

Trial report in The Lancet. Global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Ronald KigubaDepartment of Pharmacology and Therapeutics, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda. Electronic address: kiguba@gmail.com.
Helen B NdagijeNational Pharmacovigilance Centre, National Drug Authority, Kampala, Uganda.
Norah MwebazaDepartment of Pharmacology and Therapeutics, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.
Ronald SsenyongaDepartment of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda; Department of Public Health, Faculty of Health Sciences, Muni University, Kampala, Uganda.
Lilian GiibwaDepartment of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
Gerald IsabiryeNational Pharmacovigilance Centre, National Drug Authority, Kampala, Uganda.
Jonathan OwinyNational Pharmacovigilance Centre, National Drug Authority, Kampala, Uganda.
Victoria NambasaAfrican Union Development Agency, Johannesburg, South Africa.
Ismail NtaleNational Pharmacovigilance Centre, National Drug Authority, Kampala, Uganda.
Joanitah AtuhaireNational Pharmacovigilance Centre, National Drug Authority, Kampala, Uganda.
Douglas MwesigwaNational Pharmacovigilance Centre, National Drug Authority, Kampala, Uganda.
Julius MayengoNational Pharmacovigilance Centre, National Drug Authority, Kampala, Uganda.
David WalusimbiAfrican Union Development Agency, Johannesburg, South Africa.
Ian MugisaNational Pharmacovigilance Centre, National Drug Authority, Kampala, Uganda.
Cordelia KatureebeAIDS Control Programme, Ministry of Health, Kampala, Uganda.
Kendal HarrisonMedicines and Healthcare products Regulatory Agency, London, UK.
Charles KaramagiClinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
Munir PirmohamedCentre for Drug Safety Science and Wolfson Centre for Personalised Medicine, Institute of Systems, Molecular and Integrative Biology (ISMIB), University of Liverpool, Liverpool, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe massive roll-out of new and repurposed medicines in low-income and middle-income countries (LMICs) highlights the need for more efficient pharmacovigilance systems, including use of digital technologies. We assessed the effectiveness of the Med Safety app in improving suspected adverse drug reaction (ADR) reporting by health-care workers to Uganda's National Pharmacovigilance Centre.

methodsThis was a pragmatic, multicentre, open-label, cluster-randomised, controlled trial undertaken at health facilities (clusters), providing dolutegravir-based combination antiretroviral therapy in Uganda. Clusters were randomly assigned (1:1) to the intervention group or control group using a computer-generated simple randomisation sequence. In the intervention group, pharmacists with expertise in pharmacovigilance delivered 2 h of face-to-face training to health-care workers in clusters, regardless of their smartphone ownership, in Med Safety and traditional ADR reporting methods. The control group received the same training as the intervention group except for Med Safety training. The primary outcome was the cluster-level ADR reporting rate at the end of follow-up and was analysed in all sites that received the allocated intervention. The trial is registered with the Pan African Clinical Trials Registry (PACTR202009822379650) and is completed.

findingsBetween Aug 11, 2020 and Nov 1, 2022, 382 clusters were randomly assigned and 367 received the allocated intervention and were included in the primary outcome analysis (184 in the intervention group and 183 in the control group), with 2464 health-care workers (1211 in the intervention group and 1253 in the control group). The follow-up time for the included clusters was variable and was median 37·8 months (IQR 34·2-39·8). In the primary analysis, the intervention group had a higher mean overall ADR reporting rate of 10·6 (SD 17·4) reports per 100 000 person-months versus 5·9 (17·9) in the control group (incidence rate ratio 1·73 [95% CI 1·26-2·37]; p=0·001).

interpretationMed Safety increased ADR reporting rates among health-care workers in Uganda. Integrating digital technologies into pharmacovigilance systems could strengthen drug-safety monitoring in Uganda and other LMICs.

fundingUK Medical Research Council and the Foreign Commonwealth and Development Office; Makerere University Research & Innovations Fund; and Ugandan National Drug Authority.

Indexed as

Adverse Drug Reaction Reporting SystemsDrug-Related Side Effects and Adverse ReactionsHealth PersonnelMobile ApplicationsPharmacovigilanceAdultFemaleHumansMaleUganda

Identifiers

PMID40975083
PMCPMC12446902

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.