1
|
Curtolo E, Micallef B, Szijj JV, Serracino-Inglott A, Borg JJ. An exploratory study of knowledge, attitudes, practice and barriers towards adverse drug reaction reporting among healthcare professionals in Malta. INTERNATIONAL JOURNAL OF RISK & SAFETY IN MEDICINE 2024:JRS230055. [PMID: 38820023 DOI: 10.3233/jrs-230055] [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: 06/02/2024]
Abstract
BACKGROUND Understanding knowledge and attitudes of health care professionals (HCPs) towards adverse drug reaction (ADR) reporting can inform educational interventions promoting ADR reporting. OBJECTIVE To explore knowledge, attitudes, practice, and barriers of local HCPs towards ADR reporting. METHODS Focus groups involving HCPs from different settings were organized to help develop a questionnaire. The questionnaire was validated and disseminated to pharmacists, physicians, dentists and nurses practicing in Malta. A review of ADR reports reported in Malta from 2004 to 2021 was carried out to contextualise questionnaire findings. RESULTS Overall, HCPs (n = 374) had good knowledge on pharmacovigilance and a positive attitude towards ADR reporting however nurses were found to be less knowledgeable than physicians, dentists, and pharmacists. The main barrier for not reporting ADRs was difficulty to understand whether an adverse event occurred (n = 187). A total of 2581 ADR reports were reported in Malta. Among HCPs, physicians and dentists reported most ADRs (1060 reports), followed by pharmacists (307 reports) and nurses (257 reports). CONCLUSION Further ADR educational and promotional efforts are needed to increase awareness on the importance of quality ADR reporting and increase the number of ADR reports reported by local HCPs.
Collapse
Affiliation(s)
- Elisa Curtolo
- Medicines Authority, Sir Temi Żammit Buildings, Malta Life Sciences Park, San Ġwann, Malta
| | - Benjamin Micallef
- Medicines Authority, Sir Temi Żammit Buildings, Malta Life Sciences Park, San Ġwann, Malta
| | | | - Anthony Serracino-Inglott
- Medicines Authority, Sir Temi Żammit Buildings, Malta Life Sciences Park, San Ġwann, Malta
- Department of Pharmacy, University of Malta, Msida, Malta
| | - John-Joseph Borg
- Medicines Authority, Sir Temi Żammit Buildings, Malta Life Sciences Park, San Ġwann, Malta
- Department of Biology, School of Pharmacy, University of Tor Vergata, Rome, Italy
| |
Collapse
|
2
|
Hayek A, Sridhar SB, Rabbani SA, Shareef J, Wadhwa T. Exploring pharmacovigilance practices and knowledge among healthcare professionals: A cross-sectional multicenter study. SAGE Open Med 2024; 12:20503121241249908. [PMID: 38725923 PMCID: PMC11080773 DOI: 10.1177/20503121241249908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/10/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction Healthcare professionals' awareness of adverse drug reaction reporting and pharmacovigilance practices differ by country. The study assesses healthcare professionals' knowledge, practice, and potential barriers to pharmacovigilance-related practices and reporting adverse drug reaction. Methods A cross-sectional investigation was conducted in government and private healthcare settings. The study included licensed physicians, pharmacists, and nurses. To examine knowledge, practice, and potential barriers to pharmacovigilance-related practices and adverse drug reaction reporting, a 22-item validated questionnaire was used. Results The final analysis included 311 healthcare professionals. Most healthcare professionals, 59% (N = 182), mentioned encountering patients with adverse drug reactions during the last year. On the other hand, most healthcare professionals, 54% (n = 167), mentioned that they had not reported adverse drug reactions. A good proportion of respondents mentioned that it is essential to report adverse drug reactions (N = 288, 92.6%), availability of adverse drug reactions reporting forms in practice sites (N = 216, 69.5%), had awareness regarding how to report adverse drug reactions (N = 221, 71.1%), the necessity of reporting minor/less important adverse drug reactions (N = 265, 85.2%), and were trained on how to report adverse drug reactions (N = 201, 64.6%). Adverse drug reaction reporting program in the United Arab Emirates (N = 148, 47.6) was known to many healthcare professionals. Lack of time was the major impediment to reporting adverse drug reactions at 42.7% (N = 133). The predictor variable work experience does add to the model (p < 0.05) concerning association with filling of adverse drug reaction forms (Estimate = 0.380; SE = 0.452; p = 0.400), professional role (Estimate = 0.454; SE = 0.673; p = 0.500). In addition, the predictor variable practice setting adds to the model (p < 0.05) concerning the knowledge regarding the availability of adverse drug reaction reporting forms (Estimate = -1.229; SE = 0.298; p = 0.000), training on how to report adverse drug reactions (Estimate = -0.660; SE = 0.294; p = 0.025), and awareness regarding the adverse drug reaction reporting program in the United Arab Emirates (Estimate = -1.032; SE = 0.280; p = 0.000). Conclusion Pharmacists had the most knowledge regarding adverse drug reaction reporting and pharmacovigilance. The underreporting of adverse drug reactions was documented among physicians and nurses. Lack of time was the most significant barrier to reporting adverse drug reactions, followed by uncertainty and complicated adverse drug reaction documentation forms.
Collapse
Affiliation(s)
- Abdulkader Hayek
- Department of Clinical Pharmacy and Pharmacology, RAK College of Pharmacy, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
| | - Sathvik B Sridhar
- Department of Clinical Pharmacy and Pharmacology, RAK College of Pharmacy, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
| | - Syed Arman Rabbani
- Department of Clinical Pharmacy and Pharmacology, RAK College of Pharmacy, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
| | - Javed Shareef
- Department of Clinical Pharmacy and Pharmacology, RAK College of Pharmacy, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
| | - Tarun Wadhwa
- Department of Clinical Pharmacy and Pharmacology, RAK College of Pharmacy, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
| |
Collapse
|
3
|
Sorbara EE, Barbieri MA, Russo G, Cicala G, Spina E. Cardiovascular Adverse Drug Reactions of Anti-Calcitonin Gene-Related Peptide Monoclonal Antibodies for Migraine Prevention: An Analysis from the European Spontaneous Adverse Event Reporting System. BioDrugs 2024; 38:275-285. [PMID: 38402495 DOI: 10.1007/s40259-024-00651-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 02/26/2024]
Abstract
INTRODUCTION Anti-calcitonin gene-related peptide monoclonal antibodies (anti-CGRP-mAbs) have recently been approved for the prevention of migraine, and their safety profile is not fully characterized. OBJECTIVE The aim of this study was to evaluate the adverse drug reactions (ADRs) of anti-CGRP-mAbs through the analysis of individual case safety reports (ICSRs) collected in the EudraVigilance (EV) database, with a specific focus on cardiovascular (CV) ADRs. METHODS Data on ICSRs recorded between July 2018 and December 2022 in the EV database, involving one of the anti-CGRP-mAbs for migraine prevention-erenumab (ERE), galcanezumab (GMB), fremanezumab (FMB), and eptinezumab (EPT)-were included in the analysis. All ICSRs reporting at least one CV ADR, as identified within the MedDRA® System Organ Classes (SOCs) "cardiac disorders" or "vascular disorders," were selected for the analysis. The frequency of disproportionate reporting was expressed as the reporting odds ratio (ROR) with its 95% confidence interval (CI), to evaluate the frequency of reporting of CV ADRs for each anti-CGRP-mAb compared with all other monoclonal antibodies (mAbs). A case-by-case analysis was conducted paying particular attention to serious CV ADR reports, focusing on the type of seriousness, age group, sex, and concomitant drugs. RESULTS A total of 9441 ICSRs were recorded in the EV database from 2018 to 2022, of which more than half were related to ERE (58.9%), followed by GMB (21.4%), FMB (19.0%), and EPT (0.7%). CV ICSRs accounted for 1205 cases (12.8%), with a total of 1599 CV ADRs. The CV ICSRs were mainly related to female patients (82.6%) aged 18-64 years (73.4%). Of the reported CV ADRs, 67.5% were considered serious. Among the total number of ICSRs related to each anti-CGRP-mAb, those associated with FMB had a higher percentage of CV ADRs (n = 253; 14.1%), followed by ERE (n = 707; 12.7%), EPT (n = 8; 12.7%), and GMB (n = 237; 11.7%). A higher frequency of reporting hypertension was shown for ERE (ROR = 1.45; 95% CI = 1.14-1.85). Pallor was mainly observed with FMB (5.00; 1.68-14.89), as well as deep vein thrombosis (3.86; 1.57-9.51), hot flush (2.16; 1.43-3.25), and palpitations (1.48; 1.05-2.08). Atrial fibrillation (2.36; 1.02-5.46) and myocardial infarction (2.21; 1.37-3.58) were mostly reported for GMB. CONCLUSION The analysis of anti-CGRP-related CV ADRs was consistent with the information reported in the literature. However, hypertension with ERE, atrial fibrillation and myocardial infarction with GMB, as well as pallor, deep vein thrombosis, hot flush, and palpitations with FMB were not reported in the Summary of Product Characteristics (SmPCs). Considering this, more post-marketing analyses are needed to improve knowledge on the CV safety profiles of anti-CGRP-mAbs, especially for the last approved medication, EPT.
Collapse
Affiliation(s)
- Emanuela Elisa Sorbara
- Department of Clinical and Experimental Medicine, University of Messina, 98125, Messina, Italy
| | | | - Giulia Russo
- Department of Clinical and Experimental Medicine, University of Messina, 98125, Messina, Italy
| | - Giuseppe Cicala
- Department of Clinical and Experimental Medicine, University of Messina, 98125, Messina, Italy
| | - Edoardo Spina
- Department of Clinical and Experimental Medicine, University of Messina, 98125, Messina, Italy.
| |
Collapse
|
4
|
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 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.
Collapse
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
| |
Collapse
|
5
|
Christ P, Dubrall D, Schmid M, Sachs B. Comparative Analysis of Information Provided in German Adverse Drug Reaction Reports Sent by Physicians, Pharmacists and Consumers. Drug Saf 2023; 46:1363-1379. [PMID: 37987966 PMCID: PMC10684666 DOI: 10.1007/s40264-023-01355-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION Adverse drug reactions (ADRs) can be reported by Health Care Professionals (HCPs; e.g., physicians, pharmacists) and non-Health Care Professionals (non-HCPs; e.g., consumers). Previous studies investigating differences between reports from HCPs and non-HCPs rarely considered the completeness of information provided. In addition, they mostly did not distinguish between physicians and pharmacists or were performed years ago. The aim of our study was to analyse and compare the completeness of information provided in reports from physicians, pharmacists and consumers from Germany in a more recent dataset. MATERIALS AND METHODS We analysed all spontaneous reports from Germany received between 2018 and 2021 in the ADR database EudraVigilance exclusively reported by physicians (n = 69,976), pharmacists (n = 42,396) or consumers (n = 121,144). Demographical parameters of the patients were analysed descriptively. Completeness of reports was evaluated applying an established score (vigiGrade). Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using logistic regression analysis in order to identify report, patient, drug or ADR-specific information provided more often in reports from physicians, pharmacists or consumers. RESULTS Within the study period the number of reports per year by physicians and pharmacists decreased steadily, while an opposite trend was observed for consumer reports. The proportion of female patients was higher in reports from pharmacists (64.4%) and consumers (64.8%) compared to those from physicians (55.3%). On average, patients in reports from pharmacists (58.7) were older compared to those from physicians (53.5) and consumers (52.6). As an example for the presence of specific information, the time to onset of the ADR could be calculated more often in consumer compared to physician (OR 1.9 [1.8-1.9]) and pharmacist reports (OR 1.7 [1.6-1.7]). In contrast, pharmacist (OR 0.5 [0.4-0.5]) and consumer (OR 0.5 [0.5-0.5]) reports included the indication of the suspected drug less often than physician reports. Physician reports on average (mean = 0.5) were slightly more complete according to the vigiGrade score compared to reports from consumers (mean = 0.4) and pharmacists (mean = 0.4). CONCLUSION The ADR reports from consumers were comparable with regard to the completeness score with those from physicians and pharmacists underlining their value. Differences in completeness of specific information between the reporter types were found, suggesting that a common reporting of interactions between the three reporters may further improve the completeness of ADR reports. Furthermore, stratified analysis of ADR reports per reporter type may be helpful for certain objectives in scientific research.
Collapse
Affiliation(s)
- Patrick Christ
- Research Division, Federal Institute for Drugs and Medical Devices, Bonn, Germany
- Institute for Medical Biometry, Informatics and Epidemiology, University Hospital of Bonn, Bonn, Germany
| | - Diana Dubrall
- Research Division, Federal Institute for Drugs and Medical Devices, Bonn, Germany
- Institute for Medical Biometry, Informatics and Epidemiology, University Hospital of Bonn, Bonn, Germany
| | - Matthias Schmid
- Institute for Medical Biometry, Informatics and Epidemiology, University Hospital of Bonn, Bonn, Germany
| | - Bernhardt Sachs
- Research Division, Federal Institute for Drugs and Medical Devices, Bonn, Germany.
- Department for Dermatology and Allergy, University Hospital RWTH Aachen, Aachen, Germany.
| |
Collapse
|
6
|
Gustafsson M, Matos C, Joaquim J, Scholl J, van Hunsel F. Adverse Drug Reactions to Opioids: A Study in a National Pharmacovigilance Database. Drug Saf 2023; 46:1133-1148. [PMID: 37824028 DOI: 10.1007/s40264-023-01351-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION Opioids are commonly used as analgesics; however, like any medicine, they can produce adverse drug reactions (ADRs), including nausea, constipation, dependence, and respiratory depression, that result in harmful and fatal events. Therefore, it is essential to monitor the safety of these drugs in clinical practice. OBJECTIVE This study aimed to characterize the safety profile of opioids by conducting a descriptive study based on a spontaneous reporting system (SRS) for ADRs in The Netherlands, focusing on abuse, misuse, medication errors, and differences between sexes. METHODS Reports submitted to the Netherlands Pharmacovigilance Centre Lareb from January 2003 to December 2021 with an opioid drug as the suspected/interacting medicine were analyzed. Reporting odds ratios (RORs) for drug-ADR combinations were calculated, analyzed, and corrected for sex and drug utilization (expenditure) for the Dutch population. RESULTS A total of 8769 reports were analyzed. Tramadol was the opioid with the most reports during the period (n = 2746), while oxycodone or tramadol had the highest number of reports per year in the study period. The most reported ADRs from opioid use were nausea, followed by dizziness and vomiting, independent of sex, and all of them were more often reported in women. Vomiting associated with tramadol (ROR females/males = 2.17) was significantly higher in women. Buprenorphine was responsible for most ADRs when corrected for expenditure, with high RORs observed with application site hypersensitivity, application site reaction, and application site rash. Fentanyl gave rise to most of the reports of ADRs concerning abuse, misuse, and medication errors. CONCLUSION Patients treated with opioids experienced ADRs, primarily nausea, dizziness, and vomiting. For those groups of drugs, no significant differences were found between the sexes, except for the vomiting associated with tramadol. In general, ADRs related to opioids presented higher RORs when uncorrected and corrected for sexes and expenditure than other drugs. There was more disproportionate reporting for ADRs concerning abuse, misuse, and medication errors for opioids than other drugs in the Dutch SRS.
Collapse
Affiliation(s)
- Moa Gustafsson
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Polytechnic Institute of Coimbra, Coimbra Health School, Coimbra, Portugal.
| | - Cristiano Matos
- Polytechnic Institute of Coimbra, Coimbra Health School, Coimbra, Portugal
| | - João Joaquim
- Polytechnic Institute of Coimbra, Coimbra Health School, Coimbra, Portugal
| | - Joep Scholl
- Netherlands Pharmacovigilance Centre Lareb, MH's-Hertogenbosch, The Netherlands
| | - Florence van Hunsel
- Netherlands Pharmacovigilance Centre Lareb, MH's-Hertogenbosch, The Netherlands
| |
Collapse
|
7
|
Rafaniello C, Liguori V, Zinzi A, Gaio M, Falco A, Di Costanzo L, Gargano F, Trimarco V, Cataldi M, Capuano A. A Pharmacovigilance Study on the Safety of Axicabtagene Ciloleucel Based on Spontaneous Reports from the EudraVigilance Database. Biomedicines 2023; 11:2162. [PMID: 37626659 PMCID: PMC10452324 DOI: 10.3390/biomedicines11082162] [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: 07/06/2023] [Revised: 07/27/2023] [Accepted: 07/29/2023] [Indexed: 08/27/2023] Open
Abstract
During pre-approval clinical trials, the safety of axi-cel, a second-generation CAR-T-cell therapy directed against CD19, which dramatically improved the prognosis of intractable B-cell lymphomas, has been investigated only in about 400 patients. Therefore, additional information on this issue is urgently needed. In the present paper, we evaluated the 2905 ICSRs with axi-cel as the suspected drug that had been uploaded in the EudraVigilance database from 1 January 2018 to 31 December 2022. About 80% of the reported adverse events were serious, and about 20% of them did not fully resolve or caused death. The adverse events most-frequently reported were Nervous system disorders (25.6%) and, among them, immune-effector-cell-associated neurotoxicity syndrome, followed by Immune system disorders (23.1%), General disorders and administration site conditions (12.0%), Blood and lymphatic system disorders (7.2%), and Infections and infestations (5.8%). Disproportionality analysis showed that the frequency of reported adverse events related to the nervous system was higher with axi-cel than with the other approved CAR-T-cells, except brexu-cel. In conclusion, real-world pharmacovigilance data showed that nervous system and immune system disorders are the adverse events most reported in axi-cel-related ICSRs and suggest that axi-cel could be more neurotoxic than other CAR-T-cells.
Collapse
Affiliation(s)
- Concetta Rafaniello
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy; (C.R.); (V.L.); (A.Z.); (M.G.); (A.F.)
- Section of Pharmacology “L. Donatelli”, Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Valerio Liguori
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy; (C.R.); (V.L.); (A.Z.); (M.G.); (A.F.)
- Section of Pharmacology “L. Donatelli”, Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Alessia Zinzi
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy; (C.R.); (V.L.); (A.Z.); (M.G.); (A.F.)
- Section of Pharmacology “L. Donatelli”, Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Mario Gaio
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy; (C.R.); (V.L.); (A.Z.); (M.G.); (A.F.)
- Section of Pharmacology “L. Donatelli”, Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Angela Falco
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy; (C.R.); (V.L.); (A.Z.); (M.G.); (A.F.)
- Section of Pharmacology, Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy;
| | - Luigi Di Costanzo
- Section of Pharmacology “L. Donatelli”, Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Francesca Gargano
- Department of Anesthesia and Resuscitation, Biomedical Campus University of Rome, 00128 Rome, Italy;
| | - Valentina Trimarco
- Section of Pharmacology, Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy;
| | - Mauro Cataldi
- Section of Pharmacology, Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy;
| | - Annalisa Capuano
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy; (C.R.); (V.L.); (A.Z.); (M.G.); (A.F.)
- Section of Pharmacology “L. Donatelli”, Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| |
Collapse
|
8
|
Velișcu EM, Liguori V, Anatriello A, Maniscalco GT, Cantone A, Di Costanzo L, Stefanelli P, Scavone C, Capuano A. Hepatobiliary Adverse Reactions during Treatment with Cladribine: Analysis of Data from the European Spontaneous Reporting System. Pharmaceuticals (Basel) 2023; 16:1071. [PMID: 37630986 PMCID: PMC10459297 DOI: 10.3390/ph16081071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/23/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Cladribine belongs to the group of disease-modifying therapies (DMTs) used to treat multiple sclerosis (MS). According to the highlights of a meeting held by the Pharmacovigilance Risk Assessment Committee (PRAC) on 14 January 2022, cladribine may be associated with the occurrence of liver injury, and thus liver function monitoring is recommended. OBJECTIVES AND METHODS Using data from the European spontaneous reporting database (EudraVigilance-EV), we aimed to describe the main characteristics of Individual Case Safety Reports (ICSRs) reporting cases of hepatobiliary disorders related to cladribine. The reporting odds ratio (ROR) was calculated to provide the probability of reporting hepatobiliary ICSRs among DMTs used to treat MS. RESULTS Overall, 118 ICSRs described the occurrence of cladribine-induced hepatobiliary ADRs. The majority of the ICSRs reported ADRs that were classified as serious (93%), and the outcome was mostly reported as "unknown" (50.8%). The most reported hepatobiliary disorders were drug-induced liver injury, abnormal hepatic function, ALT increases, liver disorders, hepatic failure, jaundice, lymphocyte count decreases, hepatotoxicity and hypertransaminasemia. The majority of cladribine-induced hepatic ADRs occurred in female patients belonging to the age group of 18-65 years. CONCLUSION Considering the seriousness of cladribine-induced hepatic ADRs, a close monitoring of patients receiving this drug is highly recommended. In this context, further pharmacovigilance studies evaluating the hepatic safety profile of cladribine are strongly needed.
Collapse
Affiliation(s)
| | - Valerio Liguori
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.L.); (A.C.); (L.D.C.); (A.C.)
- Regional Center of Pharmacovigilance and Pharmacoepidemiology of Campania Region, 80138 Naples, Italy
| | - Antonietta Anatriello
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.L.); (A.C.); (L.D.C.); (A.C.)
- Regional Center of Pharmacovigilance and Pharmacoepidemiology of Campania Region, 80138 Naples, Italy
| | - Giorgia Teresa Maniscalco
- Multiple Sclerosis Regional Center, “A. Cardarelli” Hospital, 80131 Naples, Italy
- Neurological Clinic and Stroke Unit, “A. Cardarelli” Hospital, 80131 Naples, Italy
| | - Andrea Cantone
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.L.); (A.C.); (L.D.C.); (A.C.)
- Regional Center of Pharmacovigilance and Pharmacoepidemiology of Campania Region, 80138 Naples, Italy
| | - Luigi Di Costanzo
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.L.); (A.C.); (L.D.C.); (A.C.)
| | - Pasquale Stefanelli
- Dipartimento Farmaceutico, UOC Farmaceutica Convenzionata e Territoriale, ASL Napoli 1 Centro, 80131 Naples, Italy;
| | - Cristina Scavone
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.L.); (A.C.); (L.D.C.); (A.C.)
- Regional Center of Pharmacovigilance and Pharmacoepidemiology of Campania Region, 80138 Naples, Italy
| | - Annalisa Capuano
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (V.L.); (A.C.); (L.D.C.); (A.C.)
- Regional Center of Pharmacovigilance and Pharmacoepidemiology of Campania Region, 80138 Naples, Italy
| |
Collapse
|
9
|
Aydin OC, Aydin S, Guney HZ. Defining the awareness and attitude of the clinicians through pharmacovigilance in Turkey. World J Clin Cases 2023; 11:4861-4869. [DOI: 10.12998/wjcc.v11.i20.4861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/01/2023] [Accepted: 06/09/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Pharmacovigilance (PV) is the activities and scientific studies conducted to detect, evaluate, understand or prevent adverse reactions and other drug-related problems.
AIM To define the awareness and experiences of the clinicians on PV and adverse drug reactions (ADRs) in Turkey.
METHODS The study was cross-sectional and analytical. Data were obtained through a questionnaire. The questionnaire was sent via e-mail. The survey was sent to 2030 physicians and 670 participated.
RESULTS The most appropriate definition of PV was correctly defined by 53.9% of the participants. The most important goal of PV was correctly defined by 54.9% of the participants, and 27.3% of the participants were aware of the Turkish Pharmacovigilance Center. Nonsurgical physicians had better PV knowledge than surgical physicians. A total of 80.9% of the physicians who encountered ADRs, filled in the ADR notification form, and 8.8% received training on how to fill in the form. PV knowledge of the clinicians was not sufficient. Although half of the physicians encountered ADRs, the rates of seeing and filling in the ADR form were low.
CONCLUSION Few of the physicians followed the current information about PV. The results provide more comprehensive data on PV practices and ADR reporting at a national level.
Collapse
Affiliation(s)
- Ozlem Celik Aydin
- Department of Medical Pharmacology, Gazi University Faculty of Medicine, Ankara 06500, Turkey
| | - Sonay Aydin
- Department of Medical Pharmacology, Gazi University Faculty of Medicine, Ankara 06500, Turkey
| | - Hakkı Zafer Guney
- Department of Medical Pharmacology, Gazi University Faculty of Medicine, Ankara 06500, Turkey
| |
Collapse
|
10
|
Aydin OC, Aydin S, Guney HZ. Defining the awareness and attitude of the clinicians through pharmacovigilance in Turkey. World J Clin Cases 2023; 11:4865-4873. [PMID: 37583988 PMCID: PMC10424053 DOI: 10.12998/wjcc.v11.i20.4865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/01/2023] [Accepted: 06/09/2023] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND Pharmacovigilance (PV) is the activities and scientific studies conducted to detect, evaluate, understand or prevent adverse reactions and other drug-related problems. AIM To define the awareness and experiences of the clinicians on PV and adverse drug reactions (ADRs) in Turkey. METHODS The study was cross-sectional and analytical. Data were obtained through a questionnaire. The questionnaire was sent via e-mail. The survey was sent to 2030 physicians and 670 participated. RESULTS The most appropriate definition of PV was correctly defined by 53.9% of the participants. The most important goal of PV was correctly defined by 54.9% of the participants, and 27.3% of the participants were aware of the Turkish Pharmacovigilance Center. Nonsurgical physicians had better PV knowledge than surgical physicians. A total of 80.9% of the physicians who encountered ADRs, filled in the ADR notification form, and 8.8% received training on how to fill in the form. PV knowledge of the clinicians was not sufficient. Although half of the physicians encountered ADRs, the rates of seeing and filling in the ADR form were low. CONCLUSION Few of the physicians followed the current information about PV. The results provide more comprehensive data on PV practices and ADR reporting at a national level.
Collapse
Affiliation(s)
- Ozlem Celik Aydin
- Department of Medical Pharmacology, Gazi University Faculty of Medicine, Ankara 06500, Turkey
| | - Sonay Aydin
- Department of Medical Pharmacology, Gazi University Faculty of Medicine, Ankara 06500, Turkey
| | - Hakkı Zafer Guney
- Department of Medical Pharmacology, Gazi University Faculty of Medicine, Ankara 06500, Turkey
| |
Collapse
|
11
|
Sakr F, Akel M, Sacre H, Haddad C, Tawil S, Safwan J, Hajj A, Zeenny RM, Iskandar K, Salameh P. The specialized competency framework for community pharmacists (SCF-CP) in Lebanon: validation and evaluation of the revised version. J Pharm Policy Pract 2023; 16:77. [PMID: 37344915 DOI: 10.1186/s40545-023-00585-6] [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: 03/21/2023] [Accepted: 06/13/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND In the absence of similar studies in Lebanon, this study aimed at upgrading and validating the Lebanese specialized competencies framework for community pharmacists (SCF-CP) as a tool to transform community practice and support the professional development and career progression of community pharmacists. METHODS Content validity was assessed and improved through a team of experts. After a thorough literature review and utilizing the Delphi technique, six domains were defined in the framework, with their respective competencies and behaviors. A cross-sectional study was then carried out from March to October 2022 using an online questionnaire created on Google Forms. The snowball technique was applied to reach community pharmacists across all the Lebanese governorates. RESULTS The final sample included 512 community pharmacists. The construct validity of the framework was confirmed by factor analysis. The Kaiser-Meyer-Olkin measures of sampling adequacy were satisfactory for all models ranging from 0.500 to 0.956 with a significant Bartlett's test of sphericity (P < 0.001). The internal consistency of all competency domains was confirmed by Cronbach's alpha, with values ranging from 0.803 to 0.953. All competencies were significantly correlated with their respective domains (P < 0.001), and all domains were significantly correlated with each other and with the framework (P < 0.001). The participants declared being competent in all domains relating to fundamental skills, safe and rational use of medicines, pharmacy management, professional skills, public health fundamentals, and emergency preparedness and response, with some exceptions, such as compounding, management, and emergency preparedness. A higher declared competency level was associated with having more experience and receiving more than 50 patients per day. CONCLUSION Our findings could demonstrate that the Lebanese specialized competency framework is a valid and reliable tool. This framework could help assess the minimum competencies that community pharmacists should possess or acquire and direct initial and continuing education for better practice. Hence, it could be adopted by the authorities and implemented in the Lebanese community pharmacy setting.
Collapse
Affiliation(s)
- Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut, Lebanon.
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon.
| | - Marwan Akel
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
- School of Education, Lebanese International University, Beirut, Lebanon
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
| | - Chadia Haddad
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- School of Health Sciences, Modern University of Business and Science, Beirut, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal El Dib, Lebanon
| | - Samah Tawil
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Jihan Safwan
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
| | - Aline Hajj
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
- Laboratoire de Pharmacologie, Faculty of Pharmacy, Pharmacie Clinique et Contrôle de Qualité Des Médicament (LPCQM), Saint Joseph University of Beirut, Beirut, Lebanon
- Faculté de Pharmacie, Université Laval, Québec, Canada
- Oncology Division, CHU de Québec Université Laval Research Center, Québec, Canada
| | - Rony M Zeenny
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
- Department of Pharmacy, American University of Beirut Medical Center, Beirut, Lebanon
| | - Katia Iskandar
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique Et de Toxicologie-Liban), Beirut, Lebanon
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- University of Nicosia Medical School, Nicosia, Cyprus
| |
Collapse
|
12
|
Alqahtani SS, Ahmad S, Alam N, Kashan Syed N, Syed MH, Khardali A, Yasmeen A, Alshahrani AM, I Alzarea A, Alanazi AS, Hassan Elnaem M. Healthcare professionals' awareness, attitudes and practices towards pharmacovigilance and spontaneous adverse drug reaction reporting in Jazan Province, Saudi Arabia: A survey study. Saudi Pharm J 2023; 31:979-988. [PMID: 37234340 PMCID: PMC10205759 DOI: 10.1016/j.jsps.2023.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 04/19/2023] [Indexed: 05/27/2023] Open
Abstract
Background Globally, adverse drug reactions (ADRs) are the foremost cause of morbidity as well as mortality. This necessitates a system of surveillance that can effectively and efficiently monitor the effect of drugs on the general population. The role of pharmacovigilance (PV) is paramount in ensuring drug safety through spontaneous ADR reporting. Methods Data collection in the current research was carried out by an anonymous, online 36-item self-report questionnaire amongst a sample of 351 working healthcare professionals (HCPs) across different regions of Jazan Province, Kingdom of Saudi Arabia (KSA). The current sample comprised 54.4% males and 45.6% females, having an age range of 26-57 years, and was conducted between August 21 and October 21, 2022. Participants were recruited using the convenience snowball sampling technique. Results The participants' awareness of PV as well as spontaneous ADR reporting, had a significant association with having <40 years of age (χ2 = 27.40; p < 0.001), being pharmacists (χ2 = 212.20; p < 0.001), with more than five years of experience (χ2 = 40.80; p < 0.001), having Masters (or) Doctorate/Fellowship (χ2 = 171.94; p < 0.001), and having their practice located in an urban area (χ2 = 50.30; p < 0.001). It was also observed that most participants with excellent awareness of PV and spontaneous ADR reporting also demonstrated excellent attitudes (χ2 = 147.70; p < 0.001). Similarly, it was also seen that almost all (97%) of the study sample with excellent attitudes towards PV and spontaneous ADR reporting also demonstrated excellent practices (χ2 = 250.73; p < 0.001). Conclusion Our results demonstrate a need for designing and conducting educational programs, providing training and conducting workshops for all the HCPs to improve their awareness towards PV and spontaneous ADR reporting while also highlighting the need and importance of having positive attitudes towards spontaneous ADR reporting. Cooperation between different HCPs should be encouraged to improve their practices towards spontaneous ADR reporting.
Collapse
Affiliation(s)
- Saad S. Alqahtani
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Sarfaraz Ahmad
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Nawazish Alam
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Nabeel Kashan Syed
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Mamoon H. Syed
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Amani Khardali
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Ayesha Yasmeen
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
- Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Ali M. Alshahrani
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Abdulaziz I Alzarea
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University Sakaka, Saudi Arabia
| | - Abdullah S. Alanazi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University Sakaka, Saudi Arabia
| | - Mohamed Hassan Elnaem
- School of Pharmacy and Pharmaceutical Sciences, Ulster University, Coleraine, BT52, ISA, United Kingdom
| |
Collapse
|
13
|
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 2023:10.1007/s11096-023-01591-z. [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] [Grants] [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.
Collapse
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.
| |
Collapse
|
14
|
Khan Z, Karatas Y, Hamid SM. Evaluation of health care professionals' knowledge, attitudes, practices and barriers to pharmacovigilance and adverse drug reaction reporting: A cross-sectional multicentral study. PLoS One 2023; 18:e0285811. [PMID: 37224133 DOI: 10.1371/journal.pone.0285811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/29/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Healthcare professionals' involvement and reporting of adverse drug reactions are essential for the success of a pharmacovigilance program. The aim of this study was to assess healthcare professionals (medical doctors, pharmacists, nurses, dentists, midwives, and paramedics) current knowledge, attitude, practices, and barriers regarding pharmacovigilance and adverse drug reactions reporting in multicentral healthcare settings. METHODS A cross-sectional face-to-face survey was conducted among currently working healthcare professionals in various hospitals in ten districts of Adana province, Türkiye from March to October 2022. A self-administered, pretested questionnaire (Cronbach's alpha = 0.894 for knowledge, attitudes and practices variables) was used for data collection. The questionnaire's final draft included five sections (sociodemographic/general information, knowledge, attitude, practices, and barriers) with 58 questions. The collected data was analyzed in SPSS (version 25) using descriptive statistics, the chi-square test, and logistic regression. RESULTS Of the total 435 distributed questionnaires, 412 completed the entire questionnaire, yielding a 94% response rate. The majority of healthcare professionals (60.4%; n = 249) had never received pharmacovigilance training. Among healthcare professionals 51.9% (n = 214), 71.1% (n = 293) and 92.5% (n = 381) had poor knowledge, positive attitudes and poor practices, respectively. Only 32.5% of healthcare professionals kept the record of an adverse drug reaction and only 13.1% reported adverse drug reactions. The profession (medical doctors, pharmacists, nurses, dentists, midwives, and paramedics) of healthcare professionals and a lack of training were predictors of poor adverse drug reaction reporting (p < 0.05). A statistically significant difference in healthcare professionals and knowledge, attitude and practices scores was also observed (p < 0.05). The main barriers which were supposed to discourage adverse drug reactions reporting by the healthcare professionals were higher workload (63.8%) followed by thinking that a single adverse drug reaction report makes no impact (63.6%) and lack of a professional atmosphere (51.9%). CONCLUSION In the current study, most healthcare professionals had poor knowledge and practice, but they had a positive attitude toward pharmacovigilance and adverse drug reactions reporting. Barriers to under-reporting of adverse drug reactions were also highlighted. Periodic training programs, educational interventions, systematic follow-up of healthcare professionals by local healthcare authorities, interprofessional links between all healthcare professionals, and the implementation of mandatory reporting policies are critical for improving healthcare professionals knowledge, practices, patient safety and pharmacovigilance activities.
Collapse
Affiliation(s)
- Zakir Khan
- Department of Medical Pharmacology, Faculty of Medicines, Çukurova University, Adana, Türkiye
| | - Yusuf Karatas
- Department of Medical Pharmacology, Faculty of Medicines, Çukurova University, Adana, Türkiye
- Faculty of Medicines, Balcali Hospital, Adana, Türkiye
| | - Syed Muhammad Hamid
- Department of Community Medicine, Khyber Medical College, Peshawar, Pakistan
| |
Collapse
|
15
|
Belhekar MN, Dhorajiwala SS, Krishnamurthy B. Impact of educational interventions on pharmacovigilance and adverse drug reaction reporting by resident doctors and faculty members: A prospective comparative study. Perspect Clin Res 2023; 14:32-38. [PMID: 36909212 PMCID: PMC10003584 DOI: 10.4103/picr.picr_198_21] [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: 09/01/2021] [Revised: 10/22/2021] [Accepted: 10/28/2021] [Indexed: 11/04/2022] Open
Abstract
Purpose/Aim Adverse drug reactions (ADRs) are significantly under-reported worldwide. The aim of this study was to assess the impact of educational interventions (EIs) on knowledge, attitude, and practice (KAP) of hospital resident doctors and faculty members and compare ADR reporting in EI (medical specialties) vs. non-EI (surgical specialties) in these two cadres of doctors. Materials and Methods This study was a prospective comparative study conducted in two groups (EI and non-EI) in resident doctors and faculty members working at a tertiary care hospital. EI group (medical specialties) were provided with EI to increase awareness about ADR reporting, whereas in non-EI group (surgical specialties), no EI was provided and they served as control. Respondents were asked to fill a pretest questionnaire followed by interactive EI in EI group and posttest questionnaire in both groups. The impact of EI among respondents was evaluated by their response to questionnaire and number of ADRs reported after intervention. Results Total (n = 202) respondents were enrolled in the study. The number of resident doctors and faculty members in each group were (n = 101 [50%]). Overall, (n = 100 [49.5%]) were from the medical and (n = 102 [50.5%]) from surgical specialty. Post-EI period, there was statistically significant improvement in KAP domains. Conclusion Our study serves as credible evidence that through EI; statistically significant improvement in KAP of resident doctors and faculty members in both medical and surgical specialties toward ADR reporting and existing pharmacovigilance system can be achieved.
Collapse
Affiliation(s)
- Mahesh N. Belhekar
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Shakeeb S. Dhorajiwala
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - B. Krishnamurthy
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
| |
Collapse
|
16
|
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
| |
Collapse
|
17
|
Yawson AA, Abekah-Nkrumah G, Okai GA, Ofori CG. Awareness, knowledge, and attitude toward adverse drug reaction (ADR) reporting among healthcare professionals in Ghana. Ther Adv Drug Saf 2022; 13:20420986221116468. [PMID: 35966898 PMCID: PMC9364224 DOI: 10.1177/20420986221116468] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 06/28/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Spontaneous reporting systems are the commonest means of reporting adverse
drug reactions (ADRs) worldwide. Under-reporting remains a challenge
particularly in developing countries among healthcare professionals (HCPs)
who are considered the primary stakeholders in the reporting of ADRs. The
challenge with studies in countries such as Ghana is that the focus has been
on a single professional group or health facility. This study examines the
rate of reporting as well as awareness, knowledge, and attitudes toward ADR
reporting across professional groups (doctors, nurses, and pharmacist) and
selected health facilities (ownership types: government, quasi-government,
and private; hierarchy: district, regional, and teaching) in Ghana. Method: A cross-sectional survey was conducted to select and interview 424 healthcare
professionals (HCPs) from 8 hospitals in the Greater Accra and Eastern
regions of Ghana on issues of ADR reporting, awareness, knowledge, and
attitudes toward ADR reporting. Valid responses from 378 HCPs were obtained
and analyzed using frequencies and percentages. Findings: The results suggest that about 82.8% of the HCPs interviewed have come across
an ADR incidence, but only 52.6% of them have reported such incidence, with
pharmacist (66.7%) being the most likely to report. The results further
suggest that about 85.8% of HCPs are aware of ADR reporting procedures and
display positive attitudes toward same. In addition, the knowledge of HCPs
on ADR reporting is low with training being a major area of need. Conclusion: There is the need for healthcare managers and the regulator to pay attention
to existing gaps in awareness, attitudes, and most importantly knowledge of
HCPs on structures and modalities for ADR reporting. Plain Language Summary Awareness, knowledge, and attitude toward adverse drug reaction (ADR)
reporting among healthcare professionals in Ghana Reporting of unpleasant reactions related to the use of medicinal products
has been very low in less developed countries. Studies conducted in Ghana to
examine the reporting of unpleasant reactions associated with the use of
medicinal products have focused mainly on one health facility or health care
provider group. This article examines the level of awareness, knowledge, and
attitudes toward the reporting of unpleasant reactions to the use of
medicinal products. The authors used a quantitative method to examine the level of awareness,
knowledge, and attitude toward reporting of unpleasant reactions to
medicinal products. The study was conducted in eight hospitals in Greater
Accra and Eastern regions of Ghana using a structured questionnaire. Only
378 out of 424 healthcare providers returned the completed
questionnaire. The findings of the study show that 213 of the healthcare providers have
encountered at least one patient with an unpleasant reaction to the use of
medicinal products, although only 112 reported the unpleasant reactions.
Pharmacists were found to be more likely to report unpleasant reactions as
12 out of 18 pharmacists who responded to the questionnaire indicated that
they report the unpleasant reactions seen. In addition, 321 of the healthcare providers knew of the reporting procedures
for unpleasant reactions to a medicinal product in Ghana. Only 219
healthcare providers knew of the reporting procedures in the facilities in
which they worked, however. Furthermore, the knowledge of healthcare
providers on the method of reporting is low.
Collapse
Affiliation(s)
- Abena Ahwianfoa Yawson
- Department of Public Administration and Health Services Management, University of Ghana Business School, Accra, Ghana
| | - Gordon Abekah-Nkrumah
- Department of Public Administration and Health Services Management, University of Ghana Business School, P.O Box LG 78, Legon, Accra, Ghana
| | - Grace Adjei Okai
- Department of Public Administration and Health Services Management, University of Ghana Business School, Accra, Ghana
| | | |
Collapse
|
18
|
Loomba AP. Pharmacovigilance in emerging economies: modeling interaction among barriers. JOURNAL OF ADVANCES IN MANAGEMENT RESEARCH 2022. [DOI: 10.1108/jamr-02-2022-0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe main purpose of this paper is to identify and rank various barriers to pharmacovigilance (PV) in context of emerging economies and examine their interrelationships using the interpretive structural modeling (ISM) approach. The result is a model that offers insights about how to achieve rational and safe use of medicines and ensure patient safety as realized through robust national PV systems.Design/methodology/approachThe paper develops a model to analyze the interactions among PV barriers using the ISM approach. Based on input from clinical and medical product development experts, PV barriers in emerging economies were identified and reviewed. The hierarchical interrelationships among these PV barriers were analyzed in context of their driving/dependence powers.FindingsFindings of the study identify key PV barriers—lack of resources/infrastructure, weak legislation, unfair burden of disease, lack of PV capacity, training, and enforcement authority—that drive, or strongly influence, other barriers and thwart implementation of robust national PV systems in emerging economies. Pharmaceutical industry factors were PV barriers that were identified as autonomous, implying their relative disconnection from other barriers, and patient PV practices barrier was strongly dependent on other barriers.Research limitations/implicationsThe paper offers policy- and decision-makers alike with a framework to support further research into interdependencies among key PV barriers in emerging economies. It can serve as an impetus for further research with potential to broadening the understanding of how and why PV systems may be rendered ineffective. Future studies can be planned to apply the ISM approach to study PV barriers in the context of developed economies and draw lessons and implications for policy- and decision-makers by contrasting results from these studies.Practical implicationsThis paper contributes to the understanding of the multifaceted nature of PV and its barriers. The proposed approach gives public health decision-makers a better comprehension of driver PV barriers that have most influence on others versus dependent PV barriers, which are most influenced by others. Also, knowledge, attitude and practices of patients and caregivers can also be critical PV barriers in emerging economies. This information can be instrumental for public health policymakers, government entities, and health/PV practitioners to identify the PV barriers that they should prioritize for improvement and how to manage trade-offs between these barriers.Social implicationsPV barriers in emerging economies, as compared to developed economies, are inherently different and need to be examined in their specific context. The hierarchical ISM model suggests that resources and regulation initiatives by governments in emerging economies lead to through informed/enabled pharmaceutical supply chain players and eventually drive PV-specific knowledge, attitude, and practice outcomes improvements across their populace.Originality/valueThis paper highlights the deployment of ISM approach as a health policy decision support tool in the identifying and ranking barriers to effective PV systems in emerging economies, in terms of their contextual relationships, to achieve a better understanding as to how these interrelationships can affect national PV system outcomes.
Collapse
|
19
|
Contrast Media Adverse Drug Reactions in Highly Polluted Environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127077. [PMID: 35742323 PMCID: PMC9223239 DOI: 10.3390/ijerph19127077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 01/27/2023]
Abstract
Iodinated- (ICM) and gadolinium-based (GCM) contrast media are used in radiology imaging techniques, such as computer tomography (CT) and magnetic resonance (MR), respectively. The paper aims to analyze the adverse drug reactions of ICM and GCM on different sites of the body in a highly polluted environment. We analyzed the pharmacovigilance in contrast media on the basis of reports submitted to the Regional Center for Monitoring of Adverse Drug Reactions (ADR) at the Department of Clinical Pharmacology in Wrocław. Safety profiles were compared between different ICM and GCM and at the system organ level using the proportional reporting ratio (PRR). We analyzed 124 reports of adverse reactions related to contrast agents between 2006 and 2021. Our findings revealed that ADR combinations occurred more frequently after the use of iodinated contrast agents (72.08%) than gadolinium contrast agents (27.92%). Iomeprol and Iopromide were identified as the most frequently reported media. Each medium presented a different safety profile. Skin disorders are the most common adverse drug reactions among patients using both iodine- and gadolinium-based contrast media. Gadolinium-based contrast agents are characterized by similar organ toxicity. Conversely, iodine-based contrast agents are more diverse—some of which show tissue specificity, such as Iodixanol for the gastrointestinal system or Iohexol for the respiratory tract. This study shows relatively high occurrence of respiratory tract related ADRs in Wrocław. We also prove that it is possible to choose the most optimal contrast agent for patients with specific organ site problems to omit the possible complications.
Collapse
|
20
|
Alsheikh MY, Alasmari MM. A National Survey of Community Pharmacists’ Viewpoints About Pharmacovigilance and Adverse Drug Reaction Reporting in Saudi Arabia. Front Pharmacol 2022; 13:819551. [PMID: 35721182 PMCID: PMC9204278 DOI: 10.3389/fphar.2022.819551] [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: 11/21/2021] [Accepted: 04/21/2022] [Indexed: 11/13/2022] Open
Abstract
This study assessed the knowledge, attitudes, and practices of community pharmacists regarding pharmacovigilance and adverse drug reaction (ADR) reporting system in Saudi Arabia. A cross-sectional survey of community pharmacists from different regions in Saudi Arabia was performed through convenience sampling between November 2020 and January 2021. The responses were received from 1,172 community pharmacists. Most respondents (86.7%) were familiar with the National Pharmacovigilance and Drug Safety Center, and 830 (70.8%) knew about the ADR reporting form. The majority (94%) of the respondents agreed with the importance of reporting ADRs for patient care and national health. Although 92.2% of the participants asked their patients about ADRs, 90.2% agreed that more training programs are required to be organized by the Saudi Food and Drug Authority for healthcare professionals on the ADR detection and reporting system. Analgesic agents were the most common drug category for which ADRs were reported (67.4%). The majority (92.1%) of ADRs reportedly occurred in patients with chronic diseases. The study concluded that most community pharmacists in Saudi Arabia are knowledgeable and have good attitudes and practices regarding pharmacovigilance and ADR reporting.
Collapse
Affiliation(s)
- Mona Y. Alsheikh
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Moudi M. Alasmari
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Jeddah, Saudi Arabia
- *Correspondence: Moudi M. Alasmari,
| |
Collapse
|
21
|
Alshabi AM, Shaikh MAK, Shaikh IA, Alkahtani SA, Aljadaan A. Knowledge, attitude and practice of hospital pharmacists towards Pharmacovigilance and adverse drug reaction reporting in Najran, Saudi Arabia. Saudi Pharm J 2022; 30:1018-1026. [PMID: 35903528 PMCID: PMC9315274 DOI: 10.1016/j.jsps.2022.04.014] [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: 11/14/2021] [Accepted: 04/26/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Pharmacovigilance (PV) is critical in determining the risk–benefit ratio of medicines and encouraging their safe, rational, and effective use, hence enhancing patient safety and care. Pharmacists, as drug experts, share responsibility for ensuring that medicines remain safe. Objective The study aimed to assess the knowledge, attitude, and practice of hospital pharmacists towards PV and adverse drug reaction (ADR) reporting and to know factors that discourage them from reporting ADRs in Najran, Saudi Arabia. Methods A pre-tested self-administered questionnaire was distributed to all the pharmacists working in government hospitals who consented to participate in the study. Data was collected over three months, from 01 June 2018 to 31 Aug 2018. Data were analyzed using Statistical Package for Social Science (SPSS) software for Windows, version 23. Descriptive statistics such as frequency and percentages, mean ± standard deviation (SD) were calculated, and the Pearson's Chi-square test was used to examine the relationship between different variables. Results A total of 145 questionnaires were distributed, and the response rate obtained was 70.3%. The definition of PV and ADR were correctly identified by 42% and 68.3% of participants, respectively. A noteworthy finding is that 95% of participants were aware of the existence of the ADR reporting system, and 88.9% knew the responsible regulatory agency. Participants showed a positive attitude towards PV and ADR reporting; 90.1% considered ADR reporting a part of professional obligation, and 94.1% believed that there should be collaboration between pharmacists and other healthcare professionals. A majority of participants (86.1%) had identified an ADR during their practice, and 71.3% had reported an ADR. The unavailability of a professional environment to discuss ADR and insufficient pharmacotherapy/clinical knowledge was cited as the main factors discouraging from reporting ADRs. Conclusions Overall, the pharmacists had an average to good knowledge of and positive attitude towards PV and ADR reporting and a good ADR reporting practice. The concept of PV and ADR reporting should be further strengthened, and there is a vast potential for the same.
Collapse
Affiliation(s)
- Ali Mohamed Alshabi
- Department of Clinical Pharmacy, College of Pharmacy, Najran University, Najran, Saudi Arabia
- Corresponding author.
| | | | - Ibrahim Ahmed Shaikh
- Department of Pharmacology, College of Pharmacy, Najran University, Najran, Saudi Arabia
| | - Saad Ahmed Alkahtani
- Department of Clinical Pharmacy, College of Pharmacy, Najran University, Najran, Saudi Arabia
| | - Adel Aljadaan
- Department of Pharmacology, College of Pharmacy, Najran University, Najran, Saudi Arabia
| |
Collapse
|
22
|
Sharif MJH, Farrukh MJ, Khan FU, Khan Q, Ahmed SS, Kousar R, Ahmad T, Abid SMA, Ashfaq M, Khan SA. Exploring the factors and barriers of healthcare professionals in tertiary care hospitals toward pharmacovigilance: a multicenter study from Khyber Pakhtunkhwa, Pakistan. Curr Med Res Opin 2022; 38:595-605. [PMID: 35166143 DOI: 10.1080/03007995.2022.2042992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Spontaneous Adverse drug reactions (ADRs) reporting is a cornerstone for a successful pharmacovigilance program as under-reporting of ADRs remains a major issue around the globe. The current study aimed to assess the knowledge attitude and practices of health care professionals regarding pharmacovigilance along with barriers and factors to encourage ADR reporting at tertiary care hospitals of Khyber-Pakhtunkhwa, Pakistan. METHODS A questionnaire-based cross-sectional survey was conducted, using the convenience sampling method to collect the data from doctors, nurses, and pharmacists working in seven tertiary care hospitals from seven districts of Khyber-Pakhtunkhwa province, Pakistan, between July 2019 and March 2020. RESULTS During the study, a total of 830 questionnaires were distributed, out of which 669 were returned (response rate 80.6%). Overall, Healthcare professionals exhibited poor knowledge (79.5%) about ADR reporting and pharmacovigilance however, 73.5% of pharmacists were more knowledgeable as compared to 18.7% doctors and 13.8% nurses (p < .001). Moreover, poor reporting practices were displayed by 95.6% doctors, 94.4% nurses, 94.4 and 75.5% pharmacists (p < .001). However, the majority of healthcare professionals showed an overall positive attitude (94%) toward ADR reporting. The most frequently cited barriers were unavailability of reporting forms (92.5%), absence of a professional environment to discuss ADRs (82.5%), and lack of training (81.8%) whereas, most common factors to encourage ADR reporting were obligatory reporting (85.9%) and provision of ADR management guidelines and training (84.3%). A significant relation was found between the healthcare professionals and their professional status with the overall knowledge, attitude, and practice (KAP) scores (p < .001) whereas a medium, positive correlation was found between the knowledge and practice of pharmacovigilance and ADR reporting by the healthcare professionals (r = 0.321, n = 669, p < .001). CONCLUSION There is an overall lack of knowledge and poor reporting practices among health care professionals on ADR reporting and pharmacovigilance. Hence the study suggests that strategies should be devised by all the stakeholders to properly educate and train the healthcare professionals in this area to enhance overall patient safety and safe use of medicines.
Collapse
Affiliation(s)
| | | | - Faiz Ullah Khan
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China
| | - Qasim Khan
- Department of Pharmacy, COMSATS University Islamabad-Abbottabad Campus, Abbottabad, Pakistan
| | - Sardar Shabbir Ahmed
- Secretary Quality Control Board, Focal Person Pharmacovigilance Islamabad, Islamabad, Pakistan
| | - Rozina Kousar
- Department of Pharmacy, Women Institute of Learning, Abbottabad, Pakistan
| | - Tawseef Ahmad
- Department of Pharmacy, COMSATS University Islamabad-Abbottabad Campus, Abbottabad, Pakistan
| | - Syed Mobasher Ali Abid
- Department of Pharmacy, COMSATS University Islamabad-Abbottabad Campus, Abbottabad, Pakistan
| | - Muhammad Ashfaq
- Department of Pharmacy, COMSATS University Islamabad-Abbottabad Campus, Abbottabad, Pakistan
| | - Shujaat Ali Khan
- Department of Pharmacy, COMSATS University Islamabad-Abbottabad Campus, Abbottabad, Pakistan
| |
Collapse
|
23
|
Abdulrasool Z. The Development of a Pharmacovigilance System in Bahrain. Saudi Pharm J 2022; 30:825-841. [PMID: 35812145 PMCID: PMC9257873 DOI: 10.1016/j.jsps.2022.03.009] [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: 11/28/2021] [Accepted: 03/10/2022] [Indexed: 10/31/2022] Open
Abstract
Introduction Aim Objectives Methodology Results
Collapse
|
24
|
Khan Z, Karatas Y, Martins MAP, Jamshed S, Rahman H. Knowledge, attitude, practice and barriers towards pharmacovigilance and adverse drug reactions reporting among healthcare professionals in Turkey: a systematic review. Curr Med Res Opin 2022; 38:145-154. [PMID: 34694167 DOI: 10.1080/03007995.2021.1997287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Globally, pharmacovigilance (PV) is crucial for the patient's safety and proper use of drugs. Spontaneous reporting of adverse drug reaction (ADR) is a professional obligation of every healthcare professionals (HCPs). The purpose of this systematic review was to analyze the existing literature about the knowledge, attitude, and practices (KAP) level of HCPs regarding PV and ADRs reporting in Turkey. METHODS A systematic and comprehensive articles search strategy was carried out in different seven electronic databases (PubMed, PubMed Central, Goggle Scholar, Ovid-SP, MEDLINE, Wiley Online Library, DergiPark) from 2010 to 2020. We searched to identify existing literature about cross-sectional observational studies investigating the KAP of HCPs regarding PV and ADRs reporting in different geographical regions of Turkey. Quality assessment and risk of bias were assessed among included studies. RESULTS Fifteen studies were chosen for full-text analysis. Finally, according to inclusion criteria, seven research articles were selected for systematic review. Overall, the KAP of HCPs varies across the studies. The lack of a standardized validated measuring tool to evaluate the KAP and differences in questionnaire items were the main limitations in included studies. Around, 69.1% (range: 54.6-100%) of HCPs were not aware of the national pharmacovigilance center in Turkey. About, 37.5% (range: 7.1-75.7%) of HCPs believed that reporting of ADRs is not important and 87.5% (range: 69.3-100%) stated that they never reported ADR previously during their practice. The most frequently highlighted barriers to PV were lack of time, uncertainty and did not know where to report. CONCLUSION This systematic review revealed a major KAP gap in Turkey towards PV activities. Low ADR reporting practice of HCPs was a major identified issue. The creation of a mandatory unified PV education intervention for future HCPs to rationally report ADR of drugs are crucial for a better healthcare system.
Collapse
Affiliation(s)
- Zakir Khan
- Institute of Health Science, Faculty of Medicine, Department of Medical Pharmacology, Cukurova University, Adana, Turkey
| | - Yusuf Karatas
- Institute of Health Science, Faculty of Medicine, Department of Medical Pharmacology, Cukurova University, Adana, Turkey
- Pharmacovigilance specialist, Balcalı Hospital, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Maria Auxiliadora Parreiras Martins
- Clinical Pharmacology and Hospital Pharmacy, Department of Pharmaceutical Products, School of Pharmacy, Universidade Federal de Minas Gerais - UFMG, Brazil
| | - Shazia Jamshed
- Clinical Pharmacy and Practice, Faculty of Pharmacy, Universiti Sultan Zainal Abidin, Terengganu, Malaysia
| | - Hazir Rahman
- Department of Microbiology, Faculty of Chemical and Life Sciences, Abdul Wali Khan University Mardan (AWKUM), Mardan, Pakistan
| |
Collapse
|
25
|
Effect of Website-based Learning on Improved Monitoring of Adverse Drug Reactions in Clinical Nurses. Asian Nurs Res (Korean Soc Nurs Sci) 2021; 16:45-51. [PMID: 34973410 DOI: 10.1016/j.anr.2021.12.004] [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: 09/27/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The purpose of this study was to develop website-based learning contents to activate voluntary monitoring and reporting of adverse drug reactions (ADRs) for clinical nurses and to verify their effectiveness. METHOD Using a quasi-experimental control group pretest-posttest design with random allocation, a total of 60 nurses with more than 1 year of clinical experience were recruited from a university hospital in Seoul, Korea. A website was developed that provides learning contents including real cases and the latest drug-related knowledge, as well as video lectures. Knowledge on ADRs monitoring, self-efficacy, ADRs practice behavior, and medication performance ability were measured at 2 weeks after intervention. A small notebook for monitoring ADRs of nurses was given to the control group. Data were analyzed using descriptive statistics, the χ2test, and the independent t-test using SPSS Statistics Software Version 21.0. RESULTS The scores of ADRs monitoring knowledge, self-efficacy, and ADRs monitoring practice in the experimental group significantly increased after the intervention compared with the control group (p<.05). However, there was no significant difference between the two groups in medication performance ability related to ADRs monitoring. CONCLUSION In order to spread a safety culture in which voluntary ADRs monitoring and reporting is activated, it is necessary for clinical nurses to share and communicate ADRs-related information and real cases through an open website.
Collapse
|
26
|
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.
Collapse
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
| |
Collapse
|
27
|
The Safety Profile of General and Local Anaesthetic Agents: Data Collected during 20 Years of Spontaneous Reporting Activities in the Campania Region (Southern Italy). Pharmaceuticals (Basel) 2021; 14:ph14121261. [PMID: 34959662 PMCID: PMC8703922 DOI: 10.3390/ph14121261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 12/19/2022] Open
Abstract
Background: General and local anaesthetics are widely used during surgery. These drugs have peculiar safety profiles, being commonly associated with mild and reversible local adverse drug reactions (ADRs), but also with more severe and systemic ADRs, including respiratory and cardiovascular depression and anaphylaxis. Methods and Objectives: We carried out a descriptive analysis of Individual Case Safety Reports (ICSRs) sent to the Campania Regional Centre of Pharmacovigilance (Southern Italy) from 2001 to 2021 that reported general or local anaesthetics as suspected drugs, with the aim of describing their overall characteristics, focussing on the ADRs’ seriousness and distribution by System Organ Class (SOC) and Preferred Term (PT). Results: A total of 110 ICSRs documenting general or local anaesthetics were sent to the Italian pharmacovigilance database during 20 years of spontaneous reporting activities in the Campania region. ADRs mainly occurred in patients with a median age of 48 years and in a slightly higher percentage of men. ADRs were more commonly classified as not serious and had a favourable outcome. In terms of ADRs’ distribution by SOC and PT, both general and local anaesthetics were associated with general and cutaneous disorders, with common ADRs that included lack of efficacy, rash, and erythema. In addition, general anaesthetics were associated with the occurrence of respiratory ADRs, while local anaesthetics were associated with the occurrence of nervous ADRs. Conclusion: Even though a limited number of ICSRs documenting anaesthetics-induced ADRs were retrieved from the Italian spontaneous reporting database in the Campania region, we believe that the continuous monitoring of these drugs is highly recommended, especially among the frail population.
Collapse
|
28
|
Zhao Z, Shen J, Shen C, Zhu B, Sun J, Yu J, Sun F, Song H. An investigation of pharmacovigilance and reporting of adverse drug reactions in hospitals: a cross-sectional study in China. Curr Med Res Opin 2021; 37:2001-2006. [PMID: 34376068 DOI: 10.1080/03007995.2021.1967114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Pharmacovigilance is a science that plays a significant role in reducing ADRs and helps predict adverse reactions to drugs in community. To safely use drugs in treatment and prevention of disease, adverse drug reaction has been paid more attention. OBJECTIVES To evaluate the future needs of existing systems, the paper investigated the current state of pharmacovigilance and the reporting of ADR in Chinese hospitals. METHODS This cross-sectional, questionnaire-based study involved 10,063 pharmacists, doctors, and nurses from primary, secondary, and tertiary hospitals in all 31 provinces of China. It was commissioned by the National Centre for ADR Monitoring of China and conducted in March 2020. Three areas were assessed: sociodemographic characteristics of participants, awareness of the pharmacovigilance system, and the current state of hospitals' reporting of ADRs. Chi-square tests were used to calculate P values. RESULTS Health care professionals had heard the term "pharmacovigilance" previously (89.40%) and knew the reporting object (68.47%), content (65.94%), and range (64.83%) of pharmacovigilance. Most hospitals dispatched responsible professionals (87.64%) and departments (86.25%) to monitor ADR reporting. A total of 58.66% of tertiary medical, 45.25% of secondary, and 38.90% of primary hospitals extracted ADRs from a hospital information system. Moreover, 53.09% of tertiary medical, 38.93% of secondary, and 23.89% of primary hospitals had established a prescription automatic screening system to warn about risks for ADRs. Health care professionals' reports (99.92%) and patient feedback (77.99%) were included in most hospitals' ADR reporting. CONCLUSIONS Chinese health care professionals generally have good awareness of pharmacovigilance, and pharmacovigilance is relatively more advanced in China compared to other developing countries.
Collapse
Affiliation(s)
- Zhigang Zhao
- Department of Pharmacovigilance, Chinese Society of Toxicology, Beijing, China
- Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jiashu Shen
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Chuanyong Shen
- Department of Pharmacovigilance, National Center for ADR Monitoring, Beijing, China
| | - Bin Zhu
- Department of Pharmacovigilance, Chinese Society of Toxicology, Beijing, China
- Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jun Sun
- Department of Pharmacovigilance, ADR Monitoring Center of Jiangsu Province, Nanjing, China
| | - Jinyang Yu
- Department of Pharmacovigilance, ADR Monitoring Center of Guangdong Province, Guangzhou, China
| | - Feng Sun
- Department of Pharmacovigilance, Chinese Society of Toxicology, Beijing, China
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Haibo Song
- Department of Pharmacovigilance, Chinese Society of Toxicology, Beijing, China
- Department of Pharmacovigilance, National Center for ADR Monitoring, Beijing, China
| |
Collapse
|
29
|
The severity of adverse drug reactions and their influencing factors based on the ADR monitoring center of Henan Province. Sci Rep 2021; 11:20402. [PMID: 34650181 PMCID: PMC8516964 DOI: 10.1038/s41598-021-99908-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/30/2021] [Indexed: 01/11/2023] Open
Abstract
Adverse drug reactions (ADRs) may be a serious public health problem and have received widespread attention in recent years. This study has analyzed the factors leading to the occurrence of serious ADRs (SADRs), determined the factors affecting the prognosis of patients with severe adverse reactions at different levels of medical institutions, and finally made corresponding recommendations for the monitoring, prevention, and treatment of SADRs. We used descriptive analysis and chi-square test to analyze the year, age, gender, proportion of SADRs, and the results of the ADRs in the report. Use the logistic regression to analyze the factors affecting the prognosis of SADRs in different levels of medical institutions. A total of 387 642 people’s 394 037 ADRs were collected from the Henan Provincial Adverse Drug Reaction Monitoring Center from 2016 to 2020. Among them 35 742 cases of serious ADRs (9.1%), 96.1% were eventually relieved or cured, but 39 cases of SADRs caused death. The main causes of death included hemorrhages, organ failure, and allergies. Age, number of medication and illnesses, level of medical institution, history of adverse reactions, and type and method of medication were all factors that affected the severity of ADR. The prognosis of SADRs is worse than normal ADRs. The ADRs in autumn and winter and new adverse reactions are unique risk factors found in this study. The elderly and patients with multiple diseases or taking multiple drugs should pay attention to their adverse reactions. They should be closely observed within a week after taking the medicine. The supervision of patients with a history of allergies and new adverse reactions should be strengthened by primary medical institutions, and in nonprimary medical institutions should paid attention with past medical histories, and use imported drugs and biological agents with caution to ensure the safety and health of patients.
Collapse
|
30
|
Abstract
The advent of biologic disease-modifying antirheumatic drugs targeting specific cytokines or cell-cell interactions has dramatically changed the outlook of patients with juvenile idiopathic arthritis. However, safety concerns remain around the use of therapeutic agents for children with juvenile idiopathic arthritis. Foremost among these are the risks of serious infections and malignancy. This article provides an overview of methodologies for pharmacosurveillance in juvenile idiopathic arthritis, including spontaneous reporting systems and the use of diverse data sources, such as electronic health records, administrative claims, and clinical registries. The risks of infections and malignancies are then briefly reviewed.
Collapse
Affiliation(s)
- Natalie J Shiff
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Room 3250 - East Wing - Health Sciences Boulevard, 104 Clinic Place, Saskatoon, Saskatchewan S7N 2Z4, Canada
| | - Timothy Beukelman
- Department of Pediatrics, Division of Rheumatology, University of Alabama at Birmingham, 1600 7th Avenue South, CPPN G10, Birmingham, AL 35233, USA.
| |
Collapse
|
31
|
Seselja Perisin A, Bukic J, Rusic D, Leskur D, Bozic J, Mihanovic A, Vilovic M, Cohadzic T, Modun D. Teaching Pharmacovigilance to Healthcare Students: Identifying Gaps and Opportunities for Improvement. PHARMACY 2021; 9:147. [PMID: 34449747 PMCID: PMC8396247 DOI: 10.3390/pharmacy9030147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/21/2021] [Accepted: 08/24/2021] [Indexed: 12/03/2022] Open
Abstract
The literature indicates that the limited pharmacovigilance knowledge demonstrated by healthcare professionals is the main reason for the underreporting of adverse drug reactions. Therefore, the main objective of this study was to investigate pharmacy, dental and medical students' knowledge and attitudes to pharmacovigilance and pharmacovigilance education. The cross-sectional questionnaire study was conducted at the University of Split School of Medicine in November 2020. In total, 350 students participated in the study. The results have shown that pharmacy students showed a significantly higher knowledge score compared to dental and medical students (P < 0.001). In total 92.2% of pharmacy, 21.8% of dental and 70.8% of medical students had knowledge of patients' involvement in adverse drug reactions, reporting (P < 0.001). Interestingly, only 44.3% of all students knew that adverse drug reactions could be reported using a mobile application. Moreover, significantly more pharmacy students (74.4%) were aware of the adverse drug reactions monitoring center in Croatia, with 47.5% of dental and 39.2% of medical students correctly identifying it (P < 0.001). The results showed that most students felt that pharmacovigilance was not adequately covered in curricula; therefore, there is a great need to increase the knowledge and awareness of pharmacovigilance among students aspiring to become future healthcare professionals, and improve their reporting practice in clinical future.
Collapse
Affiliation(s)
- Ana Seselja Perisin
- Department of Pharmacy, University of Split School of Medicine, Soltanska 2, 21 000 Split, Croatia; (A.S.P.); (J.B.); (D.R.); (D.L.); (A.M.); (T.C.)
| | - Josipa Bukic
- Department of Pharmacy, University of Split School of Medicine, Soltanska 2, 21 000 Split, Croatia; (A.S.P.); (J.B.); (D.R.); (D.L.); (A.M.); (T.C.)
| | - Doris Rusic
- Department of Pharmacy, University of Split School of Medicine, Soltanska 2, 21 000 Split, Croatia; (A.S.P.); (J.B.); (D.R.); (D.L.); (A.M.); (T.C.)
| | - Dario Leskur
- Department of Pharmacy, University of Split School of Medicine, Soltanska 2, 21 000 Split, Croatia; (A.S.P.); (J.B.); (D.R.); (D.L.); (A.M.); (T.C.)
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, Soltanska 2, 21 000 Split, Croatia; (J.B.); (M.V.)
| | - Ante Mihanovic
- Department of Pharmacy, University of Split School of Medicine, Soltanska 2, 21 000 Split, Croatia; (A.S.P.); (J.B.); (D.R.); (D.L.); (A.M.); (T.C.)
- Split-Dalmatia County Pharmacy, Kneza Ljudevita Posavskog 12 b, 21 000 Split, Croatia
| | - Marino Vilovic
- Department of Pathophysiology, University of Split School of Medicine, Soltanska 2, 21 000 Split, Croatia; (J.B.); (M.V.)
| | - Tin Cohadzic
- Department of Pharmacy, University of Split School of Medicine, Soltanska 2, 21 000 Split, Croatia; (A.S.P.); (J.B.); (D.R.); (D.L.); (A.M.); (T.C.)
| | - Darko Modun
- Department of Pharmacy, University of Split School of Medicine, Soltanska 2, 21 000 Split, Croatia; (A.S.P.); (J.B.); (D.R.); (D.L.); (A.M.); (T.C.)
| |
Collapse
|
32
|
Ramos SF, Alvarez NR, Dos Santos Alcântara T, Sanchez JM, da Costa Lima E, de Lyra Júnior DP. Methods for the detection of adverse drug reactions in hospitalized children: a systematic review. Expert Opin Drug Saf 2021; 20:1225-1236. [PMID: 33926346 DOI: 10.1080/14740338.2021.1924668] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Adverse drug reactions (ADR) are a problem for healthcare systems worldwide. Pediatric patients constitute a vulnerable group with regard to ADRs. However, although pediatric patients are at increased risk for these reactions, there is little progress on ADR detection methods in this group.Areas covered: In this systematic search, performed according to PRISMA statements, we selected studies, published in PubMed/Medline databases; Scopus; LILACS; Web of Science; Embase and Cochrane Library until April, 2020, on ADRs in hospitalized pediatric patients.Expert opinion: The increase of pediatric drug safety data is essential to the improvement of childcare. Health services must continuously stimulate educational programs focused on ADR detection tools to minimize the barriers and raise awareness among professionals. Therefore, it is necessary to consider that each method has advantages and disadvantages and must be analyzed in detail to be implemented according to the peculiarities of each practice scenario. Triggers tools (active method) correlated with electronic medical notes seems a good strategy for ADR identification, whether pediatric parameters are well checked and adapted with each age group. In any event, combined methods will add data to identification and clearer ADR assessment.
Collapse
Affiliation(s)
- Sheila Feitosa Ramos
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS-UFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, SE, Brazil.,Health Sciences Graduate Program, Pro-Rectory of Research and Post-graduation, Federal University of Sergipe, São Cristóvão, Brazil
| | | | - Thaciana Dos Santos Alcântara
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS-UFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, SE, Brazil
| | - Júlia Mirão Sanchez
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS-UFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, SE, Brazil
| | | | - Divaldo Pereira de Lyra Júnior
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS-UFS), Department of Pharmacy, Federal University of Sergipe, São Cristóvão, SE, Brazil.,Health Sciences Graduate Program, Pro-Rectory of Research and Post-graduation, Federal University of Sergipe, São Cristóvão, Brazil
| |
Collapse
|
33
|
Joyner LM, Alicea LA, Goldman JL, Suppes SL, Tillman EM. Methods for Detecting Pediatric Adverse Drug Reactions From the Electronic Medical Record. J Clin Pharmacol 2021; 61:1479-1484. [PMID: 34031886 DOI: 10.1002/jcph.1916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 05/22/2021] [Indexed: 11/08/2022]
Abstract
Adverse drug reactions (ADRs) are common yet are often underreported, making them difficult to track and study. Prospective pharmacovigilance programs significantly increase detection and reporting of ADRs. The aim of this pilot study was to apply triggers used by a prospective pharmacovigilance program at a freestanding children's hospital to retrospectively detect ADRs at our institution, therefore determining if these methods could be replicated and provide the basis for implementation of a prospective pharmacovigilance program. In 2019, our institution had 22 000 inpatient admissions and 51 000 emergency room visits and had 21 ADRs voluntarily reported in an electronic medication safety tracking system. Additional ADRs were identified by methods including new or modified entries to a patient's allergy profile in the electronic medical record (EMR) and International Classification of Disease (ICD) codes. We identified 754 unique patients with changes to allergy profile and 5719 ICD codes in 3966 unique patients to evaluate. These triggers prompted screening of the EMR to validate the ADR, and we identified 280 ADRs occurring in 2019. Eight (2.8%) were identified solely by the electronic medication safety tracking system, 64 (23%) were identified by the allergy list, 110 (39%) were identified only by ICD coding, and the remaining 98 (35%) were identified by multiple methods. The use of triggers followed by review of the EMR identified 13-fold more ADRs than were voluntarily reported, illustrating the need for an active pharmacovigilance service and the successful use of multimodal methods to detect and track ADRs.
Collapse
Affiliation(s)
- Lydia M Joyner
- Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Leah A Alicea
- Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jennifer L Goldman
- Department of Pediatrics, Children's Mercy Hospital and the University of Missouri-Kansas City, Kansas City, Kansas, USA
| | - Sarah L Suppes
- Division of Clinical Pharmacology, Toxicology, and Therapeutic Innovation, Children's Mercy Hospital, Kansas City, Kansas, USA
| | - Emma M Tillman
- Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| |
Collapse
|
34
|
Khalili M, Mesgarpour B, Sharifi H, Golozar A, Haghdoost AA. Estimation of adverse drug reaction reporting in Iran: Correction for underreporting. Pharmacoepidemiol Drug Saf 2021; 30:1101-1114. [PMID: 33772938 DOI: 10.1002/pds.5235] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 02/22/2021] [Accepted: 03/24/2021] [Indexed: 12/17/2022]
Abstract
PROPOSE Underreporting of Adverse Drug Reactions (ADRs) reduces the sensitivity of pharmacovigilance systems. We described ADR reporting and its trend from 1999 to 2017 and estimated the ADR underreporting in the Iranian Pharmacovigilance Center. METHODS We expressed the number of ADR reporting per inhabitants and admissions and their possible trends. Finally, ADR underreporting percentages were estimated by three approaches: prospective studies, literature review, stratification of the country; and the trend of the proportion of ADR per inhabitants was corrected. RESULTS The proportion of ADR reporting was 15.3 per 100 000 inhabitants (95% CI: 15.2, 15.8) and 10.0 per 100 000 admissions (95% CI: 9.8, 10.2) in 2017, and its trend was increasing with 16.3% average change per annum during 19 years. The median of estimated percentages of underreporting was 76.0% (IQR: 64.32-81.35). After the correction, the mean proportion of ADR reporting for 19 years reached from 5.87 to 10.33 per 100 000 inhabitants. CONCLUSIONS The trend of ADRs reporting has been increasing over the 19 years but is still low. This study showed a considerable underreporting of ADR, and about one of four detected ADRs were reported to the pharmacovigilance center from 1999 to 2017.
Collapse
Affiliation(s)
- Malahat Khalili
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Bita Mesgarpour
- Department of Public and International Affairs, National Institute for Medical Research Development, Tehran, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Asieh Golozar
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ali Akbar Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
35
|
Salehi T, Seyedfatemi N, Mirzaee MS, Maleki M, Mardani A. Nurses' Knowledge, Attitudes, and Practice in Relation to Pharmacovigilance and Adverse Drug Reaction Reporting: A Systematic Review. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6630404. [PMID: 33937402 PMCID: PMC8062168 DOI: 10.1155/2021/6630404] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/23/2021] [Accepted: 03/29/2021] [Indexed: 12/30/2022]
Abstract
AIM To describe and synthesize aspects of knowledge, attitudes, and practice regarding pharmacovigilance and adverse drug reaction (ADR) reporting and to explore associated barriers from a nurse perspective. METHODS A systematic review was conducted. Electronic databases including MEDLINE, Embase, Scopus, and Web of Knowledge from January 2010 to October 2020 were searched. Original observational studies that were written in English and which focused on nurses' knowledge, attitudes, practice, and perceived barriers regarding pharmacovigilance and ADR reporting in various healthcare settings were included. RESULTS Twenty-three studies published in English from 2010 to 2020 were retrieved during the search process. Overall, in the knowledge domain, the median percentages of nurses who were aware of the definitions of ADRs were 74.1%, while only 26.3% were aware of the adverse drug reaction reporting form. In the attitude domain, 84.6% of nurses believed ADR reporting to be important for patient/medicine safety and 37.1% had a fear of legal liability following ADR reporting. Although 67.1% of nurses encountered ADRs during their professional life, only 21.2% had a history of ADR reporting. In addition, lack of knowledge/training (median: 47.1%) was identified as the most common barrier in ADR reporting from a nursing viewpoint. CONCLUSION Despite positive nurse attitudes, knowledge and practice in relation to pharmacovigilance activities and ADR reporting did not occur regularly or often. Improving nurses' knowledge through in-service training and degree-level education and addressing the main barriers of ADR reporting may help to achieve an improved level of reporting.
Collapse
Affiliation(s)
- Tahmine Salehi
- Nursing Care Research Center, Department of Nursing Management, School of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Naiemeh Seyedfatemi
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Saeed Mirzaee
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Maleki
- School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Mardani
- Nursing Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
36
|
Causality and avoidability of adverse drug reactions of antibiotics in hospitalized children: a cohort study. Int J Clin Pharm 2021; 43:1293-1301. [PMID: 33656658 DOI: 10.1007/s11096-021-01249-8] [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: 09/11/2020] [Accepted: 02/12/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Adverse drug reactions are a problem in healthcare systems worldwide. Children are more susceptible than adults, especially when exposed to specific drug classes, such as antibiotics. OBJECTIVE To assess the incidence, causality, severity, and avoidability of antibiotic-associated adverse drug reactions in hospitalized pediatric patients. SETTING Pediatric ward of a high-complexity public hospital in northeast Brazil. METHODS A prospective cohort study was conducted over six months, including children aged between 28 days and 12 years, hospitalized for more than 48 h, and receiving antibiotics. Liverpool's causality and avoidability assessment tools were used. Primary outcome measures: Incidence of adverse drug reactions, causality, severity, and avoidability, major antibiotics implicated, risk factors. RESULTS A total of 183 patients were followed, and 35 suspected adverse drug reactions were recorded overall incidence equal to 14.7%. Most adverse drug reactions were classified as moderate severity (76.7%), probable (57.1%) and defined (28.6%) causality, and unavoidable (66.7%). The affected organs were the gastrointestinal system (74.1%) and skin (25.9%). Major antibiotics implicated were ceftriaxone (40.7%), azithromycin (25.9%), and crystalline penicillin (11.1%). The number of antibiotics prescribed per patient during hospitalization and the length of stay were the risk factors identified. CONCLUSION Causality and severity assessment indicated that most adverse drug reactions were probable and moderate. Possibly avoidable reactions occurred due to inappropriate prescribing when preventive measures were not implemented. Monitoring the use of antibiotics in children is essential to ensure the safety of these patients.
Collapse
|
37
|
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.
Collapse
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;
| |
Collapse
|
38
|
di Mauro G, Zinzi A, Scavone C, Mascolo A, Gaio M, Sportiello L, Ferrajolo C, Rafaniello C, Rossi F, Capuano A. PCSK9 Inhibitors and Neurocognitive Adverse Drug Reactions: Analysis of Individual Case Safety Reports from the Eudravigilance Database. Drug Saf 2020; 44:337-349. [PMID: 33351170 PMCID: PMC7892743 DOI: 10.1007/s40264-020-01021-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 02/07/2023]
Abstract
Introduction Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9Is) were associated with a risk of neurocognitive adverse drug reactions (ADRs). Objective We aimed to investigate the occurrence of neuropsychiatric ADRs related to PCSK9Is. Methods We analyzed Individual Case Safety Reports (ICSRs) sent through the European pharmacovigilance database that reported alirocumab or evolocumab as the suspected drug and at least one neurological or psychiatric ADR. The reporting odds ratio (ROR) was computed to compare the probability of reporting ICSRs with neuropsychiatric ADRs between alirocumab, evolocumab and statins. Results Overall, 2041 ICSRs with alirocumab and/or evolocumab as the suspected drug described the occurrence of neuropsychiatric ADRs. The most reported preferred terms for both drugs were headache, insomnia and depression. No difference between alirocumab and evolocumab was observed for the RORs of ICSRs with ADRs belonging to the System Organ Classes (SOCs) ‘Nervous system disorders’ or ‘Psychiatric disorders’ (ROR 1.02, 95% confidence interval 0.91–1.14; and 1.12, 95% CI 0.94–1.34, respectively), while evolocumab and alirocumab had a higher reporting probability of ICSRs with ADRs belonging to the SOC ‘Nervous system disorders’ compared with atorvastatin and fluvastatin. A lower reporting probability was instead found for ICSRs with ADRs belonging to the SOC ‘Psychiatric disorders’ for evolocumab and alirocumab versus simvastatin, pravastatin and rosuvastatin. Conclusion Our results demonstrated that 22.7% of all ICSRs reporting alirocumab or evolocumab as suspect drugs described the occurrence of neuropsychiatric ADRs. The ROR showed that evolocumab and alirocumab had a higher reporting probability of neurological ADRs compared with statins. Further data from real-life contexts are needed. Electronic supplementary material The online version of this article (10.1007/s40264-020-01021-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Gabriella di Mauro
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.,Regional Centre for Pharmacovigilance, Campania Region, Naples, Italy
| | - Alessia Zinzi
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.,Regional Centre for Pharmacovigilance, Campania Region, Naples, Italy
| | - Cristina Scavone
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy. .,Regional Centre for Pharmacovigilance, Campania Region, Naples, Italy.
| | - Annamaria Mascolo
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.,Regional Centre for Pharmacovigilance, Campania Region, Naples, Italy
| | - Mario Gaio
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.,Regional Centre for Pharmacovigilance, Campania Region, Naples, Italy
| | - Liberata Sportiello
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.,Regional Centre for Pharmacovigilance, Campania Region, Naples, Italy
| | - Carmen Ferrajolo
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.,Regional Centre for Pharmacovigilance, Campania Region, Naples, Italy
| | - Concetta Rafaniello
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.,Regional Centre for Pharmacovigilance, Campania Region, Naples, Italy
| | - Francesco Rossi
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.,Regional Centre for Pharmacovigilance, Campania Region, Naples, Italy
| | - Annalisa Capuano
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.,Regional Centre for Pharmacovigilance, Campania Region, Naples, Italy
| |
Collapse
|
39
|
Aydin OC, Aydin S, Guney HZ. Pharmacovigilance and radiologists: How well do they get along? Br J Radiol 2020; 93:20200596. [PMID: 32903029 DOI: 10.1259/bjr.20200596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES Considering the growing use of imaging modalities and contrast agents, radiologists are prone to encounter adverse drug reactions (ADR). In the current study, we mainly aim to evaluate the knowledge of radiologists regarding pharmacovigilance (PV). Also, we intend to gather information about their previous ADR experiences. Secondarily, we hope to increase the awareness about contrast-medium-related ADRs and attract attention to the importance of properly reporting these ADRs. METHODS A survey was generated by using an online survey webpage, and the relevant link was e-mailed to radiologists and radiology residents. The survey begins with a short explanation about the study. The second section contains questions about PV knowledge level, and the final section aims to gather information about the experienced ADRs. RESULTS The survey was completed by 202 participants. 65.3% stated that they were aware of PV. 24.8% of the participants said that they know the national PV program. 97% told that they knew the term ADR. 66.3% of the participants encountered an ADR. 53.7% of them reported these ADRs. 70.8% of them reported these ADRs to a clinician. CONCLUSIONS Radiologists encounter ADRs almost as frequently as the other doctors. Their awareness about PV is similar with other healthcare professionals. They have fewer information about TUFAM and PvCPs. Radiologists generally prefer to communicate with a clinician about an ADR. Overall condition of radiologists about PV is quite similar with other healthcare professionals and education can improve it, as for the others. ADVANCES IN KNOWLEDGE Radiologists encounters ADRs almost as frequently as the other doctors. Overall condition of radiologists about PV is quite similar with other healthcare professionals and education can improve it, as for the others.
Collapse
Affiliation(s)
- Ozlem Celik Aydin
- Department of Medical Pharmacology, Gazi University, Faculty of Medicine, Ankara, Turkey
| | - Sonay Aydin
- Department of Radiology, Dr. Sami Ulus Training and Research Hospital, Ankara, Turkey
| | - Hakki Zafer Guney
- Department of Medical Pharmacology, Gazi University, Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
40
|
KARATAŞ Y, KHAN Z, GÖREN ÖZAGİL ES, ABUSSUUTOĞLU AB, PELİT A, KOÇAK E. Knowledge, attitude and practices about pharmacovigilance and adverse drug reactions among dental research assistants in a Turkish hospital: a cross-sectional study. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2020. [DOI: 10.32322/jhsm.720938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
41
|
ÇADIRCI D, OĞUZ E, KOÇAKOĞLU Ş, YAVUZ E, ALAŞEHİRLİ B. Knowledge and Attitudes of Resident Physicians About Adverse Drug Reactions. KONURALP TIP DERGISI 2020. [DOI: 10.18521/ktd.755655] [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]
|
42
|
Tillman EM, Suppes SL, Feldman K, Goldman JL. Enhancing Pediatric Adverse Drug Reaction Documentation in the Electronic Medical Record. J Clin Pharmacol 2020; 61:181-186. [PMID: 32776356 DOI: 10.1002/jcph.1717] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/23/2020] [Indexed: 12/13/2022]
Abstract
Adverse drug reactions (ADRs) often go unreported or are inaccurately documented in the electronic medical recorded (EMR), even when they are severe and life-threatening. Incomplete reporting can lead to future prescribing challenges and ADR reoccurrence. The aim of this study was to evaluate the documentation of ADRs within the EMR and determine specific factors associated with appropriate and timely ADR documentation. Retrospective data were collected from a pediatric hospital system ADR reports from October 2010 to November 2018. Data included implicated medication, type, and severity of reaction, treatment location, the presence or absence of ADR documentation in the EMR alert profile within 24 hours of the ADR hospital or clinic encounter discharge, ADR identification method, and the presence or absence of pharmacovigilance oversight at the facility where the ADR was treated. A linear regression model was applied to identify factors contributing to optimal ADR documentation. A total of 3065 ADRs requiring medical care were identified. Of these, 961 ADRs (31%) did not have appropriate documentation added to the EMR alert profile prior to discharge. ADRs were documented in the EMR 87% of the time with the presence of pharmacovigilance oversight and only 61% without prospective pharmacovigilance (P < .01). Severity of ADR was not a predictor of ADR documentation in the EMR, yet the implicated medication and location of treatment did impact reporting. An active pharmacovigilance service significantly improved pediatric ADR documentation. Further work is needed to assure timely, accurate ADR documentation.
Collapse
Affiliation(s)
- Emma M Tillman
- Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Sarah L Suppes
- Department of Pharmacy, Children's Mercy Hospital, Kansas City, Missouri, USA
| | - Keith Feldman
- Department of Pediatrics, Children's Mercy Hospital and the University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Jennifer L Goldman
- Department of Pediatrics, Children's Mercy Hospital and the University of Missouri-Kansas City, Kansas City, Missouri, USA
| |
Collapse
|
43
|
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.
Collapse
|
44
|
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
|
45
|
Shrestha S, Sharma S, Bhasima R, Kunwor P, Adhikari B, Sapkota B. Impact of an educational intervention on pharmacovigilance knowledge and attitudes among health professionals in a Nepal cancer hospital. BMC MEDICAL EDUCATION 2020; 20:179. [PMID: 32493307 PMCID: PMC7268292 DOI: 10.1186/s12909-020-02084-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 05/21/2020] [Indexed: 05/24/2023]
Abstract
BACKGROUND Pharmacovigilance (PV) knowledge and attitudes among health care professionals (HCPs) directly affect the practice of PV and reporting of adverse drug reactions (ADRs) in a hospital. The main aim of the study was to assess the impact of an education intervention on the knowledge and attitude of HCPs attached to the regional PV center in an oncology based hospital of Nepal. METHODS A pre-post intervention questionnaire-based study was conducted amongst HCPs, i.e. nurses and pharmacists of an oncology based hospital of Nepal. A 21-item pretested PV questionnaire (twelve and four statements for assessing knowledge and attitude respectively) was used before and after an educational intervention among 89 HCPs working in the hospital. SPSS version 21.0 was used to analyze pre- and post-survey data with descriptive and inferential statistics. The knowledge and attitude scores before and after educational intervention were analyzed with Wilcoxon rank-sum test. RESULTS After the educational intervention, the mean score for knowledge about PV and ADR increased from [mean ± S.D] 6.90 ± 2.527 (pre-test) to 11.36 ± 1.189 (post-test, p < 0.001). There were significant improvements after an educational intervention in attitude from 1.80 ± 0.932 (pre-test) to 3.61 ± 0.556 (post-test, p < 0.001). Twenty-one (23.6%) of participants responded that they lacked the time to report ADR, while 12 (13.5%) replied that there was no remuneration for reporting ADR. Approximately 24% of them recommended frequent pharmacovigilance awareness programs via continuing medical education or other similar kinds of workshops for improvement of pharmacovigilance. CONCLUSION The preliminary findings of this study showed that knowledge and attitude scores were increased following an educational intervention. They also suggested that training on PV and ADR tends to have a positive impact on knowledge and attitude among nurses and pharmacists working at an oncology based hospital in Nepal.
Collapse
Affiliation(s)
- Sunil Shrestha
- Pharmacy, Nepal Cancer Hospital and Research Center, Harisidhhi, Lalitpur, Nepal.
| | - Sabina Sharma
- Pharmacy, Nepal Cancer Hospital and Research Center, Harisidhhi, Lalitpur, Nepal
| | - Ramesh Bhasima
- Pharmacy, Nepal Cancer Hospital and Research Center, Harisidhhi, Lalitpur, Nepal
| | - Puskar Kunwor
- Clinical Pharmacy Unit, Nepal Cancer Hospital and Research Center, Harisidhhi, Lalitpur, Nepal
| | - Baburam Adhikari
- Pharmacy, Nepal Cancer Hospital and Research Center, Harisidhhi, Lalitpur, Nepal
| | - Binaya Sapkota
- Department of Pharmaceutical Sciences, Nobel College, Affiliated to Pokhara University, Sinamangal, Kathmandu, Nepal
| |
Collapse
|
46
|
Khan Z, Karataş Y, Rahman H. Adverse drug reactions reporting in Turkey and barriers: an urgent need for pharmacovigilance education. Ther Adv Drug Saf 2020; 11:2042098620922483. [PMID: 32435444 PMCID: PMC7225785 DOI: 10.1177/2042098620922483] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 04/02/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Zakir Khan
- Çukurova Üniversitesi, Tıp Fakültesi, Tıbbi Farmakoloji Anabilim Dalı, Sarıçam, Adana, 01330 Turkey Department of Pharmacy Practice, Quaid-i-Azam University Islamabad, Pakistan
| | - Yusuf Karataş
- Çukurova Üniversitesi, Tıp Fakültesi, Tıbbi Farmakoloji Anabilim Dalı, Sarıçam, Adana, Turkey Pharmacovigilance Specialist, Balcalı Hospital, Cukurova University, Adana, Turkey
| | - Hazir Rahman
- Department of Microbiology, Faculty of Chemical and Life Sciences, Abdul Wali Khan University Mardan (AWKUM), Mardan, KPK, Pakistan
| |
Collapse
|
47
|
Alshayban D, Mahmoud MA, Islam MA, Alshammari S, Alsulaiman D. Pharmacovigilance Perception and Knowledge Among Pharmacists and Interns in Saudi Arabia. Healthc Policy 2020; 13:55-61. [PMID: 32158290 PMCID: PMC6986540 DOI: 10.2147/rmhp.s241265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 01/10/2020] [Indexed: 11/29/2022] Open
Abstract
Aim The aim of this study was to determine and compare the level of knowledge and perception of ADRs reporting and pharmacovigilance among interns and hospital pharmacists in different health-care settings in Saudi Arabia. Methods A cross-sectional study was conducted among pharmacists and pharmacy interns in different hospitals in Saudi Arabia. A total of 315 participants completed the self-administered and validated questionnaire during the period from August 2018 to March 2019. Results There was poor perception and knowledge of pharmacovigilance and ADRs reporting among pharmacists as well as intern pharmacists. However, pharmacists had better knowledge score compared to interns (P=0.043). Most of the respondents believed that ADRs reporting is important. The majority of both interns and pharmacists stated that they did not receive adequate education about pharmacovigilance during their undergraduate or internship program. Conclusion There is a gap in knowledge and perception about pharmacovigilance among practicing pharmacists and new pharmacy graduates. Drug safety fundamentals and policies should be taught to undergraduate pharmacy students in Saudi Arabia.
Collapse
Affiliation(s)
- Dhfer Alshayban
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Mansour Adam Mahmoud
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Md Ashraful Islam
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Shouq Alshammari
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Duaa Alsulaiman
- Pharmacy Division, King Fahad University Hospital, Alkhobar, Saudi Arabia
| |
Collapse
|
48
|
Gidey K, Seifu M, Hailu BY, Asgedom SW, Niriayo YL. Healthcare professionals knowledge, attitude and practice of adverse drug reactions reporting in Ethiopia: a cross-sectional study. BMJ Open 2020; 10:e034553. [PMID: 32102821 PMCID: PMC7046472 DOI: 10.1136/bmjopen-2019-034553] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE This study aimed to assess the knowledge, attitude and practice of adverse drug reactions (ADRs) reporting and identify factors associated with ADRs reporting among healthcare professionals (HCPs) working in Tigray region, Ethiopia. MATERIALS AND METHODS A cross-sectional study was conducted between January and March of 2019 in a tertiary care hospital in Tigray region, Ethiopia. A self-administered, pretested questionnaire was administered to HCPs. Data were summarised using descriptive statistics. Logistic regression analysis was used to identify factors associated with poor ADRs reporting practices. RESULTS In total, 362 questionnaires were distributed, and the response rate was 84.8% (n=307). Of all respondents, 190 (61.9%) were nurses, 63 (20.5%) were pharmacist and 54 (17.6%) were physicians. About 58.3% of HCPs had poor knowledge of ADRs reporting. The majority of the respondents had a positive attitude (59.9%), and only a few (32.1%) respondents have good ADRs reporting practices. Poor knowledge (adjusted OR (AOR)=2.63, 95% CI: 1.26 to 5.45) and lack of training on ADRs reporting (AOR=7.31, 95% CI: 3.42 to 15.62) were both negatively associated with ADRs reporting practice, whereas higher work experience (≥10 years) (AOR=0.36, 95% CI: 0.13 to 0.97) was positively associated with ADRs reporting practice. CONCLUSIONS The majority of HCPs had poor knowledge and practice, but a positive attitude towards ADRs reporting. Poor knowledge, less work experience and lack of training were associated with poor ADRs reporting practice. Hence, strategies to improve the knowledge and practice of ADRs reporting should be implemented, particularly for untrained and less experienced HCPs.
Collapse
Affiliation(s)
- Kidu Gidey
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Mohammedamin Seifu
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Berhane Yohannes Hailu
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Solomon Weldegebreal Asgedom
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Yirga Legesse Niriayo
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| |
Collapse
|
49
|
Danekhu K, Shrestha S, Aryal S, Shankar PR. Health-care Professionals' Knowledge and Perception of Adverse Drug Reaction Reporting and Pharmacovigilance in a Tertiary Care Teaching Hospital of Nepal. Hosp Pharm 2019; 56:178-186. [PMID: 34024926 DOI: 10.1177/0018578719883796] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Underreporting of adverse drug reactions (ADRs) is common globally, and Nepal is not an exception to this. Health-care professionals (HCPs) play a vital role in reporting ADR during routine practice. Lack of knowledge and awareness about pharmacovigilance and reporting ADRs among HCPs may contribute to underreporting. Objective: The objective of this study was to evaluate the knowledge and perception of HCPs regarding ADR reporting and pharmacovigilance in a tertiary care teaching hospital in, Nepal. Methods: A descriptive cross-sectional study was conducted. A questionnaire was distributed to 215 HCPs (medical doctors, nurses, and pharmacists) between March and September 2018. Knowledge and perception regarding ADR reporting and pharmacovigilance were studied. Data were analyzed using IBM SPSS Statistics for Windows, Version 21.0 (IBM Corp, Armonk, New York). Results: The HCPs included 75 medical doctors, 126 nurses, and 14 pharmacists. Majority of the participants were female (67%), and the majority of participants were not aware of pharmacovigilance. Among the participants, pharmacists were found to have better knowledge regarding pharmacovigilance. However, other HCPs (doctors and nurses) strongly agreed about the necessity of having adequate knowledge about pharmacovigilance. Out of 215, 57.7% agreed that the important benefit of reporting ADR was to identify safe drugs and improve patient safety. The main reasons for not reporting were - ADR reporting was not widely promoted by relevant authorities (47%), followed by not knowing where and how to report ADR (34.9%). However, other HCPs (doctors and nurses) strongly agreed about the necessity of having adequate knowledge about pharmacovigilance. Conclusions: The knowledge of HCPs on ADR reporting and pharmacovigilance was poor. Despite a low knowledge of ADR reporting and pharmacovigilance among HCPs, there was a positive perception that ADR reporting is necessary and ADR monitoring system should be established in the hospital. This study also highlights a need for future intervention studies focusing on educating HCPs about ADR and pharmacovigilance.
Collapse
Affiliation(s)
- Krisha Danekhu
- Cogent Health Pvt Ltd, Lalitpur, Nepal.,Nepal Health Research and Innovation Foundation, Lalitpur, Nepal
| | - Sunil Shrestha
- Nepal Health Research and Innovation Foundation, Lalitpur, Nepal.,Nepal Cancer Hospital & Research Center, Lalitpur, Nepal
| | - Sushant Aryal
- Universal College of Medical Sciences, Tribhuvan University, Rupandehi, Nepal
| | | |
Collapse
|