Quality of Adverse Drug Reaction (QADRA) reports: an algorithm to appraise the efficiency of spontaneous reporting systems in pharmacovigilance

Quantity is not enough: completeness of suspected adverse drug reaction reports in Spain-differences between regional pharmacovigilance centres and pharmaceutical industry

PURPOSE

The aim of this study is to compare the completeness of relevant structured fields such as age, sex, drug and reaction start dates, time to onset, outcome and drug indication, in serious spontaneous cases reported in Spain depending on whether they have been collected by regional pharmacovigilance centres or by the marketing authorization holders.

METHODS

We analyzed the completeness of key variables for causality assessment related to the patient, the reaction and the suspected drug in all serious cases spontaneously reported and registered in the Spanish Pharmacovilance database, called FEDRA, from 1 January 2011 until 31 December 2018. The completeness scores were calculated according to the type of field and taking into account the VigiGrade tool. Cases were classified according to the reporting pathway, that is whether they were received and transmitted by marketing authorization holder or by regional pharmacovigilance centres.

RESULTS

The completeness score of cases collected by regional pharmacovigilance centres was higher in all the studied variables. The main differences were found in drug and reaction start date, and time to onset.

CONCLUSIONS

This study shows a high completeness score in cases of suspected adverse reactions reported to the regional pharmacovigilance centres with regard to key elements for causality assessment, signal and duplicate detection. In contrast, marketing authorization holder cases show a low completeness score and a decreasing tendency in all the studied variables over the studied period.

Lack of essential information in spontaneous reports of adverse drug reactions in Catalonia-a restraint to the potentiality for signal detection

PURPOSE

The aim of this study is to analyze the quality of the information contained in the adverse drug reactions (ADR) reports and to describe the magnitude and characteristics of the lacking information.

METHODS

All reports of serious ADR received by the Catalan Center of Pharmacovigilance in 2014 were analyzed using the VigiGrade and a more clinical and qualitative approach.

RESULTS

Up to 824 reports describing serious ADR were included in the study; of them, 503 (61.0%) were sent by health care professionals (HPs) and the remaining 321 (39.0%) came from pharmaceutical companies (PhC). More than 80% of missing variables such as 'onset date' or 'time-to-onset' of the ADR were from PhCs reports. 'Onset of treatment date' was not filled in 28 (22.2%) of the reports including an 'additional monitoring' medicine, and 'end of treatment' date was not completed in 53 of those reports (42.1%). In summary, 39% of the reports involving a black triangle medicine sent by PhCs lacked some essential information such as the onset date of treatment.

CONCLUSIONS

More than one third of the reports coming from manufacturers did not include information that is considered a limiting factor to evaluate any causal relationship, and can be an issue for the detection of safety signals. To take advantage of this huge amount of potentially important information that is almost useless at present, data mining tools and new algorithms should be developed and tested with the aim of finding formulas to deal with a huge amount of low quality data without losing it, nor generating a number of false associations.