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Al-Yafeai Z, Sondhi M, Vadlamudi K, Vyas R, Nadeem D, Alawadi M, Carvajal-González A, Ghoweba M, Ananthaneni A. Novel anti-psoriasis agent-associated cardiotoxicity, analysis of the FDA adverse event reporting system (FAERS). Int J Cardiol 2024; 402:131819. [PMID: 38301830 DOI: 10.1016/j.ijcard.2024.131819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/16/2024] [Accepted: 01/28/2024] [Indexed: 02/03/2024]
Abstract
INTRODUCTION Psoriasis is a chronic skin condition characterized by hyperproliferation of epidermal keratinocytes, resulting in erythematous and scaling lesions. The US Food and Drug Administration (FDA) has approved nine biologic agents to address the burden of psoriasis, but their cardiovascular risks remain poorly studied. METHODS This retrospective pharmacovigilance study utilized the FDA Adverse Event Reporting System (FAERS) database to analyze adverse events associated with newly approved therapeutic agents for psoriasis. We employed disproportionally signal analysis, calculating the reporting odds ratio (ROR) with a 95% confidence interval. RESULTS Among the vast FAERS database, which contained >25 million adverse events, a total of 334,399 events were associated with newly approved therapeutic agents for psoriasis. Cardiac adverse events accounted for 3852 cases, including pericarditis, atrial fibrillation, and coronary artery disease. Secukinumab had the highest number of reported adverse events, followed by brodalumab, while tildrakizumab had the lowest. Coronary artery disease was the most reported adverse event (1438 cases), followed by pericarditis (572 cases) and atrial fibrillation (384 cases). Secukinumab had the highest incidence of coronary artery disease, pericarditis, and atrial fibrillation. Risankizumab was significantly associated with an increased risk of coronary artery disease and atrial fibrillation, while tildrakizumab and Ixekizumab were associated with atrial fibrillation. Secukinumab was associated with an elevated risk of pericarditis. CONCLUSIONS The study uncovers the cardiovascular adverse effects related to biologic agents used in psoriasis treatment. These findings emphasize the importance of monitoring and evaluating the cardiovascular safety profiles of biological agents used in psoriasis treatment.
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Affiliation(s)
- Zaki Al-Yafeai
- Department of Internal Medicine, LSUHSC-Shreveport, Shreveport, USA; Division of Cardiology, Department of Medicine, College of Medicine, University of Illinois at Chicago.
| | - Manush Sondhi
- Department of Internal Medicine, LSUHSC-Shreveport, Shreveport, USA
| | - Kavya Vadlamudi
- Department of Internal Medicine, LSUHSC-Shreveport, Shreveport, USA
| | - Rahul Vyas
- Department of Internal Medicine, LSUHSC-Shreveport, Shreveport, USA
| | - Daniyal Nadeem
- Department of Internal Medicine, LSUHSC-Shreveport, Shreveport, USA
| | | | | | - Mohamed Ghoweba
- Department of Internal Medicine, LSUHSC-Shreveport, Shreveport, USA
| | - Anil Ananthaneni
- Department of Internal Medicine, LSUHSC-Shreveport, Shreveport, USA
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Choo SM, Sartori D, Lee SC, Yang HC, Syed-Abdul S. Data-Driven Identification of Factors That Influence the Quality of Adverse Event Reports: 15-Year Interpretable Machine Learning and Time-Series Analyses of VigiBase and QUEST. JMIR Med Inform 2024; 12:e49643. [PMID: 38568722 PMCID: PMC11024759 DOI: 10.2196/49643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 10/10/2023] [Accepted: 02/24/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND The completeness of adverse event (AE) reports, crucial for assessing putative causal relationships, is measured using the vigiGrade completeness score in VigiBase, the World Health Organization global database of reported potential AEs. Malaysian reports have surpassed the global average score (approximately 0.44), achieving a 5-year average of 0.79 (SD 0.23) as of 2019 and approaching the benchmark for well-documented reports (0.80). However, the contributing factors to this relatively high report completeness score remain unexplored. OBJECTIVE This study aims to explore the main drivers influencing the completeness of Malaysian AE reports in VigiBase over a 15-year period using vigiGrade. A secondary objective was to understand the strategic measures taken by the Malaysian authorities leading to enhanced report completeness across different time frames. METHODS We analyzed 132,738 Malaysian reports (2005-2019) recorded in VigiBase up to February 2021 split into historical International Drug Information System (INTDIS; n=63,943, 48.17% in 2005-2016) and newer E2B (n=68,795, 51.83% in 2015-2019) format subsets. For machine learning analyses, we performed a 2-stage feature selection followed by a random forest classifier to identify the top features predicting well-documented reports. We subsequently applied tree Shapley additive explanations to examine the magnitude, prevalence, and direction of feature effects. In addition, we conducted time-series analyses to evaluate chronological trends and potential influences of key interventions on reporting quality. RESULTS Among the analyzed reports, 42.84% (56,877/132,738) were well documented, with an increase of 65.37% (53,929/82,497) since 2015. Over two-thirds (46,186/68,795, 67.14%) of the Malaysian E2B reports were well documented compared to INTDIS reports at 16.72% (10,691/63,943). For INTDIS reports, higher pharmacovigilance center staffing was the primary feature positively associated with being well documented. In recent E2B reports, the top positive features included reaction abated upon drug dechallenge, reaction onset or drug use duration of <1 week, dosing interval of <1 day, reports from public specialist hospitals, reports by pharmacists, and reaction duration between 1 and 6 days. In contrast, reports from product registration holders and other health care professionals and reactions involving product substitution issues negatively affected the quality of E2B reports. Multifaceted strategies and interventions comprising policy changes, continuity of education, and human resource development laid the groundwork for AE reporting in Malaysia, whereas advancements in technological infrastructure, pharmacovigilance databases, and reporting tools concurred with increases in both the quantity and quality of AE reports. CONCLUSIONS Through interpretable machine learning and time-series analyses, this study identified key features that positively or negatively influence the completeness of Malaysian AE reports and unveiled how Malaysia has developed its pharmacovigilance capacity via multifaceted strategies and interventions. These findings will guide future work in enhancing pharmacovigilance and public health.
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Affiliation(s)
- Sim Mei Choo
- Centre of Compliance & Quality Control, National Pharmaceutical Regulatory Agency, Petaling Jaya, Malaysia
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan
| | | | - Sing Chet Lee
- Centre of Compliance & Quality Control, National Pharmaceutical Regulatory Agency, Petaling Jaya, Malaysia
| | - Hsuan-Chia Yang
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan
- International Center for Health Information Technology, Taipei Medical University, Taipei, Taiwan
- Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
- Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Shabbir Syed-Abdul
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan
- International Center for Health Information Technology, Taipei Medical University, Taipei, Taiwan
- School of Gerontology and Long-Term Care, Taipei Medical University, Taipei, Taiwan
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Boyd IW, McEwen J. Sustained Decline of Direct General Practitioner Reporting of Adverse Drug Reactions in Australia and Paucity in Details of Australian Reports in Safety Advisories. Drug Saf 2023:10.1007/s40264-023-01321-4. [PMID: 37266905 DOI: 10.1007/s40264-023-01321-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2023] [Indexed: 06/03/2023]
Abstract
INTRODUCTION There have been substantial changes in the nature of reporting pathways and review of suspected adverse drug reactions (ADRs) in Australia since the establishment of the now defunct Advisory Committee on Safety of Medicines early in 2010. OBJECTIVES The aim of this study was to (1) examine the reporting in Australia of suspected ADRs from various sources, including general practitioners (GPs), since 1990; (2) compare the reporting of Australian GPs with that in two other countries (New Zealand and the United Kingdom [UK]) with comparable safety monitoring programmes for the period 2007-2019; and (3) explore the extent to which Australian reporting of suspected adverse reactions has motivated communication to healthcare professionals in the period 1995-2019. METHODS Annual reporting of sources of ADRs in Australia were obtained from Government reports, the Australian Statistics in Medicines and Therapeutic Goods Administration (TGA) websites. Details of the annual reporting by GPs in the UK were obtained from published sources and have been provided on request by the Medicines and Healthcare products Regulatory Agency. Details of the annual reporting by GPs in New Zealand were provided on request from the Centre for Adverse Reaction Monitoring. All issues of the Australian Adverse Drug Reactions Bulletin were accessed from the National Library of Australia, and issues of the Medicines Safety Update from February 1995 to December 2019 were accessed online from the TGA website. Each issue was searched to identify and score safety advisories. RESULTS From 1990 to 2002 in Australia, overall reporting gradually increased, and the three major groups of reporters (GPs, hospitals and sponsors) each contributed about 30%. The relative contributions to reporting changed in the period 2002 to 2009. There was then a steep fall in reporting from GPs and the start of a very marked increase in reporting from product sponsors. GP reporting in Australia was lower than the two other comparable countries (New Zealand and the UK), and continues to fall, while in the UK at least, GP reporting is rising. The analysis of safety advisories shows a relatively stable Australian content from 1995 to 2008, followed by a sharp decline, so that by 2019 and 2020 there was barely any Australian reporting-driven content. In 1995 and 1996, Australian reports of suspected adverse reactions were the sole apparent reason for the publication of safety advisories. From 1997 to about 2008, Australian reports of suspected adverse reactions were the major reason for publication, but after this time, Australian reports became less important. During this later period, the apparent motive for publication of the safety advisory shifted to being based primarily on a publication in the medical literature, or publicity, but was sometimes based on an overseas regulator's advice or action, or action by a product sponsor. CONCLUSION It is our contention that the decline in GP reporting in Australia and the current paucity in details of Australian reports in safety advisories are closely linked.
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Affiliation(s)
- Ian W Boyd
- Ian Boyd Consulting, Shoalhaven, NSW, Australia.
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Mlotshwa CR, Burger JR, Vorster M, Rakumakoe DM, Cockeran M. Completeness of pharmaceutical industry insulin adverse event reports from Africa and the Middle East. Expert Opin Drug Saf 2022; 22:221-229. [PMID: 35946933 DOI: 10.1080/14740338.2022.2110863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Growing numbers of patients with diabetes mellitus in Africa and the Middle East on antidiabetic therapies necessitate an understanding of adverse event reporting in these regions. We assessed pharmaceutical industry insulin individual case safety report (ICSR) completeness and completeness-associated variables. RESEARCH DESIGN AND METHODS The observational cross-sectional study, set in an insulin-manufacturing company's safety database, assessed vigiGrade® completeness scores of African and Middle Eastern post-marketing ICSRs during January to December 2018, and the effects of case variables on completeness. Low vigiGrade® scores indicated poorly documented ICSRs. RESULTS We analyzed 4854 ICSRs; 59.8% from the Middle East. The mean vigiGrade® score was 0.58. Middle Eastern ICSRs had higher mean scores than African ICSRs (0.65 vs. 0.46, p<0.001). Scores peaked at 0.32, 0.70, and 1.00, for Middle Eastern ICSRs compared to 0.35 and 0.50 for African ICSRs. Middle Eastern serious (0.77 vs. 0.47; p<0.001) and solicited (0.70 vs. 0.48; p<0.001) ICSRs had higher mean scores than African ICSRs. Mean scores were highest for Middle Eastern physicians (0.89) and other healthcare professionals (0.82) whereas, in Africa, scores were highest for consumer- (0.47) and pharmacist-reported ICSRs (0.47) (p<0.001). CONCLUSIONS Middle Eastern pharmaceutical industry insulin ICSRs were documented with greater detail than African ICSRs. Event seriousness, report source, and reporter type significantly impacted ICSR completeness.
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Affiliation(s)
- Charity Rn Mlotshwa
- Medicine Usage in South Africa (MUSA), Faculty of Health Sciences, North-West University, South Africa
| | - Johanita R Burger
- Medicine Usage in South Africa (MUSA), Faculty of Health Sciences, North-West University, South Africa
| | - Martine Vorster
- Medicine Usage in South Africa (MUSA), Faculty of Health Sciences, North-West University, South Africa
| | - Dorcas M Rakumakoe
- Medicine Usage in South Africa (MUSA), Faculty of Health Sciences, North-West University, South Africa
| | - Marike Cockeran
- School of Mathematical and Statistical Sciences, Faculty of Natural and Agricultural Sciences, North-West University, South Africa
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Khalili M, Sharifi H, Mesgarpour B, Kheirandish M, Olsson S, Javidnikou N, Haghdoost AA. Evaluation of Pharmacovigilance System in Iran. Int J Health Policy Manag 2022; 11:990-1000. [PMID: 33590736 PMCID: PMC9808195 DOI: 10.34172/ijhpm.2020.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 11/28/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Evaluating a pharmacovigilance system helps identify its deficiencies and could facilitate measures to remedy and improve the quantity and quality of adverse drug reaction (ADR) reports and other opportunities for pharmacovigilance systems strengthening. This study aimed to evaluate the status of pharmacovigilance in Iran using the World Health Organization (WHO) pharmacovigilance indicators with the prospect of identifying the gaps and areas for improvement. METHODS This study was conducted in 2 parts. The first part included a secondary analysis of the national data obtained from the Iranian National Pharmacovigilance Center (PVC) using a structured data collection form based on WHO core pharmacovigilance indicators. In the second part, a 3-month prospective study was carried out to investigate 2 outcome indicators, ie, length of stay and costs of medicine-related hospitalization in all patients of 2 main referral hospitals in the southeast and north of Iran. RESULTS Iran has a PVC with national policy, trained staff, and a statutory budget. In 2017, the number of ADR reports was 15.0 per 100 000 population, and 262 signals were detected during the preceding 5 years. The average length of stay and costs of medicine-related hospitalization were 5 days and US$817.2 in Afzalipour hospital and 6.6 days and US$306.7 in Razi hospital, respectively. The status of pharmacovigilance in the Iranian public health programs (PHPs) is unknown, and most of the indicators could not be assessed. CONCLUSION A robust pharmacovigilance system is a pivotal part of the overall medicines regulatory system. The Iranian pharmacovigilance system has relatively the proper structural condition. Though the underreporting of ADRs, especially medicine-related deaths, is an important issue, and some indicators' status was unclear. The Iranian pharmacovigilance program requires a higher prioritization, particularly in the PHPs, a greater allocation of resources, and cross-sectoral cooperation to bolster and achieve the pharmacovigilance objectives.
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Affiliation(s)
- Malahat Khalili
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Bita Mesgarpour
- National Institute for Medical Research Development, Tehran, Iran
| | - Mehrnaz Kheirandish
- Department for Assessment and Control of Prescribing and Use of Medicines and Health Products, Food and Drug Administration, Tehran, Iran
| | - Sten Olsson
- International Society of Pharmacovigilance, London, UK
- Pharmacovigilance Consulting, Uppsala, Sweden
| | | | - Ali Akbar Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Relationship Between Pharmaceutical Knowledge and Probability of Medication Errors Among Nurses: A Cross-sectional Study in the Northwest of Iran in 2020. HEALTH SCOPE 2022. [DOI: 10.5812/jhealthscope.112269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Patient safety is a major concern for health care professionals. Medication errors have been considered a major indicator of health care quality. The lack of pharmacological knowledge is a cause of medication error among nurses. Objectives: The purpose of this study was to investigate the relationship between pharmacological knowledge and the probability of medical errors in nurses working in Urmia hospitals in 2020. Methods: This cross-sectional study included 490 nurses randomly selected from among those working in hospitals of Urmia in 2020. The data collection tool was a multiple-choice questionnaire about knowledge and pharmacological skills consisting of 3 sections: demographic information, nurses’ drug knowledge, and the confidence level of response in nurses. To analyze questions and hypotheses via SPSS version 21, the t-test and analysis of variance (ANOVA) were employed. Results: The highest pharmaceutical knowledge scores of nurses were related to methods of administration (2.9 ± 1.01 [72.56%]), and the lowest score was related to drug management (1.05 ± 0.63 [52.84%]). The mean of error probability was very low in 28.81% of nurses, low in 37.66%, high in 11.34%, and very high in 22.85%. Pharmaceutical knowledge had a significant relationship with gender, wards, type of hospital, and number of children (P < 0.05 for all). Conclusions: Since the nurses’ level of pharmaceutical knowledge has an important role in the correct prescription of medicine, we suggest that nurse managers and educational supervisors in the field of nursing use in-service training programs and prepare training booklets and posters to promote nurses’ pharmaceutical knowledge in this field.
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Shahzeydi A, Joonbakhsh F, Ajoodaniyan N, Khaksar S, Kalhor F, Sabzghabaee AM, Kalhor R. Comparing the pharmacology knowledge and performance of nurses and nursing students in the use of information resources in pediatrics wards: An observational study. SAGE Open Med 2022; 10:20503121221135397. [DOI: 10.1177/20503121221135397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 10/11/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives: One of the major duties of nurses is proper medication administration while maintaining patient safety, which requires sufficient knowledge and practice. Any gaps in knowledge used by nurses can lead to irreversible injury or death of the patient. This study is aimed to determine and compare the pharmacology knowledge and performance of nurses and nursing students in using the information resources in pediatrics wards. Method: This descriptive observational study was performed on 300 nurses and nursing students. Sources of knowledge and performance of nurses and nursing students were analyzed with researcher-made tools to determine their pharmaceutical knowledge, sources of knowledge, and attitudes by independent t-test, chi-square, one-way analysis of variance, Pearson, and Spearman tests. Result: Three hundred questionnaires were examined. The clinical experience of nurses and students was their most important source of information in drug challenges for 33.7% of the participants. About 24.6% of nurses obtained the required information from specialized books on pediatric medicine. About 17.1% of the participants attained their knowledge from multiple sources (e.g. various available sources such as the Internet, pharmacy books, software, and their experiences and colleagues), while electronic sources and the Internet were the sources of knowledge for 15.5% and 7.7% of the nurses, respectively. Concerning nursing students, 6.3% used books, 41.7% considered colleagues (clinical experiences), 20.8% employed electronic resources, 22.8% used the Internet, and 9.1% relied on multiple sources. There were significant differences in the knowledge and performance of the nurses based on their source of pharmacological knowledge (P < 0.05). Conclusion: Most of the resources used in the hospital are not up-to-date and evidence-base, and the majority of nurses tend to rely on their clinical experience or their collegues information for medication administration rather than reading books or searching for up-to-date approaches and information. Nursing students also trust nurses’ clinical experiences more than other sources provided for them including books and Internet. Some action should be taken by the managers for boosting the nurses’ tendency for using up-to-date information resources.
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Affiliation(s)
- Amir Shahzeydi
- School of Nursing and Midwifery, Isfahan University of Medical Sciences and Health Services, Isfahan, Islamic Republic of Iran
| | - Fatemeh Joonbakhsh
- School of Nursing and Midwifery, Isfahan University of Medical Sciences and Health Services, Isfahan, Islamic Republic of Iran
| | - Najmeh Ajoodaniyan
- School of Nursing and Midwifery, Isfahan University of Medical Sciences and Health Services, Isfahan, Islamic Republic of Iran
| | - Sajjad Khaksar
- School of Nursing and Midwifery, Isfahan University of Medical Sciences and Health Services, Isfahan, Islamic Republic of Iran
| | - Faramarz Kalhor
- School of Nursing and Midwifery, Isfahan University of Medical Sciences and Health Services, Isfahan, Islamic Republic of Iran
| | - Ali Mohammad Sabzghabaee
- School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences and Health Services, Isfahan, Islamic Republic of Iran
| | - Rohollah Kalhor
- Health Services Management, Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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Taylor MA, Godwin AC, Hoque S, Bennett CL. Systemic Barriers and Potential Concerns from Reporting Serious Adverse Drug Reactions. Cancer Treat Res 2022; 184:75-85. [PMID: 36449189 DOI: 10.1007/978-3-031-04402-1_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
About 1-10% of all serious adverse drug reactions (sADRs) are reported to the Food and Drug Administration (FDA) ( Moore T, Bennett C. Underreporting of Hemorrhagic and Thrombotic Complications of Pharmaceuticals to the U.S. Food and Drug Administration: Empirical Findings for Warfarin, Clopidogrel, Ticlopidine, and Thalidomide from the Southern Network on Adverse Reactions (SONAR). Semin Thromb Hemost. 2012;38(08):905-907. https://doi.org/10.1055/s-0032-1328890 ). Prevailing opinion suggests that low reporting rates reflect time constraints.
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Affiliation(s)
- Matthew A Taylor
- SONAR (Southern Network on Adverse Reactions) Program, University of South Carolina Colleges of Pharmacy and Engineering, Columbia, SC, 29208, USA
| | - Ashley C Godwin
- SONAR (Southern Network on Adverse Reactions) Program, University of South Carolina Colleges of Pharmacy and Engineering, Columbia, SC, 29208, USA
| | - Shamia Hoque
- SONAR (Southern Network on Adverse Reactions) Program, University of South Carolina Colleges of Pharmacy and Engineering, Columbia, SC, 29208, USA
| | - Charles L Bennett
- SONAR (Southern Network on Adverse Reactions) Program, University of South Carolina Colleges of Pharmacy and Engineering, Columbia, SC, 29208, USA.
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Silva LT, Modesto ACF, Amaral RG, Lopes FM. Hospitalizations and deaths related to adverse drug events worldwide: Systematic review of studies with national coverage. Eur J Clin Pharmacol 2021; 78:435-466. [PMID: 34716774 DOI: 10.1007/s00228-021-03238-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/18/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Adverse drug events are related to negative outcomes in healthcare, including hospitalization, increased duration of hospital stay and death. The aim of this study was to conduct a systematic review to evaluate hospitalizations and deaths related to adverse drug events worldwide, reported in studies with national coverage. METHODS The protocol was registered in PROSPERO (CRD42020157008). We performed a systematic search on Medline, Embase, CINAHL, LILACS, and the Cochrane Library (until March 2020) using pre-specified terms. We included published studies that reported data on hospitalizations and/or deaths related to adverse drug events from a national perspective and the use of secondary data as a source of information. Two reviewers independently extracted and synthesized data. The quality of the studies was assessed using an adapted version of the Joanna Briggs Institute critical appraisal checklist for prevalence studies. Narrative summaries of findings were undertaken. RESULTS Among 59,336 citations, 62 studies were included for data extraction and synthesis. Among these studies, 41 studies included the outcome of hospitalization, 16 included the death outcome, and five included both outcomes. Administrative databases regarding discharges and registries of vital statistics were the most common sources of information. The relative frequency of hospitalizations ranged from 0.03% to 7.3%, and from 9.7 to 383.0/100,000 population, whereas mortality rate ranged from 0.1 to 7.88/100,000 population. CONCLUSION Our study highlights information about adverse drug events using large administrative databases in a national scenario and provides an overview of databases and methods implemented to detect adverse drug events.
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Affiliation(s)
- Lunara Teles Silva
- Postgraduate Program On Health Sciences, School of Medicine, Universidade Federal de Goiás - UFG, Goiânia, Goiás, Brazil
| | | | - Rita Goreti Amaral
- School of Pharmacy, Universidade Federal de Goiás - UFG, Goiânia, Goiás, Brazil
| | - Flavio Marques Lopes
- School of Pharmacy, Universidade Federal de Goiás - UFG, Goiânia, Goiás, Brazil.
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Pham P, Cheng C, Wu E, Kim I, Zhang R, Ma Y, Kortepeter CM, Muñoz MA. Leveraging Case Narratives to Enhance Patient Age Ascertainment from Adverse Event Reports. Pharmaceut Med 2021; 35:307-316. [PMID: 34476768 DOI: 10.1007/s40290-021-00398-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Missing age presents a significant challenge when evaluating individual case safety reports (ICSRs) in the FDA Adverse Event Reporting System (FAERS). When age is missing in an ICSR's structured field, it may be in the report's free-text narrative. OBJECTIVES This study aimed to evaluate the performance and assess the potential impact of a rule-based natural language processing (NLP) tool that utilizes a text string search to identify patients' numerical age from unstructured narratives. METHODS Using FAERS ICSRs from 2002 to 2018, we evaluated the annual proportion of ICSRs with age missing in the structured field before and after NLP application. Reviewers manually identified patients' age from ICSR narratives (gold standard) from a random sample of 1500 ICSRs. The gold standard was compared to the NLP-identified age. RESULTS During the study period, the percentage of ICSRs missing age in the structured field increased from 21.9 to 43.8%. The NLP tool performed well among the random sample: sensitivity 98.5%, specificity 92.9%, positive predictive value (PPV) 94.9%, and F-measure 96.7%. It also performed well for the subset of ICSRs missing age in the structured field; when applied to these cases, NLP identified age for an additional one million ICSRs (10% of the total number of ICSRs from 2002 to 2018) and decreased the percentage of ICSRs missing age to 27% overall. CONCLUSIONS NLP has potential utility to extract patients' age from ICSR narratives. Use of this tool would enhance pharmacovigilance and research using FAERS data.
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Affiliation(s)
- Phuong Pham
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA.,Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, 20993, USA
| | - Carmen Cheng
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, 20993, USA.
| | - Eileen Wu
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, 20993, USA
| | - Ivone Kim
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, 20993, USA
| | - Rongmei Zhang
- Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, 20993, USA
| | - Yong Ma
- Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, 20993, USA
| | - Cindy M Kortepeter
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, 20993, USA
| | - Monica A Muñoz
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA.,Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, 20993, USA
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Khalili M, Mesgarpour B, Sharifi H, Golozar A, Haghdoost AA. Estimation of adverse drug reaction reporting in Iran: Correction for underreporting. Pharmacoepidemiol Drug Saf 2021; 30:1101-1114. [PMID: 33772938 DOI: 10.1002/pds.5235] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 02/22/2021] [Accepted: 03/24/2021] [Indexed: 12/17/2022]
Abstract
PROPOSE Underreporting of Adverse Drug Reactions (ADRs) reduces the sensitivity of pharmacovigilance systems. We described ADR reporting and its trend from 1999 to 2017 and estimated the ADR underreporting in the Iranian Pharmacovigilance Center. METHODS We expressed the number of ADR reporting per inhabitants and admissions and their possible trends. Finally, ADR underreporting percentages were estimated by three approaches: prospective studies, literature review, stratification of the country; and the trend of the proportion of ADR per inhabitants was corrected. RESULTS The proportion of ADR reporting was 15.3 per 100 000 inhabitants (95% CI: 15.2, 15.8) and 10.0 per 100 000 admissions (95% CI: 9.8, 10.2) in 2017, and its trend was increasing with 16.3% average change per annum during 19 years. The median of estimated percentages of underreporting was 76.0% (IQR: 64.32-81.35). After the correction, the mean proportion of ADR reporting for 19 years reached from 5.87 to 10.33 per 100 000 inhabitants. CONCLUSIONS The trend of ADRs reporting has been increasing over the 19 years but is still low. This study showed a considerable underreporting of ADR, and about one of four detected ADRs were reported to the pharmacovigilance center from 1999 to 2017.
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Affiliation(s)
- Malahat Khalili
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Bita Mesgarpour
- Department of Public and International Affairs, National Institute for Medical Research Development, Tehran, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Asieh Golozar
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ali Akbar Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Teramoto K, Takeda T, Mihara N, Shimai Y, Manabe S, Kuwata S, Kondoh H, Matsumura Y. A Method for Detecting Adverse Drug Events through the Chronological Relationship Between the Medication Period and the Presence of Adverse Reactions from Electronic Medical Record Systems: Observational Study. JMIR Med Inform 2021; 9:e28763. [PMID: 33993103 PMCID: PMC8593795 DOI: 10.2196/28763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/16/2021] [Accepted: 04/17/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Medicines may cause various adverse reactions. An enormous amount of money and effort are spent investigating adverse drug events (ADEs) in clinical trials and post-marketing surveillance. Real-world data from multiple electronic medical records (EMRs) can make it easy to understand the ADEs that occur in actual patients. OBJECTIVE In this study, we generated a patient medication history database from physician orders recorded in EMRs, which allowed the period of medication to be clearly identified. METHODS We developed a method for detecting ADEs based on the chronological relationship between the presence of an adverse event and the medication period. To verify our method, we detected ADEs with alanine aminotransferase (ALT) elevation in patients receiving aspirin, clopidogrel and ticlopidine. The accuracy of the detection was evaluated with a chart review and by comparison with the Roussel Uclaf Causality Assessment Method (RUCAM), which is a standard method for detecting drug induced liver injury. RESULTS The calculated rates of ADE with ALT elevation in patients receiving aspirin, clopidogrel and ticlopidine were 3.33% (868 of 26,059 patients), 3.70% (188 of 5,076 patients) and 5.69% (226 of 3,974 patients), respectively, which were in line with the rates of previous reports. We reviewed the medical records of the patients in whom ADEs were detected. Our method accurately predicted ADEs in 90% (27 of 30patients) treated with aspirin, 100% (9 of 9 patients) treated with clopidogrel and 100% (4 of 4 patients) treated with ticlopidine. Only 3 ADEs that were detected by the RUCAM were not detected by our method. CONCLUSIONS These findings demonstrate that the present method is effective for detecting ADEs based on EMR data. CLINICALTRIAL
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Affiliation(s)
- Kei Teramoto
- Department of Medical Informatics, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, JP.,Division of Medical Informatics, Tottori University Hospital, Yonago, JP
| | - Toshihiro Takeda
- Department of Medical Informatics, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, JP
| | - Naoki Mihara
- Department of Medical Informatics, National Cancer Center Hospital, 5-1-1 Tsukizi Chuoku Tokyo, JP
| | - Yoshie Shimai
- Department of Medical Informatics, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, JP
| | - Shirou Manabe
- Department of Medical Informatics, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, JP
| | - Shigeki Kuwata
- Department of Clinical Information Management, Nara City Hospital, Nara, JP
| | - Hiroshi Kondoh
- Division of Medical Informatics, Tottori University Hospital, Yonago, JP
| | - Yasushi Matsumura
- Department of Medical Informatics, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, JP
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13
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Araujo AGS, Lucchetta RC, Tonin FS, Pontarolo R, Borba HHL, Wiens A. Analysis of completeness for spontaneous reporting of disease-modifying therapies in multiple sclerosis. Expert Opin Drug Saf 2021; 20:735-740. [PMID: 33641547 DOI: 10.1080/14740338.2021.1897566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Introduction: Considering the need for effective postmarketing surveillance of disease-modifying therapies (DMTs) in multiple sclerosis (MS), we analyzed the potential of the spontaneous reports for safety signal detection, verifying the completeness of the reports in the FDA Adverse Event Reporting System (FAERS).Methods: All reports with DMTs for MS considered the primary suspect cause of ADRs and registered between January 2004 and June 2019 were selected. The vigiGrade completeness score was applied and reports with a score greater than 0.80 were considered well documented. Descriptive statistical analysis and comparisons of well-documented reports by DMTs were performed.Results: A total of 297,926 reports were analyzed. The lowest completeness rates were observed for type of report (13.5%), dose (62.7%), and time from treatment start to the ADR (79.0%). Overall, 80.8% of reports were classified as well documented and those related to natalizumab had the highest proportion (92.4%, p < 0.001), while the lowest was observed for reports sent in 2017 (53.1%, p < 0.001) and for teriflunomide (48.5%, p < 0.001).Conclusions: The high proportion of well-documented reports for DMTs indicates that they can be a valuable source for safety signal detection. A more careful analysis should be performed for data from the groups identified with low completeness to avoid the disclosure of spurious results.
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Affiliation(s)
- Ariane G S Araujo
- Pharmaceutical Sciences Postgraduate Research Program, Health Sciences Sector, Federal University of Paraná, Curitiba, Brazil
| | - Rosa C Lucchetta
- Department of Drugs and Medicines, Faculty of Pharmaceutical Sciences, São Paulo State University (UNESP), São Paulo, Brazil
| | - Fernanda S Tonin
- Pharmaceutical Sciences Postgraduate Research Program, Health Sciences Sector, Federal University of Paraná, Curitiba, Brazil
| | - Roberto Pontarolo
- Department of Pharmacy, Federal University of Paraná, Curitiba, Brazil
| | - Helena H L Borba
- Department of Pharmacy, Federal University of Paraná, Curitiba, Brazil
| | - Astrid Wiens
- Department of Pharmacy, Federal University of Paraná, Curitiba, Brazil
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14
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Muñoz MA, Dal Pan GJ, Wei YJJ, Delcher C, Xiao H, Kortepeter CM, Winterstein AG. Towards Automating Adverse Event Review: A Prediction Model for Case Report Utility. Drug Saf 2021; 43:329-338. [PMID: 31912439 DOI: 10.1007/s40264-019-00897-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The rapidly expanding size of the Food and Drug Administration's (FDA) Adverse Event Reporting System database requires modernized pharmacovigilance practices. Techniques to systematically identify high utility individual case safety reports (ICSRs) will support safety signal management. OBJECTIVES The aim of this study was to develop and validate a model predictive of an ICSR's pharmacovigilance utility (PVU). METHODS PVU was operationalized as an ICSR's inclusion in an FDA-authored pharmacovigilance review's case series supporting a recommendation to modify product labeling. Multivariable logistic regression models were used to examine the association between PVU and ICSR features. The best performing model was selected for bootstrapping validation. As a sensitivity analysis, we evaluated the model's performance across subgroups of safety issues. RESULTS We identified 10,381 ICSRs evaluated in 69 pharmacovigilance reviews, of which 2115 ICSRs were included in a case series. The strongest predictors of ICSR inclusion were reporting of a designated medical event (odds ratio (OR) 1.93, 95% CI 1.54-2.43) and positive dechallenge (OR 1.67, 95% CI 1.50-1.87). The strongest predictors of ICSR exclusion were death reported as the only outcome (OR 2.72, 95% CI 1.76-4.35), more than three suspect products (OR 2.69, 95% CI 2.23-3.24), and > 15 preferred terms reported (OR 2.69, 95% CI 1.90-3.82). The validated model showed modest discriminative ability (C-statistic of 0.71). Our sensitivity analysis demonstrated heterogeneity in model performance by safety issue (C-statistic range 0.58-0.74). CONCLUSIONS Our model demonstrated the feasibility of developing a tool predictive of ICSR utility. The model's modest discriminative ability highlights opportunities for further enhancement and suggests algorithms tailored to safety issues may be beneficial.
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Affiliation(s)
- Monica A Muñoz
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA.
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA.
| | - Gerald J Dal Pan
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Yu-Jung Jenny Wei
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA
- Center for Drug Evaluation and Safety (CoDES), University of Florida, Gainesville, FL, USA
| | - Chris Delcher
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, KY, USA
| | - Hong Xiao
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Cindy M Kortepeter
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Almut G Winterstein
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA
- Center for Drug Evaluation and Safety (CoDES), University of Florida, Gainesville, FL, USA
- Department of Epidemiology, College of Medicine and College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
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15
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Toki T, Ono S. Assessment of factors associated with completeness of spontaneous adverse event reporting in the United States: A comparison between consumer reports and healthcare professional reports. J Clin Pharm Ther 2019; 45:462-469. [PMID: 31765498 PMCID: PMC7317542 DOI: 10.1111/jcpt.13086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 11/05/2019] [Accepted: 11/07/2019] [Indexed: 12/03/2022]
Abstract
What is known and objective The objectives of this study were to explore completeness of direct adverse event (AE) reports from consumers and healthcare professionals (HCPs), and to discuss the reasons completeness varied among reporters with different occupations. Methods We used a total of 5475 direct AE reports to the United States (US) Food and Drug Administration (FDA) from the first and second quarters of 2016 and assessed completeness of basic information (eg, patient sex, age, weight) and information relevant to AEs (eg, suspect and concomitant drugs). Logistic regression analysis was conducted to evaluate the associations between report completeness and reporting backgrounds. Results and discussion The completeness of AE reports from consumers was generally greater than that of reports from HCPs. Completeness of specific items varied among different occupations, which may reflect accessibility to, and/or availability of, relevant information for each type of reporter. There was a clear association between the proportion of ‘known’ ADRs in a report and completeness, suggesting that consumers and HCPs are likely to consult labelling information when reporting AEs. What is new and conclusion The quality of AE reports seemed to depend on information costs accrued to potential reporters. Researchers should consider the impact of database heterogeneity and possible sample selection bias when using spontaneous AE reports as a sample of events in the United States.
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Affiliation(s)
- Tadashi Toki
- Laboratory of Pharmaceutical Regulation and Sciences, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
| | - Shunsuke Ono
- Laboratory of Pharmaceutical Regulation and Sciences, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
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16
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Bradley R, Harnett J, Cooley K, McIntyre E, Goldenberg J, Adams J. Naturopathy as a Model of Prevention-Oriented, Patient-Centered Primary Care: A Disruptive Innovation in Health Care. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E603. [PMID: 31540415 PMCID: PMC6780388 DOI: 10.3390/medicina55090603] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 08/23/2019] [Accepted: 09/10/2019] [Indexed: 01/01/2023]
Abstract
Background and Objective: The concept of a "disruptive innovation," recently extended to health care, refers to an emerging technology that represents a new market force combined with a new value system, that eventually displaces some, or all, of the current leading "stakeholders, products and strategic alliances." Naturopathy is a distinct system of traditional and complementary medicine recognized by the World Health Organization (WHO), emerging as a model of primary care. The objective here is to describe Naturopathy in the context of the criteria for a disruptive innovation. Methods: An evidence synthesis was conducted to evaluate Naturopathy as a potentially disruptive technology according to the defining criteria established by leading economists and health technology experts: (1) The innovation must cure disease; (2) must transform the way medicine is practiced; or (3) have an impact that could be disruptive or sustaining, depending on how it is integrated into the current healthcare marketplace. Results: The fact that Naturopathy de-emphasizes prescription drug and surgical interventions in favor of nonpharmacological health promotion and self-care could disrupt the present economic model that fuels health care costs. The patient-centered orientation of Naturopathy, combined with an emphasis on preventive behaviors and popular complementary and integrative health services like natural products, mind and body therapies, and other therapies not widely represented in current primary care models increase the likelihood for disruption. Conclusions: Because of its patient-centered approach and emphasis on prevention, naturopathy may disrupt or remain a durable presence in healthcare delivery depending on policymaker decisions.
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Affiliation(s)
- Ryan Bradley
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA.
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA 92093, USA.
- University of Technology Sydney, Australian Research Center in Complementary and Integrative Medicine (ARCCIM), Ultimo NSW 2007, Australia.
| | - Joanna Harnett
- University of Technology Sydney, Australian Research Center in Complementary and Integrative Medicine (ARCCIM), Ultimo NSW 2007, Australia.
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney NSW 2006, Australia.
| | - Kieran Cooley
- University of Technology Sydney, Australian Research Center in Complementary and Integrative Medicine (ARCCIM), Ultimo NSW 2007, Australia.
- Department of Research and Clinical Epidemiology, The Canadian College of Naturopathic Medicine, Toronto, ON M2K1E2, Canada.
- Transitional Doctorate Department, Pacific College of Oriental Medicine, San Diego, CA 92108, USA.
| | - Erica McIntyre
- University of Technology Sydney, Australian Research Center in Complementary and Integrative Medicine (ARCCIM), Ultimo NSW 2007, Australia.
| | - Joshua Goldenberg
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA.
- University of Technology Sydney, Australian Research Center in Complementary and Integrative Medicine (ARCCIM), Ultimo NSW 2007, Australia.
| | - Jon Adams
- University of Technology Sydney, Australian Research Center in Complementary and Integrative Medicine (ARCCIM), Ultimo NSW 2007, Australia.
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17
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Oh IS, Baek YH, Kim HJ, Lee M, Shin JY. Differential completeness of spontaneous adverse event reports among hospitals/clinics, pharmacies, consumers, and pharmaceutical companies in South Korea. PLoS One 2019; 14:e0212336. [PMID: 30763386 PMCID: PMC6375612 DOI: 10.1371/journal.pone.0212336] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 01/31/2019] [Indexed: 12/04/2022] Open
Abstract
The differential pattern and characteristics of completeness in adverse event (AE) reports generated by hospitals/clinics, pharmacies, consumer and pharmaceutical companies remain unknown. Thus, we identified the characteristics of complete AE reports, compared with those of incomplete AE reports, using a completeness score. We used Korea Institute of Drug Safety and Risk Management-Korea Adverse Event Reporting System Database (KIDS-KD) between January 1, 2016 and December 31, 2016. The completeness score was determined out of a total of 100 points, based on the presence of information on temporal relationships, age and sex of patients, AE progress, name of reported medication, reporting group by profession, causality assessment, and informational text. AE reports were organized into four groups based on affiliation: hospitals/clinics, pharmacies, consumers, and pharmaceutical companies. Affiliations that had median completeness scores greater than 80 points were classified as ‘well-documented’ and these reports were further analyzed by logistic regression to estimate the adjusted odds ratios and 95% confidence intervals. We examined 228,848 individual reports and 735,745 drug-AE combinations. The median values of the completeness scores were the highest for hospitals/clinics (95 points), followed by those for consumers (85), pharmacies (75), and manufacturers (72). Reports with causality assessment of ‘certain’, ‘probable’, or ‘possible’ were more likely to be ‘well-documented’ than reports that had causality assessments of ‘unlikely’. Serious reports of AEs were positively associated with ‘well-documented’ reports and negatively associated with hospitals/clinics.
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Affiliation(s)
- In-Sun Oh
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea
| | - Yeon-Hee Baek
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea
| | - Hye-Jun Kim
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea
| | - Mose Lee
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea
- * E-mail:
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18
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Harinstein L, Kalra D, Kortepeter CM, Muñoz MA, Wu E, Dal Pan GJ. Evaluation of Postmarketing Reports from Industry-Sponsored Programs in Drug Safety Surveillance. Drug Saf 2018; 42:649-655. [PMID: 30569267 DOI: 10.1007/s40264-018-0759-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND OBJECTIVE Adverse event reports from industry-sponsored programs, such as patient support programs, have contributed to a rise in the number of individual case safety reports in the US Food and Drug Administration Adverse Event Reporting System database. This study aimed to characterize individual case safety reports from industry-sponsored program and non-industry-sponsored program sources and compare their usefulness in safety signal detection. METHODS Individual case safety reports of six drug and biological products were identified in the Food and Drug Administration Adverse Event Reporting System database between the date of Food and Drug Administration product approval and the first quarter of 2017. A random subset of industry-sponsored program and non-industry-sponsored program individual case safety reports were then compared to identify differences in reporters, outcomes, data completeness, and usefulness. The 'usefulness' of individual case safety reports was assessed by manually reviewing the availability of key information in the narrative (e.g., temporality, comorbidities). RESULTS Compared with non-industry-sponsored program reports, more industry-sponsored program reports were associated with a serious outcome (51.4% vs. 58.8%, p = 0.02) and were reported by consumers (35.5% vs. 50.4%, p < 0.01). Industry-sponsored program reports tended to contain more data elements than non-industry-sponsored program reports (i.e., age, sex, indication for use), but completeness was variable across products. No significant difference in usefulness was identified between non-industry-sponsored program and industry-sponsored program individual case safety reports (30.6% vs. 28.5%, p = 0.42). Useful reports that contained at least one serious, unlabeled adverse event represented only 4% and 6.2% of the non-industry-sponsored program and industry-sponsored program report cohorts, respectively. CONCLUSIONS Our study suggests that reports obtained from industry-sponsored programs in the Food and Drug Administration Adverse Event Reporting System database contain more data elements but are similar to non-industry-sponsored program reports with regard to 'usefulness' in signal detection.
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Affiliation(s)
- Lisa Harinstein
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA.
| | - Dipti Kalra
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Cindy M Kortepeter
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Monica A Muñoz
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Eileen Wu
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Gerald J Dal Pan
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
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19
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Niu R, Xiang Y, Wu T, Zhang Z, Chen Y, Feng B. The quality of spontaneous adverse drug reaction reports from the pharmacovigilance centre in western China. Expert Opin Drug Saf 2018; 18:51-58. [DOI: 10.1080/14740338.2019.1559812] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Rui Niu
- The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, Shannxi, China
- The Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, Shannxi, China
| | - Yufang Xiang
- The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, Shannxi, China
- The Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, Shannxi, China
| | - Tingting Wu
- Xi’an Office for Food and Drug Control, Xi’an, Shannxi, China
| | - Zhi Zhang
- Shannxi Institute for Food and Drug Control, Xi’an, Shannxi, China
| | - Yue Chen
- The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, Shannxi, China
- The Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, Shannxi, China
| | - Bianling Feng
- The Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, Shannxi, China
- The Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, Shannxi, China
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20
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Shimai Y, Takeda T, Okada K, Manabe S, Teramoto K, Mihara N, Matsumura Y. Screening of anticancer drugs to detect drug-induced interstitial pneumonia using the accumulated data in the electronic medical record. Pharmacol Res Perspect 2018; 6:e00421. [PMID: 30009034 PMCID: PMC6043691 DOI: 10.1002/prp2.421] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 06/26/2018] [Indexed: 11/11/2022] Open
Abstract
Because drug-induced interstitial pneumonia (DIP) is a serious adverse drug reaction, its quantitative risk with individual medications should be taken into due consideration when selecting a medicine. We developed an algorithm to detect DIP using medical record data accumulated in a hospital. Chest computed tomography (CT) is mainly used for the diagnosis of IP, and chest X-ray reports, KL-6, and SP-D values are used to support the diagnosis. The presence of IP in the reports was assessed by a method using natural language-processing, in which IP was estimated according to the product of the likelihood ratio of characteristic keywords in each report. The sensitivity and the specificity of the method for chest CT reports were 0.92 and 0.97, while those for chest X-ray reports were 0.83 and 1, respectively. The occurrence of DIP was estimated by the patterns of presence of IP before, during, and after the administration of the target medicine. The occurrence rate of DIP in cases administered Gefitinib; Methotrexate (MTX); Tegafur, Gimeracil, and Oteracil potassium (TS-1); and Tegafur and Uracil (UTF) was 6.0%, 2.3%, 1.4%, and 0.7%, respectively. The estimated DIP cases were checked by having the medical records independently reviewed by medical doctors. By chart review, the positive predictive values of DIP against Gefitinib, MTX, TS-1, and UFT were 69.2%, 44.4%, 58.6%, and 77.8%, respectively. Although the cases extracted by this method included some that did not have DIP, this method can estimate the relative risk of DIP between medicines.
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Affiliation(s)
- Yoshie Shimai
- Department of Medical InformaticsOsaka University Graduate School of MedicineSuitaJapan
| | - Toshihiro Takeda
- Department of Medical InformaticsOsaka University Graduate School of MedicineSuitaJapan
| | - Katsuki Okada
- Department of Medical InformaticsOsaka University Graduate School of MedicineSuitaJapan
| | - Shirou Manabe
- Department of Medical InformaticsOsaka University Graduate School of MedicineSuitaJapan
| | - Kei Teramoto
- Department of Medical InformaticsOsaka University Graduate School of MedicineSuitaJapan
- Division of Medical InformaticsTottori University HospitalSuitaJapan
| | - Naoki Mihara
- Department of Medical InformaticsNational Cancer Center HospitalSuitaJapan
| | - Yasushi Matsumura
- Department of Medical InformaticsOsaka University Graduate School of MedicineSuitaJapan
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Toki T, Ono S. Spontaneous Reporting on Adverse Events by Consumers in the United States: An Analysis of the Food and Drug Administration Adverse Event Reporting System Database. Drugs Real World Outcomes 2018; 5:117-128. [PMID: 29725886 PMCID: PMC5984610 DOI: 10.1007/s40801-018-0134-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Voluntary reports on adverse events (AEs) submitted by consumers have been facilitated through the MedWatch program in the United States (US), but few studies have described the characteristics of voluntary reports. OBJECTIVE The aim of this study was to reveal the characteristics of current voluntary reports on AEs reported by consumers and healthcare professionals. METHODS We performed analysis on voluntary reports of AEs in the US Food and Drug Administration AE Reporting System (FAERS) database submitted in 2016. We compared reports by consumers with those by healthcare professionals. RESULTS The number of voluntary reports by consumers has increased since 2013 in the US. Reports by consumers were different from ones by health professionals in several important aspects such as demographics and outcomes of patients, AEs, and suspect drugs. The proportion of reports on female patients and on disability as a patient outcome were higher in reports by consumers than in those by healthcare professionals. Consumers more frequently reported concomitant drugs compared with healthcare professionals. Time to report varied among the occupations and depending on seriousness of outcomes. CONCLUSIONS Our analysis of voluntary AE reports in the US FAERS database has shown that voluntary reports tended to include AEs related to subjective symptoms, as in some previous studies on patient reporting in the EU. Voluntary reports by consumers seemed to be different from ones by healthcare professionals in important aspects including demographics and reporting behaviors. These findings suggest that the heterogeneities should be addressed appropriately in using spontaneous reports.
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Affiliation(s)
- Tadashi Toki
- Laboratory of Pharmaceutical Regulation and Sciences, Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Shunsuke Ono
- Laboratory of Pharmaceutical Regulation and Sciences, Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
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Completeness of Spontaneous Adverse Drug Reaction Reports Sent by General Practitioners to a Regional Pharmacovigilance Centre: A Descriptive Study. Drug Saf 2016; 39:1189-1195. [DOI: 10.1007/s40264-016-0463-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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