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Schjøtt J, Pettersen TR, Andreassen LM, Bjånes TK. Nurses as adverse drug reaction reporting advocates. Eur J Cardiovasc Nurs 2023; 22:765-768. [PMID: 36453029 DOI: 10.1093/eurjcn/zvac113] [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: 03/23/2022] [Revised: 11/25/2022] [Accepted: 11/29/2022] [Indexed: 12/18/2023]
Abstract
Adverse drug reactions (ADRs) is a challenge in modern healthcare, particularly given the increasing complexity of drug therapy, an ageing population, rising multimorbidity, and a high patient turnover. The core activity of detecting potential ADRs over the last half century has been spontaneous reporting systems. A recent Norwegian regulation commits healthcare professionals other than physicians and dentists to report serious ADRs. In this discussion paper, we share our preliminary experience with a training programme using nurses as ADR advocates to stimulate ADR reporting among the clinical staff in a hospital department.
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Affiliation(s)
- Jan Schjøtt
- Regional Medicines Information and Pharmacovigilance Centre (RELIS Vest), Haukeland University Hospital, Jonas Lies vei 91B, 5021 Bergen, Norway
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Trond R Pettersen
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Lillan Mo Andreassen
- Regional Medicines Information and Pharmacovigilance Centre (RELIS Vest), Haukeland University Hospital, Jonas Lies vei 91B, 5021 Bergen, Norway
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Tormod K Bjånes
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
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Bigi C, Tuccori M, Bocci G. Healthcare professionals and pharmacovigilance of pediatric adverse drug reactions: a 5-year analysis of Adverse Events Reporting System Database of the Food and Drug Administration. Minerva Pediatr (Torino) 2022; 74:272-280. [PMID: 28211644 DOI: 10.23736/s2724-5276.17.04733-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to analyze the Adverse Events Reporting System (AERS) Database of the Food and Drug Administration (FDA), investigating the characteristics of pediatric adverse drug reactions (ADRs) and describing the effective participation of healthcare professionals in the reporting activity. METHODS Reports of ADRs were obtained from the FDA website. Only ADRs in pediatric subjects (divided by age, by country and by professional category) were included into the analysis. The drugs suspected as primary cause of the ADRs in pediatric subjects and their principal anatomic group according to the Anatomical Therapeutic Chemical Classification system were considered. To classify the ADRs, the Medical Dictionary for Regularity Activities terminology was adopted. RESULTS Between 2008 and 2012, FDA collected 113,077 ADRs in pediatric patients. Of the total pediatric ADR reports, those performed by medical doctors were 32%, followed by consumers (26%) and healthcare professionals (25%). Most of the ADR reports were related to the adolescent group (39%). Healthcare professionals resulted the category with the highest rate of ADR reports in neonates and infants. Drugs acting on nervous system and antineoplastic/immunomodulating agents were the most involved the pediatric ADR reports. Pyrexia, convulsion, vomiting and accidental overdose were the reactions more reported both from healthcare professionals and medical doctors. CONCLUSIONS The present study describes the pediatric ADR reports of the FDA database through healthcare professional's perspective, describing the various aspects of pediatric pharmacovigilance.
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Affiliation(s)
- Caterina Bigi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,Barking, Havering and Redbridge University Hospital, NHS Trust, London, UK
| | - Marco Tuccori
- Unit of Adverse Drug Reactions Monitoring, University Hospital of Pisa, Pisa, Italy
| | - Guido Bocci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy -
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Sandberg A, Salminen V, Heinonen S, Sivén M. Under-Reporting of Adverse Drug Reactions in Finland and Healthcare Professionals’ Perspectives on How to Improve Reporting. Healthcare (Basel) 2022; 10:healthcare10061015. [PMID: 35742066 PMCID: PMC9222550 DOI: 10.3390/healthcare10061015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Adverse drug reaction (ADR) reporting has been studied relatively extensively in all the Nordic countries besides Finland, but no definitive solution to decrease under-reporting has been found. Despite many similarities in reporting, the most notable difference compared to other Nordic countries is that ADR reporting is completely voluntary in Finland. Purpose: The purpose was to examine if voluntary reporting influences healthcare professional (HCP) ADR reporting, why HCPs do not report all suspected ADRs, how could reporting be enhanced, and do we need to develop the process for collecting ADR follow-up (F/U) information from HCPs. Methods: An open and anonymous questionnaire was developed and made available online at the e-form portal of the University of Helsinki. Trade and area unions distributed the questionnaire to their respective member physicians, nurses, and pharmacists. Two independent coders performed the content analysis of answers to open-ended questions. Results: A total of 149 responses was received. Two fifths (38%) of the HCPs confirmed that they had not always reported suspected ADRs. The main reason for not reporting was that the ADR was already known. HCPs who had no previous ADR reporting experience did not report ADRs mainly because it was not clear how to report them. Seriousness (chosen by 76%) and unexpectedness of the reaction (chosen by 64%) were the most actuating factors in reporting an ADR. Only 52% of the HCPs had received ADR reporting training and only 16% of the HCPs felt that they had enough information about reporting. Most HCPs felt that ADR F/U requests are justified, and these requests did not affect their ADR reporting willingness. Conclusions: As in other Nordic countries, ADR under-reporting occurs also in Finland despite differences in reporting guidance. ADR reporting rate could be enhanced by organizing recurring training, information campaigns, and including reporting reminders to the patient information systems that HCPs use. Training should primarily aid in recognizing ADRs, educate in how to report, and promote a reporting culture among HCPs.
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Affiliation(s)
- Andreas Sandberg
- Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, FI-00014 Helsinki, Finland; (V.S.); (M.S.)
- Correspondence:
| | - Veera Salminen
- Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, FI-00014 Helsinki, Finland; (V.S.); (M.S.)
| | | | - Mia Sivén
- Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, FI-00014 Helsinki, Finland; (V.S.); (M.S.)
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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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Velasco-González V, Loya-Pérez L, Navarro-García E, Sáinz-Gil M. Reporting of suspected adverse drug reactions by nursing in Spain. An observational-descriptive retrospective study. ENFERMERIA CLINICA (ENGLISH EDITION) 2021; 31:363-370. [PMID: 34756240 DOI: 10.1016/j.enfcle.2020.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 10/25/2020] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study aimed to gain knowledge of the nurses' involvement in the spontaneous report of suspected adverse drug reactions (ADR) in the Spanish Pharmacovigilance System for Medicinal Products for Human Use (SEFV-H), describing the principal characteristics of the reported cases, identifying points of improvement. METHODS A descriptive observational retrospective study was based on the data from FEDRA, the database created by the SEFV-H. The sample taken was the spontaneous adverse drug reactions reported to SEFV-H by nurses during the first 6 months of the 2018. RESULTS Complete data was provided by 6,370 suspicions of ADR reported to SEFV-H by all healthcare professionals. Only 4,8% of the samples were taken by nurses, 62,7% came from medical centers. The majority of the ADR were not considered a serious disease (78%). The most frequently adverse drug reactions reported by nurses were local reactions. The patients most involved were children and vaccines were the most reported drugs (58,3%), followed by the intravenous contrast agents used in diagnostic tests. CONCLUSIONS Nurses report very few cases to SEFV-H and are mostly related to the administration of vaccines and are sent by nurses working in the out-of-hospital setting. Most cases are not serious and usually report known adverse reactions to the suspected drug. This observed under-notification raises the need to promote increased pharmacovigilance training among these notifying nurses so that they can continue to report, and also for those who do not do so in their daily practice, so that they can begin to do so.
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Affiliation(s)
- Verónica Velasco-González
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Valladolid, Valladolid, Spain; Centro de estudios Sobre la Seguridad de los Medicamentos, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain; Instituto de Oftalmobiología Aplicada, Universidad de Valladolid, Valladolid, Spain; Grupo de Investigación en Cuidados Enfermeros (GICE), Universidad de Valladolid, Valladolid, Spain; Grupo de investigación «Farmacogenética, Genética del Cáncer, Polimorfismos Genéticos y Farmacoepidemiología», Universidad de Valladolid, Valladolid, Spain
| | - Laura Loya-Pérez
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Valladolid, Valladolid, Spain
| | - Ester Navarro-García
- Centro de estudios Sobre la Seguridad de los Medicamentos, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain.
| | - María Sáinz-Gil
- Centro de estudios Sobre la Seguridad de los Medicamentos, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain; Centro de Farmacovigilancia de Castilla y León, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
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Velasco-González V, Loya-Pérez L, Navarro-García E, Sainz-Gil M. Reporting of suspected adverse drug reactions by nursing in Spain. An observational-descriptive retrospective study. ENFERMERIA CLINICA 2021; 31:S1130-8621(20)30534-9. [PMID: 33531221 DOI: 10.1016/j.enfcli.2020.10.033] [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: 03/13/2020] [Revised: 09/22/2020] [Accepted: 10/25/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study aimed to gain knowledge of the nurses' involvement in the spontaneous report of suspected adverse drug reactions (ADR) in the Spanish Pharmacovigilance System for Medicinal Products for Human Use (SEFV-H), describing the principal characteristics of the reported cases, identifying points of improvement. METHODS A descriptive observational retrospective study was based on the data from FEDRA, the database created by the SEFV-H. The sample taken was the spontaneous adverse drug reactions reported to SEFV-H by nurses during the first 6 months of the 2018. RESULTS Complete data was provided by 6,370 suspicions of ADR reported to SEFV-H by all healthcare professionals. Only 4,8% of the samples were taken by nurses, 62,7% came from medical centers. The majority of the ADR were not considered a serious disease (78%). The most frequently adverse drug reactions reported by nurses were local reactions. The patients most involved were children and vaccines were the most reported drugs (58,3%), followed by the intravenous contrast agents used in diagnostic tests. CONCLUSIONS Nurses report very few cases to SEFV-H and are mostly related to the administration of vaccines and are sent by nurses working in the out-of-hospital setting. Most cases are not serious and usually report known adverse reactions to the suspected drug. This observed under-notification raises the need to promote increased pharmacovigilance training among these notifying nurses so that they can continue to report, and also for those who do not do so in their daily practice, so that they can begin to do so.
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Affiliation(s)
- Verónica Velasco-González
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Valladolid, Valladolid, España; Centro de Estudios sobre la Seguridad de los Medicamentos, Facultad de Medicina, Universidad de Valladolid, Valladolid, España; Instituto de Oftalmobiología Aplicada, Universidad de Valladolid, Valladolid, España; Grupo de Investigación en Cuidados Enfermeros (GICE), Universidad de Valladolid, Valladolid, España; Grupo de investigación «Farmacogenética, Genética del Cáncer, Polimorfismos Genéticos y Farmacoepidemiología», Universidad de Valladolid, Valladolid, España
| | - Laura Loya-Pérez
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Valladolid, Valladolid, España
| | - Ester Navarro-García
- Centro de Estudios sobre la Seguridad de los Medicamentos, Facultad de Medicina, Universidad de Valladolid, Valladolid, España.
| | - María Sainz-Gil
- Centro de Estudios sobre la Seguridad de los Medicamentos, Facultad de Medicina, Universidad de Valladolid, Valladolid, España; Centro de Farmacovigilancia de Castilla y León, Facultad de Medicina, Universidad de Valladolid, Valladolid, España
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Vaismoradi M, Jordan S, Logan PA, Amaniyan S, Glarcher M. A Systematic Review of the Legal Considerations Surrounding Medicines Management. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:65. [PMID: 33450903 PMCID: PMC7828352 DOI: 10.3390/medicina57010065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/06/2021] [Accepted: 01/10/2021] [Indexed: 12/13/2022]
Abstract
This study explores the legal considerations surrounding medicines management, providing a synthesis of existing knowledge. An integrative systematic review of the current international knowledge was performed. The search encompassed the online databases of PubMed (including Medline), Scopus, CINAHL, and Web of Science using MeSH terms and relevant keywords relating to the legal considerations of medicines management in healthcare settings. The search process led to the identification of 6051 studies published between 2010 and 2020, of which six articles were found to be appropriate for data analysis and synthesis based on inclusion criteria. Research methods were varied and included qualitative interviews, mixed-methods designs, retrospective case reports and cross-sectional interrupted time-series analysis. Their foci were on the delegation of medicines management, pharmacovigilance and reporting of adverse drug reactions (ADRs) before and after legislation by nurses, physicians and pharmacists, medico-legal litigation, use of forced medication and the prescription monitoring program. Given the heterogenicity of the studies in terms of aims and research methods, a meta-analysis could not be performed and, therefore, our review findings are presented narratively under the categories of 'healthcare providers' education and monitoring tasks', 'individual and shared responsibility', and 'patients' rights'. This review identifies legal aspects surrounding medicines management, including supervision and monitoring of the effects of medicines; healthcare providers' knowledge and attitudes; support and standardised tools for monitoring and reporting medicines' adverse side effects/ADRs; electronic health record systems; individual and shared perceptions of responsibility; recognition of nurses' roles; detection of sentinel medication errors; covert or non-voluntary administration of medication, and patient participation.
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Affiliation(s)
- Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, 8049 Bodø, Norway
| | - Sue Jordan
- Department of Nursing, Swansea University, Swansea SA2 8PP, UK;
| | - Patricia A. Logan
- Faculty of Science, Charles Sturt University, Bathurst 2795, Australia;
| | - Sara Amaniyan
- Student Research Center, Semnan University of Medical Sciences, Semnan 3514799442, Iran;
| | - Manela Glarcher
- Institute of Nursing Science and Practice, Paracelsus Medical University, 5020 Salzburg, Austria;
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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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Mulchandani R, Kakkar AK. Reporting of adverse drug reactions in India: A review of the current scenario, obstacles and possible solutions. INTERNATIONAL JOURNAL OF RISK & SAFETY IN MEDICINE 2019; 30:33-44. [PMID: 30175985 DOI: 10.3233/jrs-180025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Pharmacovigilance is a practice aimed to monitor drug safety in real life conditions and capture adverse drug events during the post marketing phase of drug's life cycle. But under reporting of adverse reactions is a major cause of concern and a threat to the pharmacovigilance systems. The present article looks into the major obstacles affecting the spontaneous reporting of adverse drug reactions (ADRs) in India and the possible solutions. As per available scientific literature, the major impediments to ADR reporting are inadequate knowledge and awareness among health professionals, clinicians' perceptions towards reporting, problems with establishing reporting systems in hospitals and insufficient training to recognize ADRs. Measures to improve the situation include greater involvement of nurses, pharmacists as well as consumers in the reporting of ADRs, making the process simpler and faster through electronic means, introducing educational interventions and training programs for health care providers and spreading awareness about the reporting system amongst caregivers and receivers alike. Providing a momentum to the pharmacovigilance system and ensuring a robust reporting process is a challenge but proper planning, feasible solutions and focussed efforts can help bring about the change ensuring patient safety - the ultimate goal of pharmacovigilance.
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Affiliation(s)
| | - Ashish Kumar Kakkar
- Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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10
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Jordan S, Banner T, Gabe-Walters M, Mikhail JM, Round J, Snelgrove S, Storey M, Wilson D, Hughes D. Nurse-led medicines' monitoring in care homes study protocol: a process evaluation of the impact and sustainability of the adverse drug reaction (ADRe) profile for mental health medicines. BMJ Open 2018; 8:e023377. [PMID: 30269073 PMCID: PMC6169755 DOI: 10.1136/bmjopen-2018-023377] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/02/2018] [Accepted: 08/07/2018] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Improved medicines' management could lead to real and sustainable improvements to the care of older adults. The overuse of mental health medicines has featured in many reports, and insufficient patient monitoring has been identified as an important cause of medicine-related harms. Nurse-led monitoring using the structured adverse drug reaction (ADRe) profile identifies and addresses the adverse effects of mental health medicines. Our study investigates clinical impact and what is needed to sustain utilisation in routine practice in care homes. METHODS AND ANALYSIS This process evaluation will use interviews and observations with the participants of all five homes involved in earlier research, and five newly recruited homes caring for people prescribed mental health medicines. The ADRe profile is implemented by nurses, within existing resources, to check for signs and symptoms of ADRs, initiate amelioration and share findings with pharmacists and prescribers for medication review. Outcome measures are the numbers and nature of problems addressed and understanding of changes needed to optimise clinical gain and sustain implementation. Data will be collected by 30 observations and 30 semistructured interviews. Clinical gains will be described and narrated. Interview analysis will be based on the constant comparative method. ETHICS AND DISSEMINATION Ethical approval was conferred by the National Health Service Wales Research Ethics Committee. If the ADRe profile can be sustained in routine practice, it has potential to (1) improve the lives of patients, for example, by reducing pain and sedation, and (2) assist in early identification of problems caused by ADRs. Therefore, in addition to peer-reviewed publications and conferences, we shall communicate our findings to healthcare professionals, policy-makers and sector regulators. TRIAL REGISTRATION NUMBER NCT03110471.
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Affiliation(s)
- Sue Jordan
- College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Timothy Banner
- Welsh School of Pharmacy, Cardiff University, Cardiff, UK
| | | | - Jane M Mikhail
- College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Jeff Round
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Mel Storey
- College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Douglas Wilson
- College of Human and Health Sciences, Swansea University, Swansea, UK
| | - David Hughes
- College of Human and Health Sciences, Swansea University, Swansea, UK
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11
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AlShammari TM, Almoslem MJ. Knowledge, attitudes & practices of healthcare professionals in hospitals towards the reporting of adverse drug reactions in Saudi Arabia: A multi-centre cross sectional study. Saudi Pharm J 2018; 26:925-931. [PMID: 30416347 PMCID: PMC6218328 DOI: 10.1016/j.jsps.2018.04.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 04/24/2018] [Indexed: 11/15/2022] Open
Abstract
Introduction Adverse drug reactions (ADRs) are a major global clinical problem, causing substantial mortality and morbidity especially in hospitals. Healthcare professionals (HCPs) knowledges’, attitude and practices are crucial points to evaluate the hospital safety environment. Objective of the study was to investigate the knowledge, attitudes, and practices of HCPs regarding the ADRs reporting system. Methods A cross-sectional survey was conducted between January and February of 2013 in nine tertiary care hospitals (governmental and private) that provide highly specialized medical services in Riyadh, Qassim, and the Eastern region of the Kingdom of Saudi Arabia. A validated questionnaire was used to assess the knowledge, attitudes, and practices of HCPs regarding the ADR reporting system. All statistical analyses were performed using SAS version 9.2. Results In total, 480 questionnaires were distributed, and the response rate was 70% (n = 336). Only 33% of the participants were aware of the National Pharmacovigilance Centre (NPC). Of those HCPs who were familiar with the NPC and their responsibility to report ADRs, most (50%) were pharmacists, followed by physicians (24%) and nurses (16%), and these differences were statistically significant (p < 0.01). Twenty-seven percent of the participants were involved in reporting ADRs; among these HCPs, 62% were pharmacists, 26% were nurses, and 6% were physicians. Most participants (95%) favoured reporting ADRs caused by antibiotics and new/old drugs. The prominent factors discouraging ADR reporting included fear that the report might be incorrect (46%) and lack of time (44%). Conclusions A significant lack of knowledge, positive attitudes, and practices regarding ADRs and reporting was observed in hospital HCPs. This finding represents an international concern, and urgent action is needed to promote drug safety and pharmacovigilance in this region.
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Affiliation(s)
- Thamir M AlShammari
- Department of Clinical Pharmacy, College of Pharmacy, University of Hail, Hail, Saudi Arabia.,Medication Safety Research Chair, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.,Saudi Food and Drug Authority, Riyadh, Saudi Arabia
| | - Mohammed J Almoslem
- Department of Clinical Pharmacy, College of Pharmacy, University of Hail, Hail, Saudi Arabia
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Bigi C, Bocci G. The key role of clinical and community health nurses in pharmacovigilance. Eur J Clin Pharmacol 2017; 73:1379-1387. [PMID: 28770283 DOI: 10.1007/s00228-017-2309-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 07/19/2017] [Indexed: 12/14/2022]
Abstract
PURPOSE The reporting of suspected adverse drug reactions (ADRs) is starting to become routine to nurses. The aim of this review is to underline the role of clinical and community health nurses in pharmacovigilance and to promote their effective participation in ADR reporting in different countries and for patients of different ages. METHODS The PubMed, Scopus and ISI Web of Science databases were searched for research articles published between January 1985 and April 2017 using the search items "pharmacovigilance" AND "nurse;" "adverse drug reaction report" AND "nurse;" "community health nurse" AND "adverse drug reaction." RESULTS A total of 987 articles were identified using our search strategy, of which 180 articles remained over after the removal of duplicate articles. Of these 180 studies, upon full review we identified 24 which met the inclusion/exclusion criteria and included these in our review. ADR reports by clinical nurses in some countries are comparable in quality and number to those submitted by physicians or pharmacists. Data on ADRs reported by community nurses are currently not available. However, numerous publications emphasized the challenges faced by nurses in reporting ADRs and the need to include pharmacovigilance training in both clinical and community health nurse academic education. CONCLUSIONS Nurses are central actors in pharmacovigilance activities, particularly in identifying ADRs which remain outside the reach of other healthcare providers and in being fundamental to the preservation of the health of patients and of the entire community, with attention to the more vulnerable patients, such as children and the elderly.
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Affiliation(s)
- Caterina Bigi
- Division of Pharmacology, Department of Clinical and Experimental Medicine, Scuola Medica, University of Pisa, Via Roma 55, 56126, Pisa, Italy.,Barking, Havering and Redbridge University Hospital, HNS Trust, London, UK
| | - Guido Bocci
- Division of Pharmacology, Department of Clinical and Experimental Medicine, Scuola Medica, University of Pisa, Via Roma 55, 56126, Pisa, Italy.
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Angelis AD, Pancani L, Steca P, Colaceci S, Giusti A, Tibaldi L, Alvaro R, Ausili D, Vellone E. Testing an explanatory model of nurses' intention to report adverse drug reactions in hospital settings. J Nurs Manag 2017; 25:307-317. [PMID: 28127821 DOI: 10.1111/jonm.12467] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2016] [Indexed: 12/01/2022]
Abstract
AIM To test an explanatory model of nurses' intention to report adverse drug reactions in hospital settings, based on the theory of planned behaviour. BACKGROUND Under-reporting of adverse drug reactions is an important problem among nurses. METHODS A cross-sectional design was used. Data were collected with the adverse drug reporting nurses' questionnaire. Confirmatory factor analysis was performed to test the factor validity of the adverse drug reporting nurses' questionnaire, and structural equation modelling was used to test the explanatory model. RESULTS The convenience sample comprised 500 Italian hospital nurses (mean age = 43.52). Confirmatory factor analysis supported the factor validity of the adverse drug reporting nurses' questionnaire. The structural equation modelling showed a good fit with the data. Nurses' intention to report adverse drug reactions was significantly predicted by attitudes, subjective norms and perceived behavioural control (R² = 0.16). CONCLUSIONS The theory of planned behaviour effectively explained the mechanisms behind nurses' intention to report adverse drug reactions, showing how several factors come into play. IMPLICATIONS FOR NURSING MANAGEMENT In a scenario of organisational empowerment towards adverse drug reaction reporting, the major predictors of the intention to report are support for the decision to report adverse drug reactions from other health care practitioners, perceptions about the value of adverse drug reaction reporting and nurses' favourable self-assessment of their adverse drug reaction reporting skills.
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Affiliation(s)
- Alessia De Angelis
- Department of Nursing, Local Health Authority Roma 4, Civitavecchia, Rome, Italy
| | - Luca Pancani
- Department of Psychology, University of Milan-Bicocca, Milan, Italy
| | - Patrizia Steca
- Department of Psychology, University of Milan-Bicocca, Milan, Italy
| | - Sofia Colaceci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Angela Giusti
- National Center of Epidemiology, Surveillance and Health Promotion National Institute of Health, Rome, Italy
| | - Laura Tibaldi
- Department of Nursing, Local Health Authority Roma 4, Civitavecchia, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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