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Shukla S, Sharma P, Gupta P, Pandey S, Agrawal R, Rathour D, Kumar Kewat D, Singh R, Kumar Thakur S, Paliwal R, Sulakhiya K. Current Scenario and Future Prospects of Adverse Drug Reactions (ADRs) Monitoring and Reporting Mechanisms in the Rural Areas of India. Curr Drug Saf 2024; 19:172-190. [PMID: 37132145 DOI: 10.2174/1574886318666230428144120] [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: 08/17/2022] [Revised: 03/13/2023] [Accepted: 03/20/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND Pharmacovigilance (PV) deals with the detection, collection, assessment, understanding, and prevention of adverse effects associated with drugs. The objective of PV is to ensure the safety of the medicines and patients by monitoring and reporting all adverse drug reactions (ADRs) associated with prescribed medicine usage. Findings have indicated that about 0.2- 24% of hospitalization cases are due to ADRs, of which 3.7% of patients have lethal ADRs. The reasons include the number of prescribed drugs, an increased number of new medicines in the market, an inadequate PV system for ADR monitoring, and a need for more awareness and knowledge about ADR reporting. Severe ADRs lead to enhanced hospital stays, increased treatment costs, risk of death, and many medical and economic consequences. Therefore, ADR reporting at its first instance is essential to avoid further harmful effects of the prescribed drugs. In India, the rate of ADR reporting is less than 1%, whereas worldwide, it is 5% due to a need for more awareness about PV and ADR monitoring among healthcare providers and patients. The main objective of this review is to highlight the current scenario and possible futuristic ways of ADR reporting methods in rural areas of India. We have searched the literature using PubMed, Google scholar, Indian citation index to retrieve the resources related to ADR monitoring and reporting in India's urban and rural areas. Spontaneous reporting is the most commonly used PV method to report ADRs in India's urban and rural areas. Evidence revealed that no effective ADR reporting mechanisms developed in rural areas causing underreporting of ADR, thus increasing the threat to the rural population. Hence, PV and ADR reporting awareness among healthcare professionals and patients, telecommunication, telemedicine, use of social media and electronic medical records, and artificial intelligence are the potential approaches for prevention, monitoring, and reporting of ADRs in rural areas.
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Affiliation(s)
- Shalini Shukla
- Department of Pharmacy, Neuropharmacology Research Laboratory, Indira Gandhi National Tribal University (IGNTU), Amarkantak, Madhya Pradesh, India
| | - Priyanka Sharma
- Department of Pharmacy, Neuropharmacology Research Laboratory, Indira Gandhi National Tribal University (IGNTU), Amarkantak, Madhya Pradesh, India
| | - Priya Gupta
- Department of Pharmacy, Neuropharmacology Research Laboratory, Indira Gandhi National Tribal University (IGNTU), Amarkantak, Madhya Pradesh, India
| | - Shikha Pandey
- Department of Pharmacy, Neuropharmacology Research Laboratory, Indira Gandhi National Tribal University (IGNTU), Amarkantak, Madhya Pradesh, India
| | - Reshu Agrawal
- Department of Pharmacy, Neuropharmacology Research Laboratory, Indira Gandhi National Tribal University (IGNTU), Amarkantak, Madhya Pradesh, India
| | - Deepak Rathour
- Department of Pharmacy, Neuropharmacology Research Laboratory, Indira Gandhi National Tribal University (IGNTU), Amarkantak, Madhya Pradesh, India
| | - Dharmendra Kumar Kewat
- Department of Pharmacy, Neuropharmacology Research Laboratory, Indira Gandhi National Tribal University (IGNTU), Amarkantak, Madhya Pradesh, India
| | - Ramu Singh
- Department of Pharmacy, Neuropharmacology Research Laboratory, Indira Gandhi National Tribal University (IGNTU), Amarkantak, Madhya Pradesh, India
| | | | - Rishi Paliwal
- Department of Pharmacy, Nanomedicine and Bioengineering Research Laboratory (NBRL), Indira Gandhi National Tribal University, Amarkantak, India
| | - Kunjbihari Sulakhiya
- Department of Pharmacy, Neuropharmacology Research Laboratory, Indira Gandhi National Tribal University (IGNTU), Amarkantak, Madhya Pradesh, India
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Shaikh S, Raut A, Jambhale P, Iyer S, Shah J. Incidence and Severity of Adverse Drug Reactions in Medical Intensive Care Unit. Curr Drug Saf 2024; 19:332-341. [PMID: 37587829 DOI: 10.2174/1574886318666230816090606] [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: 03/21/2023] [Revised: 05/17/2023] [Accepted: 07/03/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Adverse drug reactions (ADRs) curtail patients' quality of life by virtue of increasing therapeutic complexity and rising multimorbidity. In India, the frequency of ADRs for individual drugs and their economic burdens are rarely evaluated. This study aimed at identifying the incidence and severity of ADRs leading to hospitalization (ADRA) and occurring during a hospital stay (ADRH). OBJECTIVE The objective of this study is to evaluate the incidence the incidence and severity of ADRs in the ICU and their impact on the duration of hospitalization, along with the cost incurred to treat ADRs in the ICU. METHODS Demographic, clinical, and pharmacological data on patients admitted to the ICU were collected, analyzed and evaluated for ADRs. According to the setting analyzed, a descriptive analysis of the reactions, suspected medicines, and associated factors was undertaken. RESULTS A total of 208 patients were admitted to the ICU during the study period, of which ADRA contributed 9.1% of the incidence rate and 8.1% of ADRH in 36 patients. Males had a higher incidence of ADRs than females. Patients who had ADRs had a substantially longer length of stay than those who did not. Electrolyte disturbance was the most commonly found ADR. According to the Hartwig scale and WHO-causality scale, 88.9% were moderate, and 97.2% were possible ADRs, respectively. CONCLUSION In this study, a similar incidence rate of ADRA and ADRH was observed. The average cost for treating ADRA was higher than that for treating ADRH. As a result, identifying and preventing these reactions is critical, as they cause the patient greater suffering.
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Affiliation(s)
- Sana Shaikh
- Department of Pharmacy Practice, Poona College of Pharmacy, Bharati Vidyapeeth (Deemed to be University), Pune, India
| | - Asawari Raut
- Department of Pharmacy Practice, Poona College of Pharmacy, Bharati Vidyapeeth (Deemed to be University), Pune, India
| | - Prajkta Jambhale
- Department of Pharmacy Practice, Poona College of Pharmacy, Bharati Vidyapeeth (Deemed to be University), Pune, India
| | - Shivkumar Iyer
- Department of Critical Care Medicine, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, India
| | - Jignesh Shah
- Department of Critical Care Medicine, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, India
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Delgado-Pérez G, Dávila-Espinoza C, Beltran-Noblega C. Impact of the Role of the Clinical Pharmacist on the Underreporting of Adverse Drug Reactions at a Peruvian hospital. Hosp Pharm 2023; 58:295-303. [PMID: 37216081 PMCID: PMC10192994 DOI: 10.1177/00185787221138006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
Background: The clinical pharmacists play a key role in the Pharmacovigilance System. They are integrated to the health team performing pharmacotherapeutic follow-up (PF), drug information, at third level care hospital. The objective of this study was to assess the impact of the clinical pharmacists' role in increasing the reporting of suspected adverse drug reactions (SADRs) after including in-service training (IST) in their role, as well as to characterize the reported ADRs. Methods: A longitudinal study was performed, reports of SADRs received through medical interconsultations were evaluated, before and after applying IST, in 2 periods: January 2017 to June 2018 and July 2018 to December 2019. Results: Interconsultations after IST were increased by 168,4%; of these, 75 were ADRs reported to the Dirección General de Medicamentos, Insumos y Drogas (DIGEMID). Internal Medicine and Pneumology services reported more SADR in both periods. There was significant statistical difference in ADRs' causality (P = .001) and type (P = .009). Severe ADRs highlighted after IST (4 vs 12). The most affected organ and system in both periods was skin and appendages. Conclusion: The reporting of SADRs augmented, reflected in an increase in medical interconsultations as a modality of SADR notification, after including IST to the role of the clinical pharmacist, allowing the development of convenient FP, which led to the evaluation of SARs. A higher number of serious ADRs were reported.
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Affiliation(s)
- Gladys Delgado-Pérez
- Universidad Nacional Mayor de San
Marcos Facultad de Farmacia y Bioquimica, Lima, Peru
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Khan Z, Karataş Y, Kıroğlu O. Evaluation of Adverse Drug Reactions in Paediatric Patients: A Retrospective Study in Turkish Hospital. Front Pharmacol 2021; 12:786182. [PMID: 34867419 PMCID: PMC8638749 DOI: 10.3389/fphar.2021.786182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/25/2021] [Indexed: 12/28/2022] Open
Abstract
Drug safety in paediatric patients is a serious public health concern around the world. The paediatric patients are more prone to adverse drug reactions (ADRs) than adults. Moreover, there is a scarcity of information about ADRs in paediatric patients. This study was conducted to determine the frequency, causality, severity, preventability of paediatric patients’ ADRs reported in a tertiary care hospital in Adana, Turkey. A retrospective study was conducted on all spontaneously reported ADRs between January 01, 2020, to July 30, 2021, in paediatric patients. The ADRs reports were evaluated in terms of gender, age, ADR characteristics, suspected drugs and reporting source. All included ADRs reports were characterized according to the Naranjo Algorithm/World Health Organization (WHO) causality scales, Hartwig/Siegel and Common Terminology Criteria for Adverse Events (CTCAE) severity scales, the modified Schoumock and Thornton preventability scale and hospital pharmacovigilance center criteria for seriousness. Therapeutic groups were also coded using the WHO-Anatomical Therapeutic and Chemical (ATC) classification. During the study period, 8,912 paediatric patients who were admitted had 16 ADRs with 1.7 ADRs/1,000 admissions. The majority of ADRs were found in infants (31.2%) and children (56.2%) as compared to adolescents (12.5%). ADRs were observed more in females (81.2%) than males. Skin (62.5%) was the most affected organ due to the ADRs, and maculopapular rash and erythema multiforme were the most commonly reported symptoms. Most ADRs were probable/likely (93.7%), severe (50%), preventable or probably preventable (43.7%) and serious (37.5%). Antibiotics (93.7%) were found to be the most common cause of ADRs in paediatric patients. The majority of ADRs were associated with vancomycin (68.7%). Most of the ADRs were reported by a medical doctor in this study. This small sample size study highlights significant problems of ADRs in paediatric patients, mainly caused by antibiotics and with a majority of ADRs manifest as skin reactions. Furthermore, a high proportion of the identified ADRs were found to be preventable. More focused efforts are needed at the national level to avoid preventable ADRs in hospitals. Monitoring and management of ADRs and future studies would be beneficial for better patient care and safety.
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Affiliation(s)
- Zakir Khan
- Department of Pharmacology, Institute of Health Sciences, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Yusuf Karataş
- Department of Pharmacology, Institute of Health Sciences, Faculty of Medicine, Cukurova University, Adana, Turkey.,Pharmacovigilance Specialist, Balcali Hospital, Faculty of Medicines, Cukurova University, Adana, Turkey
| | - Olcay Kıroğlu
- Department of Pharmacology, Institute of Health Sciences, Faculty of Medicine, Cukurova University, Adana, Turkey
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Ambwani S, Dutta S, Mishra G, Lal H, Singh S, Charan J. Adverse Drug Reactions Associated With Drugs Prescribed in Psychiatry: A Retrospective Descriptive Analysis in a Tertiary Care Hospital. Cureus 2021; 13:e19493. [PMID: 34912634 PMCID: PMC8664397 DOI: 10.7759/cureus.19493] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2021] [Indexed: 11/17/2022] Open
Abstract
Background Psychiatric disorders are chronic in nature which often require long and continuous medications. These medications are known to cause adverse effects on their use. Their monitoring and prevention are crucial for the practicing family and community physicians. Method This is a cross-sectional retrospective study conducted to analyze all the spontaneous adverse drug reactions (ADRs) reported from the psychiatry department to the ADR Monitoring Center, Department of Pharmacology, AIIMS Jodhpur during the time period from 2014 to 2020. Results A total of 334 ADRs were reported. The majority of the ADRs were reported from antipsychotics (60.6%) followed by antidepressants (25.5%) and antiepileptic drugs (5.8%). On further subgroup analysis of the drug classes among antipsychotics, Clozapine (15.8%) was the leading offending agent. Similarly, among Antidepressants, Escitalopram (6.1%) was causing the most side effects. The most common ADR reported was sedation (7.26%) followed by salivary hypersecretion (6.7%), akathisia (5.52%), and weight gain (5.52%). Conclusion Knowledge of common ADRs help in better management of the diseases and psychotropics as a class has various frequents ADRs. Early detection and suitable intervention can help the community physicians in the proper care of the patients and rational use of drugs.
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Affiliation(s)
- Sneha Ambwani
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, IND
| | - Siddhartha Dutta
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, IND
| | - Govind Mishra
- Department of Pharmacology, All India Institute of Medical Sciences, Bhubaneshwar, IND
| | - Hina Lal
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, IND
| | - Surjit Singh
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, IND
| | - Jaykaran Charan
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, IND
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Khan Z, Muhammad K, Karatas Y, Bilen C, Khan FU, Khan FU. Pharmacovigilance and incidence of adverse drug reactions in hospitalized pediatric patients: a mini systematic review. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2020. [DOI: 10.1186/s43054-020-00038-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Pharmacovigilance is an identifying and responding process against an adverse drug reaction (ADRs) problem encountered in the drug administration. ADRs are among the common reasons for morbidity and fatality in pediatrics throughout the globe.
Main body
A systemic review of the previous 10 years (2010–2019) published studies were taken into consideration to describe observational studies on ADRs and to determine the incidence and characteristics of ADRs in pediatrics. Electronic relevant literature was searched in PMC, PubMed, Google Scholar, and OvidSP databases using MESH heading and text words. The titles, text, and abstracts were checked for patients below 18 years of age, nature of ADRs, observational studies (prospective or retrospective), and maximum information was recorded to count their frequency. The studies which discussed specific or particular drug exposures were not selected in this review. Of the 36,689 titles retrieved, 27 studies were selected for full-text review. Ten observational studies were added in the final review. Observational studies on pediatric were carried out in seven distinct nations. The predominant study design within observational methodological studies was prospective (n = 5, 50%). The overall average occurrence of ADRs incidence was 9.52%. ADRs reporting in male patients (54.6%) were more than females (45.4%). The severe types of ADRs were reported in four studies. Anti-microbials were the most common class of drugs related to ADRs.
Conclusion
This systematic review reveals that ADRs in pediatrics are serious public health problems. Periodic drug surveillance studies are mandatory for the safe and appropriate usage of medicines in pediatrics.
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KHAN Z, ÖZ E, KIROĞLU O, KARATAŞ Y. Bir eğitim hastanesinde farmakovijilans merkezine yönlendirilen yatan hastalardaki advers ilaç reaksiyonlarının analizi. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.671198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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