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Cervantes-Arellano MJ, Castelán-Martínez OD, Marín-Campos Y, Chávez-Pacheco JL, Morales-Ríos O, Ubaldo-Reyes LM. Educational interventions in pharmacovigilance to improve the knowledge, attitude and the report of adverse drug reactions in healthcare professionals: Systematic Review and Meta-analysis. Daru 2024; 32:421-434. [PMID: 38427161 PMCID: PMC11087385 DOI: 10.1007/s40199-024-00508-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/15/2024] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVES Underreporting of adverse drug reactions (ADRs) limits and delays the detection of signs. The aim of this systematic review with meta-analyses was to synthesize the evidence of educational interventions (EIs) efficacy in health professionals to increase ADR reporting, attitudes, and knowledge of pharmacovigilance. EVIDENCE ACQUISITION A systematic literature review was carried out to identify randomized clinical trials evaluating the efficacy of EI in pharmacovigilance in health professionals to improve ADR reports, knowledge, and attitude toward pharmacovigilance. ADR reports were pooled by calculating Odds Ratio (OR) with a 95% confidence interval (95%CI), while pharmacovigilance knowledge and attitude were pooled by calculating a mean difference (MD) with 95%CI. In addition, the subanalysis was performed by EI type. Meta-analysis was performed with RevMan 5.4 software. PROSPERO registry CRD42021254270. RESULTS Eight hundred seventy-five articles were identified as potentially relevant, and 11 were included in the systematic review. Metanalysis showed that EI increased ADR reporting in comparison with control group (OR = 4.74, [95%CI, 2.46 to 9.12], I2 = 93%, 5 studies). In subgroup analysis, the workshops (OR = 6.26, [95%CI, 4.03 to 9.73], I2 = 57%, 3 studies) increased ADR reporting more than telephone-based interventions (OR = 2.59, [95%CI, 0.77 to 8.73], I2 = 29%, 2 studies) or combined interventions (OR = 5.14, [95%CI, 0.97 to 27.26], I2 = 93%, 3 studies). No difference was observed in pharmacovigilance knowledge. However, the subanalysis revealed that workshops increase pharmacovigilance knowledge (SMD = 1.85 [95%CI, 1.44 to 2.27], 1 study). Only one study evaluated ADR reporting attitude among participants and showed a positive effect after the intervention. CONCLUSION EI improves ADR reports and increases pharmacovigilance knowledge. Workshops are the most effective EI to increase ADR reporting.
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Affiliation(s)
- Mónica J Cervantes-Arellano
- Anatomy Department, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Osvaldo D Castelán-Martínez
- Clinical Pharmacology Laboratory, UMIEZ, Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México (UNAM), Batalla 5 de Mayo s/n Esquina Fuerte de Loreto, Col. Ejército de Oriente, Iztapalapa, Mexico City, C.P. 09230, Mexico.
| | - Yolanda Marín-Campos
- Pharmacology Department, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Juan L Chávez-Pacheco
- Clinical Pharmacology Laboratory, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - Olga Morales-Ríos
- Unidad Habilitada de Apoyo al Predictamen, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Laura M Ubaldo-Reyes
- Anatomy Department, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
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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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Putri RA, Ikawati Z, Rahmawati F, Yasin NM. An Awareness of Pharmacovigilance Among Healthcare Professionals Due to an Underreporting of Adverse Drug Reactions Issue: A Systematic Review of the Current State, Obstacles, and Strategy. Curr Drug Saf 2024; 19:317-331. [PMID: 38989832 PMCID: PMC11327747 DOI: 10.2174/0115748863276456231016062628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/18/2023] [Accepted: 09/27/2023] [Indexed: 07/12/2024]
Abstract
BACKGROUND Healthcare professionals play an essential role in reporting adverse drug reactions as part of pharmacovigilance activities. However, adverse drug reactions reported by healthcare professionals remain low. OBJECTIVE The aim of this systematic review was to investigate healthcare professionals' knowledge, awareness, attitude, and practice on pharmacovigilance and adverse drug reaction reporting, explore the causes of the underreporting issue, and provide improvement strategies. METHODS This systematic review was conducted using four electronic databases for original papers, including PubMed, Scopus, Google Scholar, and Scholar ID. Recent publications from 1st January 2012 to 31st December 2022 were selected. The following terms were used in the search: "awareness", "knowledge", "adverse drug reaction", "pharmacovigilance", "healthcare professional", and "underreporting factor". Articles were chosen, extracted, and reviewed by the two authors. RESULTS Twenty-five studies were selected for systematic review. This review found that 24.8%-73.33% of healthcare professionals were unaware of the National Pharmacovigilance Center. Around 20%-95.7% of healthcare professionals have a positive attitude toward pharmacovigilance and adverse drug reaction reporting, while 12%-60.8% of healthcare professionals have experience reporting any adverse drug reaction in their practice. The most frequently highlighted barriers to pharmacovigilance were a lack of awareness and knowledge regarding what, when, and to whom to report. CONCLUSION Underreporting issues require immediate attention among healthcare professionals due to a lack of awareness and knowledge of pharmacovigilance and adverse drug reaction reporting. Educational and training program interventions have been suggested by most studies to address these issues.
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Affiliation(s)
- Risani Andalasia Putri
- Department of Pharmacy, Dharmais National Cancer Hospital, RS, Kanker Dharmais, Jl. S. Parman Kav, 84 - 86, West Jakarta, Indonesia
| | - Zullies Ikawati
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Sekip Utara Street, Yogyakarta, Indonesia
| | - Fita Rahmawati
- Department of Pharmacy, Universitas Gadjah Mada, Bulaksumur, Caturtunggal, Kec. Depok, Kabupaten Sleman, Daerah Istimewa Yogyakarta, 55281, Indonesia
| | - Nanang Munif Yasin
- Department of Pharmacy, Universitas Gadjah Mada, Bulaksumur, Caturtunggal, Kec. Depok, Kabupaten Sleman, Daerah Istimewa Yogyakarta, 55281, Indonesia
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Fossouo Tagne J, Yakob RA, Mcdonald R, Wickramasinghe N. A Web-Based Tool to Report Adverse Drug Reactions by Community Pharmacists in Australia: Usability Testing Study. JMIR Form Res 2023; 7:e48976. [PMID: 37773620 PMCID: PMC10576234 DOI: 10.2196/48976] [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: 05/13/2023] [Revised: 08/04/2023] [Accepted: 08/04/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Adverse drug reactions (ADRs) are unintended and harmful events associated with medication use. Despite their significance in postmarketing surveillance, quality improvement, and drug safety research, ADRs are vastly underreported. Enhanced digital-based communication of ADR information to regulators and among care providers could significantly improve patient safety. OBJECTIVE This paper presents a usability evaluation of the commercially available GuildCare Adverse Event Recording system, a web-based ADR reporting system widely used by community pharmacists (CPs) in Australia. METHODS We developed a structured interview protocol encompassing remote observation, think-aloud moderating techniques, and retrospective questioning to gauge the overall user experience, complemented by the System Usability Scale (SUS) assessment. Thematic analysis was used to analyze field notes from the interviews. RESULTS A total of 7 CPs participated in the study, who perceived the system to have above-average usability (SUS score of 68.57). Nonetheless, the structured approach to usability testing unveiled specific functional and user interpretation issues, such as unnecessary information, lack of system clarity, and redundant data fields-critical insights not captured by the SUS results. Design elements like drop-down menus, free-text entry, checkboxes, and prefilled or auto-populated data fields were perceived as useful for enhancing system navigation and facilitating ADR reporting. CONCLUSIONS The user-centric design of technology solutions, like the one discussed herein, is crucial to meeting CPs' information needs and ensuring effective ADR reporting. Developers should adopt a structured approach to usability testing during the developmental phase to address identified issues comprehensively. Such a methodological approach may promote the adoption of ADR reporting systems by CPs and ultimately enhance patient safety.
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Affiliation(s)
- Joel Fossouo Tagne
- School of Health Sciences and Biostatistics, Swinburne University of Technology, Melbourne, Australia
- Centre for Health Analytics, Murdoch Children's Research Institute, Health Informatics, Melbourne, Australia
| | | | - Rachael Mcdonald
- MedTechVic, Swinburne University of Technology, Melbourne, Australia
- Department of Nursing and Allied Health, Occupational Therapy, Swinburne University of Technology, Melbourne, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
| | - Nilmini Wickramasinghe
- School of Health Sciences and Biostatistics, Swinburne University of Technology, Melbourne, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
- Epworth Healthcare, Melbourne, Australia
- School of Computing, Engineering & Mathematical Sciences, La Trobe University, Melbourne, Australia
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Shafei L, Mekki L, Maklad E, Alhathal T, Ghanem R, Almalouf R, Stewart D, Nazar Z. Factors that influence patient and public adverse drug reaction reporting: a systematic review using the theoretical domains framework. Int J Clin Pharm 2023; 45:801-813. [PMID: 37247158 PMCID: PMC10366238 DOI: 10.1007/s11096-023-01591-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 04/01/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Only 5-10% of all adverse drug reactions (ADRs) are reported. Mechanisms to support patient and public reporting offer numerous advantages to health care systems including increasing reporting rate. Theory-informed insights into the factors implicated in patient and public underreporting are likely to offer valuable opportunity for the development of effective reporting-interventions and optimization of existing systems. AIM To collate, summarize and synthesize the reported behavioral determinants using the theoretical domains framework (TDF), that influence patient and public reporting of ADRs. METHOD Cochrane, CINAHL, Web of science, EMBASE and PubMed were systematically searched on October 25th, 2021. Studies assessing the factors influencing public or patients reporting of ADRs were included. Full-text screening, data extraction and quality appraisal were performed independently by two authors. Extracted factors were mapped to TDF. RESULTS 26 studies were included conducted in 14 countries across five continents. Knowledge, social/professional role and identity, beliefs about consequences, and environmental context and resources, appeared to be the most significant TDF domains that influenced patient and public behaviors regarding ADR reporting. CONCLUSION Studies included in this review were deemed of low risk of bias and allowed for identification of key behavioural determinants, which may be mapped to evidence-based behavioral change strategies that facilitate intervention development to enhance rates of ADR reporting. Aligning strategies should focus on education, training and further involvement from regulatory bodies and government support to establish mechanisms, which facilitate feedback and follow-ups on submitted reports.
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Affiliation(s)
- Laila Shafei
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Lina Mekki
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Esraa Maklad
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Turfa Alhathal
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Rawan Ghanem
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Rama Almalouf
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Derek Stewart
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Zachariah Nazar
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar.
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García-Abeijon P, Costa C, Taracido M, Herdeiro MT, Torre C, Figueiras A. Factors Associated with Underreporting of Adverse Drug Reactions by Health Care Professionals: A Systematic Review Update. Drug Saf 2023:10.1007/s40264-023-01302-7. [PMID: 37277678 DOI: 10.1007/s40264-023-01302-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2023] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Underreporting is a major limitation of the voluntary reporting system of adverse drug reactions (ADRs). A 2009 systematic review showed the knowledge and attitudes of health professionals were strongly related with underreporting of ADRs. OBJECTIVE Our aim was to update our previous systematic review to determine factors (sociodemographic, knowledge and attitudes) associated with the underreporting of ADRs by healthcare professionals. METHODS We searched the MEDLINE and EMBASE databases for studies published between 2007 and 2021 that met the following inclusion criteria: (1) published in English, French, Portuguese or Spanish; (2) involving health professionals; and (3) the goal was to evaluate factors associated with underreporting of ADRs through spontaneous reporting. RESULTS Overall, 65 papers were included. While health professional sociodemographic characteristics did not influence underreporting, knowledge and attitudes continue to show a significant effect: (1) ignorance (only serious ADRs need to be reported) in 86.2%; (2) lethargy (procrastination, lack of interest, and other excuses) in 84.6%; (3) complacency (the belief that only well tolerated drugs are allowed on the market) in 46.2%; (4) diffidence (fear of appearing ridiculous for reporting merely suspected ADRs) in 44.6%; and (5) insecurity (it is nearly impossible to determine whether or not a drug is responsible for a specific adverse reaction) in 33.8%, and the absence of feedback in 9.2%. In this review, the non-obligation to reporting and confidentiality emerge as new reasons for underreporting. CONCLUSIONS Attitudes regarding the reporting of adverse reactions continue to be the main determinants of underreporting. Even though these are potentially modifiable factors through educational interventions, minimal changes have been observed since 2009. CLINICAL TRIALS REGISTRATION PROSPERO registration number CRD42021227944.
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Affiliation(s)
- Patricia García-Abeijon
- Department of Public Health, Faculty of Farmacy, University of Santiago de Compostela, Praza do Seminario de Estudos Galegos, s/n, 15705, Santiago de Compostela, Spain
| | - Catarina Costa
- Faculdade de Farmácia da, Universidade de Lisboa, Lisbon, Portugal
| | - Margarita Taracido
- Department of Public Health, Faculty of Farmacy, University of Santiago de Compostela, Praza do Seminario de Estudos Galegos, s/n, 15705, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), Madrid, Spain
| | - Maria Teresa Herdeiro
- Department of Medical Sciences, Institute of Biomedicine-iBiMED, University of Aveiro, Aveiro, Portugal
| | - Carla Torre
- Faculdade de Farmácia da, Universidade de Lisboa, Lisbon, Portugal
- Laboratory of Systems Integration Pharmacology, Clinical and Regulatory Science, Research Institute for Medicines (iMED.ULisboa), Lisbon, Portugal
| | - Adolfo Figueiras
- Department of Public Health, Faculty of Farmacy, University of Santiago de Compostela, Praza do Seminario de Estudos Galegos, s/n, 15705, Santiago de Compostela, Spain.
- Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), Madrid, Spain.
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Fossouo Tagne J, Yakob RA, Mcdonald R, Wickramasinghe N. Linking Activity Theory Within User-Centered Design: Novel Framework to Inform Design and Evaluation of Adverse Drug Reaction Reporting Systems in Pharmacy. JMIR Hum Factors 2023; 10:e43529. [PMID: 36826985 PMCID: PMC10007010 DOI: 10.2196/43529] [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: 10/14/2022] [Revised: 01/02/2023] [Accepted: 01/24/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Adverse drug reactions (ADRs) may cause serious injuries including death. Timely reporting of ADRs may play a significant role in patient safety; however, underreporting exists. Enhancing the electronic communication of ADR information to regulators and between health care providers has the potential to reduce recurrent ADRs and improve patient safety. OBJECTIVE The main objectives were to explore the low rate of ADR reporting by community pharmacists (CPs) in Australia, evaluate the usability of an existing reporting system, and how this knowledge may influence the design of subsequent electronic ADR reporting systems. METHODS The study was carried out in 2 stages. Stage 1 involved qualitative semistructured interviews to identify CPs' perceived barriers and facilitators to ADR reporting. Data were analyzed by thematic analysis, and identified themes were subsequently aligned to the task-technology fit (TTF) framework. The second stage involved a usability evaluation of a commercial web-based ADR reporting system. A structured interview protocol that combined virtual observation, think-aloud moderating techniques, retrospective questioning of the overall user experience, and a System Usability Scale (SUS). The field notes from the interviews were subjected to thematic analysis. RESULTS In total, 12 CPs were interviewed in stage 1, and 7 CPs participated in stage 2. The interview findings show that CPs are willing to report ADRs but face barriers from environmental, organizational, and IT infrastructures. Increasing ADR awareness, improving workplace practices, and implementing user-focused electronic reporting systems were seen as facilitators of ADR reporting. User testing of an existing system resulted in above average usability (SUS 68.57); however, functional and user interpretation issues were identified. Design elements such as a drop-down menu, free-text entry, checkbox, and prefilled data fields were perceived to be extremely useful for navigating the system and facilitating ADR reporting. CONCLUSIONS Existing reporting systems are not suited to report ADRs, or adapted to workflow, and are rarely used by CPs. Our study uncovered important contextual information for the design of future ADR reporting interventions. Based on our study, a multifaceted, theory-guided, user-centered, and best practice approach to design, implementation, and evaluation may be critical for the successful adoption of ADR reporting electronic interventions and patient safety. Future studies are needed to evaluate the effectiveness of theory-driven frameworks used in the design and implementation of ADR reporting systems.
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Affiliation(s)
- Joel Fossouo Tagne
- School of Health Sciences and Biostatistics, Swinburne University of Technology, Melbourne, Australia.,Centre for Health Analytics, Murdoch Children's Research Institute, Melbourne, Australia.,MedTechVic, Swinburne University of Technology, Melbourne, Australia
| | | | - Rachael Mcdonald
- MedTechVic, Swinburne University of Technology, Melbourne, Australia.,Department of Nursing and Allied Health, Occupational Therapy, Swinburne University of Technology, Melbourne, Australia.,Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
| | - Nilmini Wickramasinghe
- School of Health Sciences and Biostatistics, Swinburne University of Technology, Melbourne, Australia.,Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia.,Epworth Healthcare, Melbourne, Australia
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Leskur D, Bozic J, Rusic D, Seselja Perisin A, Cohadzic T, Pranic S, Modun D, Bukic J. Adverse drug reaction reporting via mobile applications: A narrative review. Int J Med Inform 2022; 168:104895. [DOI: 10.1016/j.ijmedinf.2022.104895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 10/01/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022]
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Mount J, Arthurson V. Encouraging and facilitating adverse event reporting in veterinary practice. Vet Rec 2022; 191:252-254. [PMID: 36149713 DOI: 10.1002/vetr.2255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- James Mount
- Department of Drug Safety, Swedish Medical Products Agency, Uppsala, Sweden
| | - Veronica Arthurson
- Department of Drug Safety, Swedish Medical Products Agency, Uppsala, Sweden
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Li R, Curtis K, Zaidi ST, Van C, Castelino R. A new paradigm in adverse drug reaction reporting: consolidating the evidence for an intervention to improve reporting. Expert Opin Drug Saf 2022; 21:1193-1204. [DOI: 10.1080/14740338.2022.2118712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Raymond Li
- Faculty of Medicine and Health, University of Sydney, Parramatta Road, Camperdown NSW 2006
| | - Kate Curtis
- Faculty of Medicine and Health, University of Sydney, Parramatta Road, Camperdown NSW 2006
| | | | - Connie Van
- Faculty of Medicine and Health, University of Sydney, Parramatta Road, Camperdown NSW 2006
| | - Ronald Castelino
- Faculty of Medicine and Health, University of Sydney, Parramatta Road, Camperdown NSW 2006
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Yan J, Xiong X, Shen J, Huang T. Adverse drug reaction reporting quality among different health professionals and the contribution of clinical pharmacists: A pilot study. J Clin Pharm Ther 2022; 47:1768-1774. [PMID: 35781820 DOI: 10.1111/jcpt.13731] [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: 04/08/2022] [Revised: 05/28/2022] [Accepted: 06/14/2022] [Indexed: 11/27/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Adverse drug reaction (ADR) reporting is generally of poor quality, which may delay post-marketing regulatory actions. Here, we evaluated the quality of ADR reporting at our institution and examined the roles of clinical pharmacists in this process. METHODS We retrospectively reviewed ADR reports at our hospital between 2017 and 2019 to assess the number, source, drugs, and routes of administration. The quality assessment of ADR case reports form issued by the China Adverse Drug Reaction Monitoring Centre was used to assess the quality of ADR reports. Quality scores of ADR reports from pharmacists and nonpharmacists were assessed before and after review by clinical pharmacists. RESULTS AND DISCUSSION Reports of adverse drug reaction reporting by healthcare professionals increased annually, with 59, 77 and 82 reports submitted in 2017, 2018 and 2019, respectively. The numbers of new or serious ADR reports by healthcare professionals in 2017, 2018, and 2019 were 5 (8.47%), 77 (11.69%) and 82 (10.98%), respectively. New or serious ADR reports accounted for approximately 10% (23/218) of all reported cases, and more than 70% (158/218) of the reports were from pharmacists. Systemic administration accounted for more than 80% (233/265) of adverse reactions, whereas ADRs due to topical drug use were rarely reported. The drugs that reportedly triggered ADRs were mainly antibacterial and patented Chinese medicines and accounted for more than half of all reported cases. The scores of ADR reports from pharmacists and nonpharmacists before modification by clinical pharmacists were 86.69 ± 8.12 and 68.36 ± 5.94, respectively, and the scores of ADR reports from pharmacists and nonpharmacists after modification by clinical pharmacists were 91.14 ± 6.64 and 90.02 ± 5.63, respectively. WHAT IS NEW AND CONCLUSION In a real-world setting, pharmacists are commonly responsible for most ADR reports. The quality of ADR reports from pharmacists and nonpharmacists before review did not reach the standard of excellence. An audit of clinical pharmacists may improve the overall quality of ADR reports. However, under-reporting of adverse reactions still occurs.
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Affiliation(s)
- Jingchao Yan
- Department of Pharmacy, Eye Ear Nose Throat Hospital of Fudan University, Shanghai, China
| | - Xiaomei Xiong
- Department of Pharmacy, Eye Ear Nose Throat Hospital of Fudan University, Shanghai, China
| | - Jianwen Shen
- Department of Pharmacy, Eye Ear Nose Throat Hospital of Fudan University, Shanghai, China
| | - Taomin Huang
- Department of Pharmacy, Eye Ear Nose Throat Hospital of Fudan University, Shanghai, China
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Paut Kusturica M, Tomas A, Rašković A, Gigov S, Crnobrnja V, Jevtić M, Stilinović N. Community pharmacists' challenges regarding adverse drug reaction reporting: a cross-sectional study. Curr Med Res Opin 2022; 38:1229-1236. [PMID: 35470747 DOI: 10.1080/03007995.2022.2070380] [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] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The effectiveness of the national drug safety monitoring program directly depends on the active participation of healthcare professionals in reporting suspected adverse drug reactions (ADRs). The aim of the study was to explore community pharmacists' comprehension of pharmacovigilance, their perspectives toward reporting ADRs and investigate the current practice of ADR reporting among pharmacists in Serbia. METHODS This descriptive cross-sectional study was performed on a sample of pharmacists in Serbia between November 2019 and March 2020 using a pre-tested questionnaire distributed online. Eligible participants were community pharmacists in Serbia who were willing to participate in the study during the data collection period. Non-parametric statistical tests were performed in the analysis of knowledge, perspectives and ADR reporting. The validity and reliability of the survey were measured by exploratory factor analysis. RESULTS The median knowledge score was 6 out of 10 (interquartile range 5-7, range 2-10). No significant differences in the knowledge scores of pharmacists were found based on weekly working hours (U = 24,805, p = .374), working experience (χ2 = 4.011, DF = 2, p = .135), being a member of a professional organization (U = 24,312, p = .209), or highest level of pharmacy qualification obtained (χ2 = 3.233, DF = 3, p = .506). Only 28.8% of pharmacists reported ADR at least once a year, while the majority of them have never reported any ADRs. CONCLUSIONS Despite the community pharmacists' positive attitude toward adverse drug reporting and their role in the process, they show limited knowledge regarding the issue and highly prevalent under-reporting of ADRs. Educational programs are necessary to increase ADRs reporting.
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Affiliation(s)
- Milica Paut Kusturica
- Faculty of Medicine Novi Sad, Department of Pharmacology, Toxicology and Clinical Pharmacology, University of Novi Sad, Novi Sad, Serbia
| | - Ana Tomas
- Faculty of Medicine Novi Sad, Department of Pharmacology, Toxicology and Clinical Pharmacology, University of Novi Sad, Novi Sad, Serbia
| | - Aleksandar Rašković
- Faculty of Medicine Novi Sad, Department of Pharmacology, Toxicology and Clinical Pharmacology, University of Novi Sad, Novi Sad, Serbia
| | - Slobodan Gigov
- Faculty of Pharmacy, University Business Academy in Novi Sad, Novi Sad, Serbia
| | - Veljko Crnobrnja
- Faculty of Medicine Novi Sad, Department of Pathophysiology, University of Novi Sad, Novi Sad, Serbia
| | - Marija Jevtić
- Faculty of Medicine Novi Sad, Department of Hygiene, University of Novi Sad, Novi Sad, Serbia
| | - Nebojša Stilinović
- Faculty of Medicine Novi Sad, Department of Pharmacology, Toxicology and Clinical Pharmacology, University of Novi Sad, Novi Sad, Serbia
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Fossouo Tagne J, Yakob RA, Mcdonald R, Wickramasinghe N. Barriers and Facilitators Influencing Real-Time & Digital Based Reporting of Adverse Drug Reactions by Community Pharmacists: a qualitative study using the Task Technology Fit Framework (Preprint). Interact J Med Res 2022; 11:e40597. [DOI: 10.2196/40597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/03/2022] [Accepted: 09/27/2022] [Indexed: 01/29/2023] Open
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Why hospital-based healthcare professionals do not report adverse drug reactions: a mixed methods study using the Theoretical Domains Framework. Eur J Clin Pharmacol 2022; 78:1165-1175. [PMID: 35476123 PMCID: PMC9043508 DOI: 10.1007/s00228-022-03326-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/18/2022] [Indexed: 11/09/2022]
Abstract
Purpose Adverse drug reaction (ADR) underreporting is highly prevalent across the world. This study aimed to identify factors associated with ADR reporting and map these to a behavioural change framework to help inform future interventions designed to improve ADR underreporting. Methods A mixed methods survey was distributed to healthcare professionals at a tertiary hospital in Sydney, Australia. Quantitative data was analysed using logistic regression to identify factors that predict ADR reporting. Qualitative data was evaluated using content analysis. These were then integrated and mapped to the 14 domains within the Theoretical Domains Framework (TDF) to identify target areas relevant for improving ADR reporting. Results One hundred thirty-three healthcare professionals completed the survey. Knowing how to report ADRs (OR 4.56, 95%CI 1.95–10.7), having been trained on ADR reporting (OR 2.72, 95%CI 1.29–5.77), and encountering ADRs as part of clinical practice (OR 10.3, 95%CI 3.59–29.4) were significant predictors of reporting an ADR. Content analysis identified three categories: modifying the ADR reporting process, enabling clinicians to report ADRs, and creating a positive ADR reporting culture. After data integration, the three target TDF domains were knowledge, environmental context/resources, and beliefs about consequences. Conclusion Future interventions designed to improve ADR reporting should address these target domains to instigate behaviour change in healthcare professionals’ reporting of ADRs. Supplementary information The online version contains supplementary material available at 10.1007/s00228-022-03326-x.
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Lim R, Thornton C, Stanek J, Ellett LK, Thiessen M. Development of a web-based system to report medication-related adverse effects: a design and usability study (Preprint). JMIR Form Res 2022; 6:e37605. [PMID: 36206034 PMCID: PMC9587488 DOI: 10.2196/37605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 08/02/2022] [Accepted: 08/17/2022] [Indexed: 11/23/2022] Open
Abstract
Background Medicine use is the most common intervention in health care. The frequency with which medicines are used means medication-related problems are very common. One common type of medication-related problems is adverse drug events, which are unintended and harmful effects associated with use of medicines. Reporting of adverse drug events to regulatory authorities is important for evaluation of safety of medicines; however, these adverse effects are frequently unreported due to various factors, including lack of consumer-friendly reporting tools. Objective The aim of this study was to develop a user-friendly digital tool for consumers to report medication-related adverse effects. Methods The project consisted of 3 parts: (1) content development, including a systematic literature search; (2) iterative system development; and (3) usability testing. The project was guided by participatory design principles, which suggest involving key stakeholders throughout the design process. The first 2 versions were developed as a mobile app and were tested with end users in 2 workshops. The third version was developed as a web application and was tested with consumers who were taking regular medicines. Consumers were asked to complete a modified version of the mHealth app usability questionnaire (MAUQ), an 18-item questionnaire with each item scored using a 7-point Likert scale ranging from 0 (strongly disagree) to 7 (strongly agree). The MAUQ assessed 3 subscales including ease of use (5 items), interface and satisfaction (7 items), and usefulness (6 items). Continuous variables were reported as mean (SD) values, whereas categorical variables were presented as frequencies (percentages). Data analysis was conducted in Microsoft Excel. Results The content for the system was based on a systematic literature search and short-listing of questions, followed by feedback from project team members and consumers. Feedback from consumers in the 2 workshops were incorporated to improve the functionality, visual design, and stability of the third (current) version. The third version of the system was tested with 26 consumers. A total of 79% (N=307/390) of all responses on the MAUQ were scored 6 or 7, indicating that users generally strongly agree with the usability of the system. When looking at the individual domains, the system had an average score of 6.3 (SD 0.9) for “ease of use,” 6.3 (SD 0.8) for “interface and satisfaction,” and 5.2 (SD 1.4) for “usefulness.” Conclusions The web-based system for medicine adverse effects reporting is a user-friendly tool developed using an iterative participatory design approach. Future research includes further improving the system, particularly the usefulness of the system, as well as testing the scalability and performance of the system in practice.
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Affiliation(s)
- Renly Lim
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | | | - Jan Stanek
- UniSA STEM, University of South Australia, Adelaide, Australia
| | - Lisa Kalisch Ellett
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Myra Thiessen
- Art, Design and Architecture, Monash University, Melbourne, Australia
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16
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Aung AK, Walker S, Khu YL, Tang MJ, Lee JI, Graudins LV. Adverse drug reaction management in hospital settings: review on practice variations, quality indicators and education focus. Eur J Clin Pharmacol 2022; 78:781-791. [PMID: 35171316 PMCID: PMC9005418 DOI: 10.1007/s00228-022-03287-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 01/31/2022] [Indexed: 11/28/2022]
Abstract
Purpose Adverse drug reactions (ADRs) contribute significantly to healthcare burden. However, they are largely preventable through appropriate management processes. This narrative review aims to identify the quality indicators that should be considered for routine monitoring of processes within hospital ADR management systems. It also examines the potential reasons behind variation in ADR management practices amongst HCPs, and explores possible solutions, focusing on targeted education programmes, to improve both the quality and quantity indicators of ADR management processes. Methods A comprehensive literature review was conducted to explore relevant themes and topics concerning ADR management, quality indicators and educational interventions. Results Substantial variability exists in ADR management amongst healthcare professionals (HCPs) with regard to reporting rates, characteristics of ADRs reported, quality of assessment, completeness of reports and, most importantly, risk communication practices. These variable practices not only threaten patient safety but also undermine pharmacovigilance processes. To date, quality indicators to monitor ADR management practices within hospital settings remain ill-defined. Furthermore, evidence behind effective interventions, especially in the form of targeted education strategies, to improve the quality of ADR management remains limited. Conclusions The focus of ADR management in hospitals should be to promote patient safety through comprehensive assessment, risk communication and safe prescribing. There is a need to develop a system to define, measure and monitor the quality of ADR management. Educational strategies may help improve the quality of ADR management processes.
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Affiliation(s)
- Ar Kar Aung
- Department of General Medicine, Alfred Hospital, Melbourne, Australia. .,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Steven Walker
- Department of Pharmacy, Alfred Hospital, Melbourne, Australia
| | - Yin Li Khu
- Department of General Medicine, Alfred Hospital, Melbourne, Australia
| | - Mei Jie Tang
- Department of General Medicine, Alfred Hospital, Melbourne, Australia
| | - Jennifer I Lee
- Department of Medicine, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York, USA.,Quality Improvement Academy, Weill Cornell Medicine, New York, USA
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17
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Davies H, Pinchbeck G, Noble PM, Diesel G, Pirmohamed M, Anderson N, Killick DR. UK veterinary professionals' perceptions and experiences of adverse drug reaction reporting. Vet Rec 2022; 191:e1796. [PMID: 35665513 PMCID: PMC9795988 DOI: 10.1002/vetr.1796] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/31/2022] [Accepted: 05/11/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Spontaneous reporting of suspected adverse drug reactions (ADRs) is the cornerstone of pharmacovigilance. Despite this, it is believed that there is significant under-reporting in the veterinary setting. Low reporting rates delay marketing authorisation holders (MAHs) and regulators taking mitigating action in the case of safety concerns. METHOD We designed a survey to explore the perceptions, attitudes and experiences of UK veterinary professionals towards ADR reporting. The survey was advertised widely through conventional and social media and at several conferences. RESULTS In total, 260 respondents completed the survey, including 210 veterinary surgeons, 49 veterinary nurses and one suitably qualified person. Respondents generally understood the need to report ADRs. The main barrier to reporting was the suspected ADR being well known, and the most popular potential facilitator identified was the ability to report via the practice management system. Facilitation via education in the form of a pharmacovigilance themed continuing professional development event was particularly popular among veterinary nurses, who reported time as being less of a barrier to reporting than their veterinary surgeon counterparts. CONCLUSIONS Our findings suggest that technological interventions to facilitate reporting and empowerment of veterinary nurses to report through a tailored training event should be explored further.
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Affiliation(s)
- Heather Davies
- Institute of Infection, Veterinary and Ecological SciencesUniversity of LiverpoolNestonUK
| | - Gina Pinchbeck
- Institute of Infection, Veterinary and Ecological SciencesUniversity of LiverpoolNestonUK
| | - Peter‐John M. Noble
- Institute of Infection, Veterinary and Ecological SciencesUniversity of LiverpoolNestonUK
| | - Gillian Diesel
- Pharmacovigilance UnitVeterinary Medicines DirectorateAddlestoneUK
| | - Munir Pirmohamed
- Wolfson Centre for Personalised Medicine, Institute of Systems, Molecular and Integrative BiologyUniversity of LiverpoolLiverpoolUK
| | - Nadine Anderson
- Pharmacovigilance UnitVeterinary Medicines DirectorateAddlestoneUK
| | - David R. Killick
- Institute of Infection, Veterinary and Ecological SciencesUniversity of LiverpoolNestonUK
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18
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Ibrahim MS, Mohamed Yusoff H, Abu Bakar YI, Thwe Aung MM, Abas MI, Ramli RA. Digital health for quality healthcare: A systematic mapping of review studies. Digit Health 2022; 8:20552076221085810. [PMID: 35340904 PMCID: PMC8943311 DOI: 10.1177/20552076221085810] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/20/2021] [Indexed: 01/05/2023] Open
Abstract
Objective To systematically catalogue review studies on digital health to establish extent of evidence on quality healthcare and illuminate gaps for new understanding, perspectives and insights for evidence-informed policies and practices. Methods We systematically searched PubMed database using sensitive search strings. Two reviewers independently conducted two-phase selection via title and abstract, followed by full-text appraisal. Consensuses were derived for any discrepancies. A standardized data extraction tool was used for reliable data mining. Results A total of 54 reviews from year 2014 to 2021 were included with notable increase in trend of publications. Systematic reviews constituted the majority (61.1%, (37.0% with meta-analyses)) followed by scoping reviews (38.9%). Domains of quality being reviewed include effectiveness (75.9%), accessibility (33.3%), patient safety (31.5%), efficiency (25.9%), patient-centred care (20.4%) and equity (16.7%). Mobile apps and computer-based were the commonest (79.6%) modalities. Strategies for effective intervention via digital health included engineering improved health behaviour (50.0%), better clinical assessment (35.1%), treatment compliance (33.3%) and enhanced coordination of care (24.1%). Psychiatry was the discipline with the most topics being reviewed for digital health (20.3%). Conclusion Digital health reviews reported findings that were skewed towards improving the effectiveness of intervention via mHealth applications, and predominantly related to mental health and behavioural therapies. There were considerable gaps on review of evidence on digital health for cost efficiency, equitable healthcare and patient-centred care. Future empirical and review studies may investigate the association between fields of practice and tendency to adopt and research the use of digital health to improve care.
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Affiliation(s)
| | | | | | - Myat Moe Thwe Aung
- Faculty of Medicine, Universiti Sultan Zainal Abidin, Terengganu, Malaysia
| | | | - Ras Azira Ramli
- Faculty of Medicine, Universiti Sultan Zainal Abidin, Terengganu, Malaysia
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19
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Adegbuyi TA, Fadare JO, Araromi EJ, Sijuade AO, Bankole I, Fasuba IK, Alabi RA. Assessment of Knowledge, Attitude and Practice of Adverse Drug Reaction Reporting Among Healthcare Professionals working in Primary, Secondary and Tertiary Healthcare Facilities in Ekiti State, South-West Nigeria. Hosp Pharm 2021; 56:751-759. [PMID: 34732934 DOI: 10.1177/0018578720957968] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Adverse drug reactions (ADRs) constitute a significant global healthcare challenge associated with increased morbidity, mortality and healthcare costs; however, there are concerns that ADRs are grossly under-reported by different categories of healthcare professionals (HCPs) in many countries. The main objective of this study was to assess the knowledge, attitude and practice of ADR reporting of HCPs working at the primary, secondary and tertiary levels of care in Ekiti State, Nigeria. Methodology This was a self-administered questionnaire-based study conducted among HCPs working in Ekiti State, South-west Nigeria. The questionnaire which was adapted from ones used in similar studies was reviewed for content validity by experts in the field. Healthcare professionals (medical doctors, pharmacists, nurses, community health extension workers, and other allied HCPs) working in the 3 tiers of healthcare participated in the study. The questionnaire consisted of sections on the demographics of respondents, their knowledge, attitude and practice of ADR reporting. Data analysis was done using SPSS (version 25) employing t test, ANOVA and chi-square as appropriate with P-value < .05 accepted as being statistically significant. Results Three hundred HCPs comprising of nurses (112; 37.3%), physicians (75; 25.0%), pharmacists (53; 17.7%), community health extension workers (40; 13.3%) and others (20; 6.7%) completed the questionnaire with 166 (55.3%) of them working in tertiary healthcare facilities. Male respondents (6.3 ± 1.7; P = .003), pharmacists (7.0 ± 1.6; P < .0001), HCPs and those from tertiary centers (6.2 ± 1.7; P = .028) had higher knowledge scores. While 228 (76%) respondents had observed incidents of ADR during their professional practice, only 75 (25%) have ever reported it. Only 113 (37.7%) of respondents had seen the adverse drug reaction reporting form with only 53 (17.7%) ever using it. The reporting methods preferred by respondents were through email/internet (102; 34.0%), phone/SMS (78; 26.0%) and using the hard copy of the forms (95; 31.7%). The attitude of respondents towards ADR reporting was mainly positive. Conclusion There was significant variation in the knowledge of different categories of HCPs and facility levels about ADR reporting. Encouragingly, the overall attitude of respondents towards ADR reporting was positive. Based on the above, strategies are needed to build capacity of HCPs in the area of on adverse drug reaction and its' reporting.
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Affiliation(s)
| | - Joseph O Fadare
- Ekiti State University, Ado-Ekiti, Nigeria.,Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | | | | | - Iyanu Bankole
- Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
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20
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Raghvan HPN, Fatokun O. Factors associated with the intention of community pharmacists to report adverse drug reactions to regulatory authority in Malaysia: application of the theory of planned behaviour. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2021; 29:435-442. [PMID: 34244775 DOI: 10.1093/ijpp/riab036] [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: 12/22/2020] [Accepted: 06/09/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES It is known that community pharmacists in Malaysia underreport adverse drug reactions (ADRs). In order to improve ADR reporting, a theory-based understanding of the factors associated with the community pharmacists' reporting behaviour is important. This study used the theory of planned behaviour (TPB) to identify the predictors of behavioural intention to report ADRs to the regulatory authority among community pharmacists in Malaysia and to assess the relative importance of the predictors. METHODS A questionnaire-based study was conducted among 188 randomly selected community pharmacists in the state of Johor, Malaysia. The questionnaire included four main TPB constructs (intention, attitude, subjective norms and perceived behavioural control) and related measures, including perceived moral obligation, past reporting behaviour and sociodemographic variables. Descriptive and hierarchical regression analyses were conducted. KEY FINDINGS A total of 164 questionnaires were collected. The mean score of intention to report ADRs was 15.43 (SD = 2.99). The final model of the hierarchical regression analysis showed that attitude towards ADR reporting (P = 0.004), subjective norm (P = 0.010) and perceived moral obligation (P = 0.014) were significant predictors of intention to report ADRs. Attitude was the most significant predictor, followed by subjective norm and perceived moral obligation. CONCLUSIONS Interventions targeting community pharmacists' attitude, subjective norms and perceived moral obligations towards ADR reporting, with a specific focus on attitude would likely have a positive impact on improving ADR reporting in Malaysia.
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Affiliation(s)
- Hari Pretha Nair Raghvan
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Omotayo Fatokun
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur, Malaysia
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21
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Gahr M, Connemann B, Zeiss R, Schönfeldt-Lecuona C, Dreyhaupt J, Lazik C. Reporting, handling, and subjective importance of adverse drug reactions among general practitioners: an exploratory cross-sectional survey. Expert Opin Drug Saf 2021; 20:979-985. [PMID: 34014779 DOI: 10.1080/14740338.2021.1933430] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background: Interventions for improving reporting and management of adverse drug reactions (ADRs) need regular evaluations of attitude and knowledge of health care professionals regarding pharmacovigilance.Research design and methods: An exploratory survey among general practitioners in Germany was conducted.Results: We interviewed 302 individuals (participation rate 34.3%; mean age 54 yrs; 37.1% female). Underreporting was prevalent in the sample (only 16.6% had reported an ADR in 2015; average total number of ADR-reports was 5). We found awareness of the importance of pharmacovigilance and ADRs, information deficits (43% were not aware of the obligation to report ADRs), and several uncertainties regarding the detection and reporting of ADRs. The participants rated the German ADR reporting system as satisfactory (mean grade 3.7 ± 1.2) and criticized the expenditure of time (63.6%) and the overall complexity (47.4%). To increase the motivation to report ADRs, the majority requested the possibility to report by telephone (61.3%), feedback after reporting (49.3%), telephone consultations (47.4%), and more education and training in pharmacovigilance (31.1%), also during medical school (25.8%).Conclusions: We found evidence of objective and subjective need for further (mandatory) education and training in pharmacovigilance, already during medical school. Our results point to some shortcomings of the German pharmacovigilance system.
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Affiliation(s)
- Maximilian Gahr
- Department of Psychiatry and Psychotherapy III, University Clinic of Ulm, Ulm, Germany
| | - Bernhard Connemann
- Department of Psychiatry and Psychotherapy III, University Clinic of Ulm, Ulm, Germany
| | - René Zeiss
- Department of Psychiatry and Psychotherapy III, University Clinic of Ulm, Ulm, Germany
| | | | - Jens Dreyhaupt
- Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
| | - Christopher Lazik
- Department of Psychiatry and Psychotherapy III, University Clinic of Ulm, Ulm, Germany
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22
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Li R, Curtis K, Zaidi STR, Van C, Thomson A, Castelino R. Prevalence, characteristics, and reporting of adverse drug reactions in an Australian hospital: a retrospective review of hospital admissions due to adverse drug reactions. Expert Opin Drug Saf 2021; 20:1267-1274. [PMID: 34077311 DOI: 10.1080/14740338.2021.1938539] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Adverse drug reaction (ADR) related hospitalizations is a major cause of morbidity and mortality in Australia. This study investigated the prevalence, characteristics, and reporting of ADR related hospitalizations at a tertiary hospital in Australia.Research design and methods: A retrospective review of all ADR related hospitalizations from October to December 2019 was conducted using eMedical Records. They were classified by medicine class, ADR type, preventability, and the strength of causal relationship. ADRs were searched within the regulator's safety database to verify whether it was reported.Results: A total of 496 ADR related hospitalizations were identified from 5521 records (9.0%). Nervous system agents (32.3%) were responsible for most ADR hospitalizations and were more likely to cause psychiatric disorders (RR 9.71, 95%CI 4.98-18.87). They were also more likely to cause preventable ADRs (HR 1.62, 95%CI 1.46-1.81). Patient age (OR 1.04, 95%CI 1.03-1.05) and the number of medicines (OR 1.13, 95%CI 1.11-1.15) were associated with ADR related hospitalizations. Under-reporting to the national regulator was over 99%.Conclusions: ADR under-reporting is highly prevalent in Australian hospitals. Further research into identifying specific barriers toward reporting ADRs are needed to inform strategies with a focus on healthcare professionals involved in prescribing, dispensing, and administrating nervous system agents.
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Affiliation(s)
- Raymond Li
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Kate Curtis
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Syed Tabish Razi Zaidi
- Faculty of Medicine and Health, University of Leeds, Leeds, UK.,National Institute for Health Research (NIHR) Yorkshire and Humber Patient Safety Translational Research Centre, West Yorkshire, UK
| | - Connie Van
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Amy Thomson
- NSW Poisons Information Centre, Sydney Children's Hospital Network, Camperdown, NSW, Australia
| | - Ronald Castelino
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
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23
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Reumerman M, Tichelaar J, van Eekeren R, van Puijenbroek EP, Richir MC, van Agtmael MA. The potential of training specialist oncology nurses in real-life reporting of adverse drug reactions. Eur J Clin Pharmacol 2021; 77:1531-1542. [PMID: 33978781 PMCID: PMC8440292 DOI: 10.1007/s00228-021-03138-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 04/07/2021] [Indexed: 11/26/2022]
Abstract
Specialist oncology nurses (SONs) have the potential to play a major role in monitoring and reporting adverse drug reactions (ADRs); and reduce the level of underreporting by current healthcare professionals. The aim of this study was to investigate the long term clinical and educational effects of real-life pharmacovigilance education intervention for SONs on ADR reporting. This prospective cohort study, with a 2-year follow-up, was carried out in the three postgraduate schools in the Netherlands. In one of the schools, the prescribing qualification course was expanded to include a lecture on pharmacovigilance, an ADR reporting assignment, and group discussion of self-reported ADRs (intervention). The clinical value of the intervention was assessed by analyzing the quantity and quality of ADR-reports sent to the Netherlands Pharmacovigilance Center Lareb, up to 2 years after the course and by evaluating the competences regarding pharmacovigilance of SONs annually. Eighty-eight SONs (78% of all SONs with a prescribing qualification in the Netherlands) were included. During the study, 82 ADRs were reported by the intervention group and 0 by the control group. This made the intervention group 105 times more likely to report an ADR after the course than an average nurse in the Netherlands. This is the first study to show a significant and relevant increase in the number of well-documented ADR reports after a single educational intervention. The real-life pharmacovigilance educational intervention also resulted in a long-term increase in pharmacovigilance competence. We recommend implementing real-life, context- and problem-based pharmacovigilance learning assignments in all healthcare curricula.
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Affiliation(s)
- M Reumerman
- Department of Internal Medicine, AmsterdamUMC, Location VUmc, De Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands.
- Research and Expertise Center in Pharmacotherapy Education (RECIPE), De Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands.
| | - J Tichelaar
- Department of Internal Medicine, AmsterdamUMC, Location VUmc, De Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
- Research and Expertise Center in Pharmacotherapy Education (RECIPE), De Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
| | - R van Eekeren
- The Netherlands Pharmacovigilance Centre Lareb, Hertogenbosch, The Netherlands
- Groningen Research Institute of Pharmacy, PharmacoTherapy, - Epidemiology & -Economics, University of Groningen, Groningen, The Netherlands
| | - E P van Puijenbroek
- The Netherlands Pharmacovigilance Centre Lareb, Hertogenbosch, The Netherlands
- Groningen Research Institute of Pharmacy, PharmacoTherapy, - Epidemiology & -Economics, University of Groningen, Groningen, The Netherlands
| | - M C Richir
- Department of Internal Medicine, AmsterdamUMC, Location VUmc, De Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
- Research and Expertise Center in Pharmacotherapy Education (RECIPE), De Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
| | - M A van Agtmael
- Department of Internal Medicine, AmsterdamUMC, Location VUmc, De Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
- Research and Expertise Center in Pharmacotherapy Education (RECIPE), De Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
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24
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Abu Esba LC, Al Mardawi G, AlJasser MI, Aljohani B, Abu Alburak A. Adverse Drug Reactions Spontaneously Reported at a Tertiary Care Hospital and Preventable Measures Implemented. J Clin Pharm Ther 2020; 46:460-469. [PMID: 33285001 PMCID: PMC8247361 DOI: 10.1111/jcpt.13306] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/07/2020] [Accepted: 10/12/2020] [Indexed: 02/04/2023]
Abstract
What is known Limitations of clinical trials in determining all safety concerns related to a drug are well recognized. Monitoring spontaneous adverse drug reaction (ADR) reports remains an easy and relatively inexpensive method for overseeing that a drug remains a safe and effective option for patients. Objective To characterize and describe ADR reports at one of the largest healthcare institutions in the region and share the measures implemented by the team. Methods We conducted a retrospective analysis of all ADRs submitted by healthcare providers in a tertiary healthcare system in Saudi Arabia between January 2016 and December 2019. The main outcome measures included reporting rate, patient characteristics, suspected drugs involved, seriousness and reporting specialities. Results and discussion Throughout this study, 1156 ADR reports were submitted. The top reported ADR was immune system disorders (87.8%). The most represented class were antimicrobials (56.8%), followed by analgesics (11.4%) and diagnostic agents (5.1%). The ADRs were deemed definitely avoidable in 11.4% (132/1156) of the cases, and 24.2% (280/1156) were deemed possibly avoidable. Reporting ADRs has steadily increased over the years at our institution, but there continues to be a lack of reporting by physicians. Almost one‐third of the reported ADRs were considered to be avoidable or possibly avoidable, which is a driver to continue pharmacovigilance activates on an institutional level and provide specific and tailored preventative measures guided by the specific types of ADRs reported. What is new and conclusion This is the first study to report trends of ADRs spontaneously reported at one of the largest healthcare institutions in the Middle East. It shows similar trends to what has been reported by other institutions, with mainly immediate immunological ADRs being the top reported ADRs, which could be explained by the immediate onset which simplifies the temporal association. Every institution should support and maintain an active ADR team, with responsibilities of evaluating incidents, monitoring trends and most importantly identifying opportunities to improve medication and patient safety. We share here our workflow and hope it serves as a guide for other institutions.
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Affiliation(s)
- Laila Carolina Abu Esba
- Pharmaceutical Care Department, King Abdulaziz Medical City- Ministry of National Guard, Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ghada Al Mardawi
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Department of Quality Improvement, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia
| | - Mohammed I AlJasser
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,Division of Dermatology, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Badr Aljohani
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,William Harvey Research Institute, Queen Mary University of London, London, UK.,Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia
| | - Amjed Abu Alburak
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,Nursing Medication Safety Program, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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25
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Li R, Curtis K, Zaidi STR, Van C, Castelino R. Effect of the black triangle scheme and its online educational campaign on the quantity and quality of adverse drug event reporting in Australia: a time series analysis. Expert Opin Drug Saf 2020; 19:747-753. [DOI: 10.1080/14740338.2020.1746762] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Raymond Li
- Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Kate Curtis
- Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Syed Tabish Razi Zaidi
- Faculty of Medicine and Health, University of Leeds, Leeds, England
- National Institute for Health Research (NIHR), Yorkshire and Humber Patient Safety Translational Research Centre, West Yorkshire, England
| | - Connie Van
- Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Ronald Castelino
- Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
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