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Nyame L, Hu Y, Xue H, Fiagbey EDK, Li X, Tian Y, Fan L, Du W. Variation of adverse drug events in different settings in Africa: a systematic review. Eur J Med Res 2024; 29:333. [PMID: 38880895 PMCID: PMC11181533 DOI: 10.1186/s40001-024-01934-0] [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: 02/26/2024] [Accepted: 06/09/2024] [Indexed: 06/18/2024] Open
Abstract
BACKGROUND Adverse drug events (ADEs) represent challenges affecting Africa's healthcare systems owing to the increased healthcare expenditure and negative health outcomes of ADEs. OBJECTIVES We aimed to systematically review published studies on ADEs and synthesize the existing evidence of ADE prevalence in Africa. METHODS Studies reporting on ADE occurrence in African settings and published from Jan 1, 2000 to Oct 1, 2023 were identified by searching PubMed, EBSCO, Science Direct, and Web of Science. Studies that either articulately investigated ADEs caused by clinical condition (such as HIV patients) or ADEs caused by exposure to specific drug(s) (such as antibiotics) were considered specific and the remaining were general. Grouped ADE prevalence rates were described using median and interquartile range (IQR). PROSPERO registration (CRD42022374095). RESULTS We included 78 observational studies from 15 African countries that investigated the prevalence of ADEs leading to hospital admissions (17 studies), developed during hospitalizations (30 studies), and captured in the outpatient departments (38 studies) or communities (4 studies). Twelve studies included multiple settings. The median prevalence of ADE during hospitalization was 7.8% (IQR: 4.2-21.4%) and 74.2% (IQR: 54.1-90.7%) in general and specific patients, respectively. The ADE-related fatality rate was 0.1% and 1.3% in general and specific patients. The overall median prevalence of ADEs leading to hospital admissions was 6.0% (IQR: 1.5-9.0%); in general, patients and the median prevalence of ADEs in the outpatient and community settings were 22.9% (IQR: 14.6-56.1%) and 32.6% (IQR: 26.0-41.3%), respectively, with a median of 43.5% (IQR: 16.3-59.0%) and 12.4% (IQR: 7.1-28.1%) of ADEs being preventable in general and specific patients, respectively. CONCLUSIONS The prevalence of ADEs was significant in both hospital and community settings in Africa. A high ADE prevalence was observed in specific patients, emphasizing important areas for improvement, particularly in at-risk patient groups (e.g., pediatrics, HIV, and TB patients) in various settings. Due to limited studies conducted in the community setting, future research in this setting is encouraged.
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Affiliation(s)
- Linda Nyame
- School of Public Health, Southeast University, Nanjing, China.
| | - Yuhua Hu
- School of Public Health, Southeast University, Nanjing, China
| | - Hui Xue
- School of Public Health, Southeast University, Nanjing, China
| | - Emmanuel D K Fiagbey
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Xi Li
- Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - Yong Tian
- School of Public Health, Southeast University, Nanjing, China
| | - Lijun Fan
- School of Public Health, Southeast University, Nanjing, China
| | - Wei Du
- School of Public Health, Southeast University, Nanjing, China.
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Chinmayee A, Subbarayan S, Myint PK, Cherubini A, Cruz-Jentoft AJ, Petrovic M, Gudmundsson A, Byrne S, O'Mahony D, Soiza RL. Diabetes mellitus increases risk of adverse drug reactions and death in hospitalised older people: the SENATOR trial. Eur Geriatr Med 2024; 15:189-199. [PMID: 38127206 PMCID: PMC10876722 DOI: 10.1007/s41999-023-00903-w] [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: 09/25/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE Adverse drug reactions (ADRs) are a major cause of morbidity and mortality, especially in older people. Older people with diabetes mellitus may be at especially high risk of ADRs but this risk has not been well studied. This study aimed to compare severity and type of ADRs in hospitalised, multimorbid older people with and without diabetes and secondly to assess the impact of ADRs on mortality, rehospitalisation and length of stay. METHODS Participants in the SENATOR (Software Engine for the Assessment and optimization of drug and non-drug Therapy in Older peRsons) trial were assessed for 12 common and 'other' prevalent and incident adverse drug reactions using a blinded end-point adjudication process. Descriptive analyses, logistic regression and mediation analyses were undertaken. RESULTS Of 1537 people in the SENATOR trial, 540 (35.1%) had diabetes mellitus (mean age 77.4 ± 7.3 years, 58.5% male). In the total population, 773 prevalent and 828 incident ADRs were reported. Both prevalent and incident symptomatic hypoglycaemia and incident acute kidney injury (AKI) were significantly more common in people with diabetes (p < 0.05). Patients with diabetes had higher all-cause mortality at 12 weeks than those without (9.1% vs 6.3%, p = 0.04). Mediation analysis revealed that mortality was significantly higher (OR = 1.43, Sobel test p = 0.048) in people with diabetes and ADRs causing AKI. CONCLUSIONS Older multimorbid people with diabetes presenting to hospital with acute illness have significantly more ADRs than those without, and a significantly higher mortality that is mediated by medication-associated AKI and poorer renal function.
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Affiliation(s)
- Anagha Chinmayee
- Ageing Clinical and Experimental Research (ACER) Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Selvarani Subbarayan
- Ageing Clinical and Experimental Research (ACER) Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Phyo Kyaw Myint
- Ageing Clinical and Experimental Research (ACER) Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, Scotland, UK
| | - Antonio Cherubini
- Geriatria, Accettazione Geriatrica e Centro Di Ricerca Per L'invecchiamento, IRCCS INRCA, Ancona, Italy
| | | | - Mirko Petrovic
- Department of Geriatrics, Ghent University Hospital, Ghent, Belgium
| | | | - Stephen Byrne
- School of Pharmacy, University College Cork, Cork, Ireland
| | - Denis O'Mahony
- Department of Medicine (Geriatrics), School of Medicine, University College Cork, Cork, Ireland
| | - Roy L Soiza
- Ageing Clinical and Experimental Research (ACER) Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
- Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, Scotland, UK.
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Álvarez-Almazán S, Solís-Domínguez LC, Duperou-Luna P, Fuerte-Gómez T, González-Andrade M, Aranda-Barradas ME, Palacios-Espinosa JF, Pérez-Villanueva J, Matadamas-Martínez F, Miranda-Castro SP, Mercado-Márquez C, Cortés-Benítez F. Anti-Diabetic Activity of Glycyrrhetinic Acid Derivatives FC-114 and FC-122: Scale-Up, In Silico, In Vitro, and In Vivo Studies. Int J Mol Sci 2023; 24:12812. [PMID: 37628991 PMCID: PMC10454726 DOI: 10.3390/ijms241612812] [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: 06/30/2023] [Revised: 08/07/2023] [Accepted: 08/12/2023] [Indexed: 08/27/2023] Open
Abstract
Type 2 diabetes (T2D) is one of the most common diseases and the 8th leading cause of death worldwide. Individuals with T2D are at risk for several health complications that reduce their life expectancy and quality of life. Although several drugs for treating T2D are currently available, many of them have reported side effects ranging from mild to severe. In this work, we present the synthesis in a gram-scale as well as the in silico and in vitro activity of two semisynthetic glycyrrhetinic acid (GA) derivatives (namely FC-114 and FC-122) against Protein Tyrosine Phosphatase 1B (PTP1B) and α-glucosidase enzymes. Furthermore, the in vitro cytotoxicity assay on Human Foreskin fibroblast and the in vivo acute oral toxicity was also conducted. The anti-diabetic activity was determined in streptozotocin-induced diabetic rats after oral administration with FC-114 or FC-122. Results showed that both GA derivatives have potent PTP1B inhibitory activity being FC-122, a dual PTP1B/α-glucosidase inhibitor that could increase insulin sensitivity and reduce intestinal glucose absorption. Molecular docking, molecular dynamics, and enzymatic kinetics studies revealed the inhibition mechanism of FC-122 against α-glucosidase. Both GA derivatives were safe and showed better anti-diabetic activity in vivo than the reference drug acarbose. Moreover, FC-114 improves insulin levels while decreasing LDL and total cholesterol levels without decreasing HDL cholesterol.
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Affiliation(s)
- Samuel Álvarez-Almazán
- Laboratory of Biotechnology, Unidad de Posgrado, Facultad de Estudios Superiores Cuautitlán Campus 1, Universidad Nacional Autónoma de México, Cuautitlán Izcalli 54740, Mexico; (S.Á.-A.); (L.C.S.-D.); (T.F.-G.); (M.E.A.-B.); (S.P.M.-C.)
| | - Luz Cassandra Solís-Domínguez
- Laboratory of Biotechnology, Unidad de Posgrado, Facultad de Estudios Superiores Cuautitlán Campus 1, Universidad Nacional Autónoma de México, Cuautitlán Izcalli 54740, Mexico; (S.Á.-A.); (L.C.S.-D.); (T.F.-G.); (M.E.A.-B.); (S.P.M.-C.)
| | - Paulina Duperou-Luna
- Laboratory of Synthesis and Isolation of Bioactive Substances, Departamento de Sistemas Biológicos, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana–Xochimilco (UAM–X), Mexico City 04960, Mexico; (P.D.-L.); (J.F.P.-E.); (J.P.-V.); (F.M.-M.)
| | - Teresa Fuerte-Gómez
- Laboratory of Biotechnology, Unidad de Posgrado, Facultad de Estudios Superiores Cuautitlán Campus 1, Universidad Nacional Autónoma de México, Cuautitlán Izcalli 54740, Mexico; (S.Á.-A.); (L.C.S.-D.); (T.F.-G.); (M.E.A.-B.); (S.P.M.-C.)
| | - Martin González-Andrade
- Laboratory of Biosensors and Molecular Modelling, Departamento de Bioquímica, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico;
| | - María E. Aranda-Barradas
- Laboratory of Biotechnology, Unidad de Posgrado, Facultad de Estudios Superiores Cuautitlán Campus 1, Universidad Nacional Autónoma de México, Cuautitlán Izcalli 54740, Mexico; (S.Á.-A.); (L.C.S.-D.); (T.F.-G.); (M.E.A.-B.); (S.P.M.-C.)
| | - Juan Francisco Palacios-Espinosa
- Laboratory of Synthesis and Isolation of Bioactive Substances, Departamento de Sistemas Biológicos, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana–Xochimilco (UAM–X), Mexico City 04960, Mexico; (P.D.-L.); (J.F.P.-E.); (J.P.-V.); (F.M.-M.)
| | - Jaime Pérez-Villanueva
- Laboratory of Synthesis and Isolation of Bioactive Substances, Departamento de Sistemas Biológicos, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana–Xochimilco (UAM–X), Mexico City 04960, Mexico; (P.D.-L.); (J.F.P.-E.); (J.P.-V.); (F.M.-M.)
| | - Félix Matadamas-Martínez
- Laboratory of Synthesis and Isolation of Bioactive Substances, Departamento de Sistemas Biológicos, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana–Xochimilco (UAM–X), Mexico City 04960, Mexico; (P.D.-L.); (J.F.P.-E.); (J.P.-V.); (F.M.-M.)
| | - Susana Patricia Miranda-Castro
- Laboratory of Biotechnology, Unidad de Posgrado, Facultad de Estudios Superiores Cuautitlán Campus 1, Universidad Nacional Autónoma de México, Cuautitlán Izcalli 54740, Mexico; (S.Á.-A.); (L.C.S.-D.); (T.F.-G.); (M.E.A.-B.); (S.P.M.-C.)
| | - Crisóforo Mercado-Márquez
- Isolation and Animal Facility Unit, Facultad de Estudios Superiores Cuautitlán 28, Universidad Nacional Autónoma de México, Cuautitlán Izcalli 54714, Mexico;
| | - Francisco Cortés-Benítez
- Laboratory of Synthesis and Isolation of Bioactive Substances, Departamento de Sistemas Biológicos, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana–Xochimilco (UAM–X), Mexico City 04960, Mexico; (P.D.-L.); (J.F.P.-E.); (J.P.-V.); (F.M.-M.)
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Brown R, Bateman CJ, Gossell-Williams M. Influence of Jamaican Cultural and Religious Beliefs on Adherence to Pharmacotherapy for Non-Communicable Diseases: A Pharmacovigilance Perspective. Front Pharmacol 2022; 13:858947. [PMID: 35359857 PMCID: PMC8963898 DOI: 10.3389/fphar.2022.858947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/25/2022] [Indexed: 11/13/2022] Open
Abstract
Worldwide, socio-cultural determinants have been shown to influence the beliefs of patients about their health and decision making for treatment. This is consistent with the evidence that cultural and religious beliefs affect illness conceptualization and behaviors of Jamaican patients living with non-communicable diseases, such as diabetes mellitus and hypertension. Despite these known socio-cultural influences, an acknowledgment of relevance of adherence to pharmacotherapy has been grossly understudied. Furthermore, while poor adherence to pharmacotherapy, especially in the management of patients living with non-communicable diseases is associated with adverse drug reactions; reporting of such information in the pharmacovigilance process is inadequate. We review previous studies on the cultural and religious beliefs within the Jamaican context that may contribute to poor adherence to pharmacotherapy, especially among those patients living with non-communicable diseases. We support the ongoing perspective that current pharmacovigilance processes need retooling with the inclusion of socio-cultural influences on adherence to pharmacotherapy.
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Affiliation(s)
- Robyn Brown
- Department of Sociology, Psychology, and Social Work, Faculty of Social Sciences, The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Caryl James Bateman
- Department of Sociology, Psychology, and Social Work, Faculty of Social Sciences, The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Maxine Gossell-Williams
- Section of Pharmacology and Pharmacy, Faculty of Medical Sciences, The University of the West Indies, Mona Campus, Kingston, Jamaica
- *Correspondence: Maxine Gossell-Williams,
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Rezaie Z, Taghizadeh-Ghehi M, Jafarzadeh Kohneloo A. Are adverse drug reactions to anti-diabetic drugs more common in patients whose treatment do not adhere to diabetes management clinical guidelines? Comments on a study report. Eur J Clin Pharmacol 2021; 77:1429-1430. [PMID: 33811492 DOI: 10.1007/s00228-021-03119-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/02/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Zahra Rezaie
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Taghizadeh-Ghehi
- Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, 4th floor, No 92, Karimkhan Zand Ave., Hafte Tir Sq, Tehran, Iran.
| | - Aarefeh Jafarzadeh Kohneloo
- Department of Epidemiology and Biostatistics, Faculty of Health, Tehran University of Medical Sciences, Tehran, Iran
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