The survey revealed that only about half of the sample had taken steps to ensure that their children were immunized (51.9%). Almost a third (30.6%) indicated that they had to pay for routine immunization, and amongst those who had vaccinated their children, the majority (74.6%) preferred services from public hospitals (p< 0.05). ConClusions: Due to the mixed methods approach employed, a relationship between health system funding and immunization coverage has emerged. Out of pocket payment for immunization is a significant barrier to access, particularly in poor populations. The confidence in public hospitals shown in this study can be leveraged to increase access to vaccines if the relevant capacity is provided. PHP77 EPIDEMIOLOGY AND ECONOMIC BURDEN OF ADVERSE DRUG REACTIONS IN CLINICAL PRACTICE: ROLE OF THE PHARMACIST Bollu M. chalapathi institute of pharmaceutical sciences, guntur, India objeCtives: To determine the prevalence and the economic burden of ADRs presenting to various hospitals in and around Guntur. Methods: A prospective, cross sectional, observational study carried out over a 8 months period in 2015. The prevalence of ADRs, their economic burden from the hospital perspective, severity, and preventability were assessed using standard criteria. Results: 127 patients was observed during the study period. Of these, 83 patients had ADR's (65.35%). The most common ADR's were anti-tubercular drugs induced hepatotoxicity, NSAID's induced ARF,warfarin induced hemorrhage, phenytoin toxicity calcium channel blockers induced edema , albendalzole caused agranulocytosis and ACE inhibitors induced dry cough, olanzapine caused diabetes mellitus, Augmentin caused rash.Using the Naranjo's algorithm, causality assessment was done and it was found that ,out of 127 ADRs ,46 were definite, 58 were probable, and 23 were possible ADR's. Severity was assessed by using the Modified Hartwig and Siegel scale, it was seen that 34 (26.77%) patients had mild ADRs while 65 (51.18%) had ADRs of moderate severity and 28 (22.04%) patients had severe ADRs. Schumock and Thornton scale was used to identify the preventability of ADR's. 39 (30.7%) ADR's were definitely preventable , 56 (44.09%) were probably preventable and 32(25.19%) were not preventable. The mean hospital stay of patients was 6 days and the average cost per patient suffered with an ADR was INR 5,376/-(USD 81.3$). ConClusions: Adverse drug reactions not only impose the additional economic burden on the patients but also impact their care givers and the health care system. Training of patients and prescribers for earlier identification and reporting of ADR's may lead to a reduction in hospitalization due to preventable ADRs and thus lessen their economic burden. clinical pharmacist has a role in conducting medication history interview and they have a role in dose tailoring based on the individual patient characteristics.
