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Bigi C, Tuccori M, Bocci G. Healthcare professionals and pharmacovigilance of pediatric adverse drug reactions: a 5-year analysis of Adverse Events Reporting System Database of the Food and Drug Administration. Minerva Pediatr (Torino) 2022; 74:272-280. [PMID: 28211644 DOI: 10.23736/s2724-5276.17.04733-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to analyze the Adverse Events Reporting System (AERS) Database of the Food and Drug Administration (FDA), investigating the characteristics of pediatric adverse drug reactions (ADRs) and describing the effective participation of healthcare professionals in the reporting activity. METHODS Reports of ADRs were obtained from the FDA website. Only ADRs in pediatric subjects (divided by age, by country and by professional category) were included into the analysis. The drugs suspected as primary cause of the ADRs in pediatric subjects and their principal anatomic group according to the Anatomical Therapeutic Chemical Classification system were considered. To classify the ADRs, the Medical Dictionary for Regularity Activities terminology was adopted. RESULTS Between 2008 and 2012, FDA collected 113,077 ADRs in pediatric patients. Of the total pediatric ADR reports, those performed by medical doctors were 32%, followed by consumers (26%) and healthcare professionals (25%). Most of the ADR reports were related to the adolescent group (39%). Healthcare professionals resulted the category with the highest rate of ADR reports in neonates and infants. Drugs acting on nervous system and antineoplastic/immunomodulating agents were the most involved the pediatric ADR reports. Pyrexia, convulsion, vomiting and accidental overdose were the reactions more reported both from healthcare professionals and medical doctors. CONCLUSIONS The present study describes the pediatric ADR reports of the FDA database through healthcare professional's perspective, describing the various aspects of pediatric pharmacovigilance.
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Affiliation(s)
- Caterina Bigi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,Barking, Havering and Redbridge University Hospital, NHS Trust, London, UK
| | - Marco Tuccori
- Unit of Adverse Drug Reactions Monitoring, University Hospital of Pisa, Pisa, Italy
| | - Guido Bocci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy -
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2
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Velasco-González V, Loya-Pérez L, Navarro-García E, Sáinz-Gil M. Reporting of suspected adverse drug reactions by nursing in Spain. An observational-descriptive retrospective study. ENFERMERIA CLINICA (ENGLISH EDITION) 2021; 31:363-370. [PMID: 34756240 DOI: 10.1016/j.enfcle.2020.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 10/25/2020] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study aimed to gain knowledge of the nurses' involvement in the spontaneous report of suspected adverse drug reactions (ADR) in the Spanish Pharmacovigilance System for Medicinal Products for Human Use (SEFV-H), describing the principal characteristics of the reported cases, identifying points of improvement. METHODS A descriptive observational retrospective study was based on the data from FEDRA, the database created by the SEFV-H. The sample taken was the spontaneous adverse drug reactions reported to SEFV-H by nurses during the first 6 months of the 2018. RESULTS Complete data was provided by 6,370 suspicions of ADR reported to SEFV-H by all healthcare professionals. Only 4,8% of the samples were taken by nurses, 62,7% came from medical centers. The majority of the ADR were not considered a serious disease (78%). The most frequently adverse drug reactions reported by nurses were local reactions. The patients most involved were children and vaccines were the most reported drugs (58,3%), followed by the intravenous contrast agents used in diagnostic tests. CONCLUSIONS Nurses report very few cases to SEFV-H and are mostly related to the administration of vaccines and are sent by nurses working in the out-of-hospital setting. Most cases are not serious and usually report known adverse reactions to the suspected drug. This observed under-notification raises the need to promote increased pharmacovigilance training among these notifying nurses so that they can continue to report, and also for those who do not do so in their daily practice, so that they can begin to do so.
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Affiliation(s)
- Verónica Velasco-González
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Valladolid, Valladolid, Spain; Centro de estudios Sobre la Seguridad de los Medicamentos, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain; Instituto de Oftalmobiología Aplicada, Universidad de Valladolid, Valladolid, Spain; Grupo de Investigación en Cuidados Enfermeros (GICE), Universidad de Valladolid, Valladolid, Spain; Grupo de investigación «Farmacogenética, Genética del Cáncer, Polimorfismos Genéticos y Farmacoepidemiología», Universidad de Valladolid, Valladolid, Spain
| | - Laura Loya-Pérez
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Valladolid, Valladolid, Spain
| | - Ester Navarro-García
- Centro de estudios Sobre la Seguridad de los Medicamentos, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain.
| | - María Sáinz-Gil
- Centro de estudios Sobre la Seguridad de los Medicamentos, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain; Centro de Farmacovigilancia de Castilla y León, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
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3
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Ferreira-da-Silva R, Ribeiro-Vaz I, Silva AM, Marques J, Polónia JJ. [Looking back on 20 years of work at the Porto Pharmacovigilance Centre, Portugal]. CAD SAUDE PUBLICA 2021; 37:e00304420. [PMID: 34644762 DOI: 10.1590/0102-311x00304420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/12/2021] [Indexed: 11/21/2022] Open
Abstract
Since 1963, the World Health Organization has acknowledged pharmacovigilance as a priority area in global public health, guaranteeing permanent monitoring of drug safety. This study aimed to characterize the reports of adverse drug reactions received by the Porto Pharmacovigilance Centre (UFPorto), Portugal, in the unit's two decades of work. The analysis included all reports of suspected adverse drug reactions received from January 2001 to December 2019. We calculated the annual reporting rates and distribution by origin, type of notifier and place of work, severity, prior knowledge, and causality of the reported adverse drug reactions. During the study period, UFPorto received 9,711 notifications of suspected adverse drug reactions. Hospital institutions reported the most suspected adverse drug reactions (n = 6,003; 64%), as did physicians among healthcare workers (n = 5,284; 54.4%). The most frequently reported adverse events were severe (n = 6,275; 72%) and are described in the respective Summary of Product Characteristics (n = 6,978; 72%). Most of the reports received by UFPorto were evaluated as having "probable" causality (n = 7,473; 77%), independently of the type of notifier. The results are consistent with other data previously reported in the international medical literature and official national reports. However, the underreporting rates are still higher than expected. In approximately 20 years, UFPorto has experienced an increase in its activity in various areas of drug safety.
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Affiliation(s)
- Renato Ferreira-da-Silva
- Unidade de Farmacovigilância do Porto, Infarmed, I.P./Universidade do Porto, Porto, Portugal.,Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,CINTESIS - Centro de Investigação em Tecnologia e Serviços de Saúde, Porto, Portugal
| | - Inês Ribeiro-Vaz
- Unidade de Farmacovigilância do Porto, Infarmed, I.P./Universidade do Porto, Porto, Portugal.,Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,CINTESIS - Centro de Investigação em Tecnologia e Serviços de Saúde, Porto, Portugal
| | - Ana Marta Silva
- Unidade de Farmacovigilância do Porto, Infarmed, I.P./Universidade do Porto, Porto, Portugal.,Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,CINTESIS - Centro de Investigação em Tecnologia e Serviços de Saúde, Porto, Portugal
| | - Joana Marques
- Unidade de Farmacovigilância do Porto, Infarmed, I.P./Universidade do Porto, Porto, Portugal.,Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,CINTESIS - Centro de Investigação em Tecnologia e Serviços de Saúde, Porto, Portugal
| | - Jorge Junqueira Polónia
- Unidade de Farmacovigilância do Porto, Infarmed, I.P./Universidade do Porto, Porto, Portugal.,Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,CINTESIS - Centro de Investigação em Tecnologia e Serviços de Saúde, Porto, Portugal
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4
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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.
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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
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5
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Velasco-González V, Loya-Pérez L, Navarro-García E, Sainz-Gil M. Reporting of suspected adverse drug reactions by nursing in Spain. An observational-descriptive retrospective study. ENFERMERIA CLINICA 2021; 31:S1130-8621(20)30534-9. [PMID: 33531221 DOI: 10.1016/j.enfcli.2020.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 09/22/2020] [Accepted: 10/25/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study aimed to gain knowledge of the nurses' involvement in the spontaneous report of suspected adverse drug reactions (ADR) in the Spanish Pharmacovigilance System for Medicinal Products for Human Use (SEFV-H), describing the principal characteristics of the reported cases, identifying points of improvement. METHODS A descriptive observational retrospective study was based on the data from FEDRA, the database created by the SEFV-H. The sample taken was the spontaneous adverse drug reactions reported to SEFV-H by nurses during the first 6 months of the 2018. RESULTS Complete data was provided by 6,370 suspicions of ADR reported to SEFV-H by all healthcare professionals. Only 4,8% of the samples were taken by nurses, 62,7% came from medical centers. The majority of the ADR were not considered a serious disease (78%). The most frequently adverse drug reactions reported by nurses were local reactions. The patients most involved were children and vaccines were the most reported drugs (58,3%), followed by the intravenous contrast agents used in diagnostic tests. CONCLUSIONS Nurses report very few cases to SEFV-H and are mostly related to the administration of vaccines and are sent by nurses working in the out-of-hospital setting. Most cases are not serious and usually report known adverse reactions to the suspected drug. This observed under-notification raises the need to promote increased pharmacovigilance training among these notifying nurses so that they can continue to report, and also for those who do not do so in their daily practice, so that they can begin to do so.
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Affiliation(s)
- Verónica Velasco-González
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Valladolid, Valladolid, España; Centro de Estudios sobre la Seguridad de los Medicamentos, Facultad de Medicina, Universidad de Valladolid, Valladolid, España; Instituto de Oftalmobiología Aplicada, Universidad de Valladolid, Valladolid, España; Grupo de Investigación en Cuidados Enfermeros (GICE), Universidad de Valladolid, Valladolid, España; Grupo de investigación «Farmacogenética, Genética del Cáncer, Polimorfismos Genéticos y Farmacoepidemiología», Universidad de Valladolid, Valladolid, España
| | - Laura Loya-Pérez
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Valladolid, Valladolid, España
| | - Ester Navarro-García
- Centro de Estudios sobre la Seguridad de los Medicamentos, Facultad de Medicina, Universidad de Valladolid, Valladolid, España.
| | - María Sainz-Gil
- Centro de Estudios sobre la Seguridad de los Medicamentos, Facultad de Medicina, Universidad de Valladolid, Valladolid, España; Centro de Farmacovigilancia de Castilla y León, Facultad de Medicina, Universidad de Valladolid, Valladolid, España
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6
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Mendes D, Oliveira AR, Alves C, Batel Marques F. Spontaneous reports of hypersensitivity adverse drug reactions in Portugal: a retrospective analysis. Expert Opin Drug Saf 2020; 19:763-769. [PMID: 32167395 DOI: 10.1080/14740338.2020.1743262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Hypersensitivity adverse drug reactions (ADRs) are usually serious, unpredictable, and associated with high morbidity and mortality. This study describes cases of hypersensitivity ADRs spontaneously reported in Central Portugal. METHODS Spontaneous reports (SRs) of ADRs received between 2010 and 2017 were reviewed to identify cases of hypersensitivity reactions, using a Standardized MedDRA Query (SMQ). Seriousness, expectedness, and causality were assessed. Descriptive statistics were used to analyze data. RESULTS Among 2050 SRs, 598 (29.2%) contained 726 hypersensitivity ADRs: 657 (90.5%) serious, 569 (78.4%) unexpected, and 469 (64.6%) certainly related to drug exposure. Anaphylactic reactions (n = 93; 12.8%), rash maculopapular (n = 82; 11.3%), rash (n = 67; 9.2%) and DRESS (n = 54; 7.4%) were the most common reactions. Frequently implicated drug classes comprised antibiotics (n = 150; 23.0%), antineoplastic agents (n = 124; 19.0%), antigout preparations (n = 54; 8.3%), and anti-inflammatories (n = 44; 6.8%). Top-causative drugs were allopurinol (n = 54; 8.3%), docetaxel (n = 46; 7.1%), and trimethoprim/sulfamethoxazole (n = 26; 4.0%). CONCLUSIONS Most hypersensitivity ADRs were serious, unexpected, and with strong causal relationship with suspected drugs. Allopurinol was the top-causative drug. Besides antibiotics and anti-inflammatories, antineoplastic agents were frequently cited. These results deserve further investigation.
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Affiliation(s)
- Diogo Mendes
- UFC-Coimbra Regional Pharmacovigilance Unit, CHAD-Centre for Health Technology Assessment and Drug Research, AIBILI-Association for Innovation and Biomedical Research on Light and Image , Coimbra, Portugal
| | - Ana Rita Oliveira
- Laboratory of Social Pharmacy and Public Health, School of Pharmacy, University of Coimbra , Coimbra, Portugal
| | - Carlos Alves
- UFC-Coimbra Regional Pharmacovigilance Unit, CHAD-Centre for Health Technology Assessment and Drug Research, AIBILI-Association for Innovation and Biomedical Research on Light and Image , Coimbra, Portugal.,Laboratory of Social Pharmacy and Public Health, School of Pharmacy, University of Coimbra , Coimbra, Portugal
| | - Francisco Batel Marques
- UFC-Coimbra Regional Pharmacovigilance Unit, CHAD-Centre for Health Technology Assessment and Drug Research, AIBILI-Association for Innovation and Biomedical Research on Light and Image , Coimbra, Portugal.,Laboratory of Social Pharmacy and Public Health, School of Pharmacy, University of Coimbra , Coimbra, Portugal
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7
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Oh IS, Baek YH, Kim HJ, Lee M, Shin JY. Differential completeness of spontaneous adverse event reports among hospitals/clinics, pharmacies, consumers, and pharmaceutical companies in South Korea. PLoS One 2019; 14:e0212336. [PMID: 30763386 PMCID: PMC6375612 DOI: 10.1371/journal.pone.0212336] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 01/31/2019] [Indexed: 12/04/2022] Open
Abstract
The differential pattern and characteristics of completeness in adverse event (AE) reports generated by hospitals/clinics, pharmacies, consumer and pharmaceutical companies remain unknown. Thus, we identified the characteristics of complete AE reports, compared with those of incomplete AE reports, using a completeness score. We used Korea Institute of Drug Safety and Risk Management-Korea Adverse Event Reporting System Database (KIDS-KD) between January 1, 2016 and December 31, 2016. The completeness score was determined out of a total of 100 points, based on the presence of information on temporal relationships, age and sex of patients, AE progress, name of reported medication, reporting group by profession, causality assessment, and informational text. AE reports were organized into four groups based on affiliation: hospitals/clinics, pharmacies, consumers, and pharmaceutical companies. Affiliations that had median completeness scores greater than 80 points were classified as ‘well-documented’ and these reports were further analyzed by logistic regression to estimate the adjusted odds ratios and 95% confidence intervals. We examined 228,848 individual reports and 735,745 drug-AE combinations. The median values of the completeness scores were the highest for hospitals/clinics (95 points), followed by those for consumers (85), pharmacies (75), and manufacturers (72). Reports with causality assessment of ‘certain’, ‘probable’, or ‘possible’ were more likely to be ‘well-documented’ than reports that had causality assessments of ‘unlikely’. Serious reports of AEs were positively associated with ‘well-documented’ reports and negatively associated with hospitals/clinics.
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Affiliation(s)
- In-Sun Oh
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea
| | - Yeon-Hee Baek
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea
| | - Hye-Jun Kim
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea
| | - Mose Lee
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea
- * E-mail:
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8
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Dorji C, Tragulpiankit P, Riewpaiboon A, Tobgay T. Knowledge of Adverse Drug Reaction Reporting Among Healthcare Professionals in Bhutan: A Cross-Sectional Survey. Drug Saf 2017; 39:1239-1250. [PMID: 27743333 DOI: 10.1007/s40264-016-0465-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The Bhutan National Pharmacovigilance Centre (NPC) became an official member of the WHO Programme for International Drug Monitoring in December 2014; however, the number of adverse drug reactions (ADRs) reported is very low (50 reports per 773,722 inhabitants over 10 years). Surveys of healthcare professionals (HCPs) in similar countries have indicated that adequate knowledge of both ADRs and ADR reporting is likely to increase the number of ADR reports submitted. OBJECTIVE The aim of this study was to investigate the level of knowledge of both ADRs and ADR reporting among HCPs, including traditional medicine practitioners. METHODS A cross-sectional survey was conducted, using a validated self-administered questionnaire. The questionnaires were distributed to 670 HCPs, including clinical doctors, nurses, pharmacists and traditional medicine practitioners from four referral hospitals. The survey consisted of 12 questions pertaining to ADRs and 10 questions pertaining to knowledge of ADR reporting. The collected response was then analysed descriptively and results presented as mean ± standard deviation (SD) using SPSS version 20. RESULTS The overall response rate was 434 (65 %) questionnaires, with HCPs consisting of clinical doctors (94, 22 %), nurses (257, 59 %), pharmacists (52, 12 %) and traditional medicine practitioners (31, 7 %). The overall mean ± SD score with regard to the level of knowledge of ADRs was 6.52 ± 2.81 out of a maximum score of 12, among which clinical doctors scored 7.48 ± 2.95, nurses 6.15 ± 2.47, pharmacists 8.15 ± 2.49 and traditional medicine practitioners 4.13 ± 3.18. The mean ± SD score with regard to the level of knowledge of ADR reporting among HCPs was 3.94 ± 1.89 out of a maximum score of 10, among which clinical doctors scored 3.93 ± 1.81, nurses 3.75 ± 1.74, pharmacists 5.00 ± 1.81 and traditional medicine practitioners 4.00 ± 1.77. CONCLUSION Clinical doctors and pharmacists have better knowledge of ADRs than nurses and traditional medicine practitioners, while knowledge of ADR reporting was low for all HCPs surveyed.
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Affiliation(s)
- Choki Dorji
- Department of Pharmacy, Faculty of Pharmacy, Mahidol University, 447 Sri-Ayudhaya Road, Bangkok, 10400, Thailand.,Drug Regulatory Authority, Thimphu, Bhutan
| | - Pramote Tragulpiankit
- Department of Pharmacy, Faculty of Pharmacy, Mahidol University, 447 Sri-Ayudhaya Road, Bangkok, 10400, Thailand.
| | - Arthorn Riewpaiboon
- Department of Pharmacy, Faculty of Pharmacy, Mahidol University, 447 Sri-Ayudhaya Road, Bangkok, 10400, Thailand
| | - Tashi Tobgay
- Khesar Gyalpo University of Medical Sciences, Thimphu, Bhutan
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Bigi C, Bocci G. The key role of clinical and community health nurses in pharmacovigilance. Eur J Clin Pharmacol 2017; 73:1379-1387. [PMID: 28770283 DOI: 10.1007/s00228-017-2309-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 07/19/2017] [Indexed: 12/14/2022]
Abstract
PURPOSE The reporting of suspected adverse drug reactions (ADRs) is starting to become routine to nurses. The aim of this review is to underline the role of clinical and community health nurses in pharmacovigilance and to promote their effective participation in ADR reporting in different countries and for patients of different ages. METHODS The PubMed, Scopus and ISI Web of Science databases were searched for research articles published between January 1985 and April 2017 using the search items "pharmacovigilance" AND "nurse;" "adverse drug reaction report" AND "nurse;" "community health nurse" AND "adverse drug reaction." RESULTS A total of 987 articles were identified using our search strategy, of which 180 articles remained over after the removal of duplicate articles. Of these 180 studies, upon full review we identified 24 which met the inclusion/exclusion criteria and included these in our review. ADR reports by clinical nurses in some countries are comparable in quality and number to those submitted by physicians or pharmacists. Data on ADRs reported by community nurses are currently not available. However, numerous publications emphasized the challenges faced by nurses in reporting ADRs and the need to include pharmacovigilance training in both clinical and community health nurse academic education. CONCLUSIONS Nurses are central actors in pharmacovigilance activities, particularly in identifying ADRs which remain outside the reach of other healthcare providers and in being fundamental to the preservation of the health of patients and of the entire community, with attention to the more vulnerable patients, such as children and the elderly.
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Affiliation(s)
- Caterina Bigi
- Division of Pharmacology, Department of Clinical and Experimental Medicine, Scuola Medica, University of Pisa, Via Roma 55, 56126, Pisa, Italy.,Barking, Havering and Redbridge University Hospital, HNS Trust, London, UK
| | - Guido Bocci
- Division of Pharmacology, Department of Clinical and Experimental Medicine, Scuola Medica, University of Pisa, Via Roma 55, 56126, Pisa, Italy.
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10
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Outcomes From the First 6 Years of Operation of the Central Portugal Pharmacovigilance Unit. J Patient Saf 2016; 16:e136-e142. [PMID: 27997457 DOI: 10.1097/pts.0000000000000273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The aim of this study was to analyze and characterize the outcomes of the Central Portugal Regional Pharmacovigilance Unit over a 6-year period. METHODS Spontaneous reports received between January 2009 and December 2014 were considered. The annual reporting ratios were estimated. The cases were characterized according to their seriousness, previous description, causality assessment, reporting professional, pharmacotherapeutic groups of the suspected drugs, and type of adverse drug reactions most frequently reported. RESULTS The Pharmacovigilance Unit received 1277 reports that contained 3222 adverse events. In 2014, the reporting rate was estimated at 124 reports per million inhabitants. Sixty-five percent of the reports were assessed as serious. Seventy-three percent of the cases were assessed as being at least possibly related with the suspected drug. Physicians reported 49% of the cases. The suspected drugs most frequently reported were "anti-infectives for systemic use" (n = 494, 38%). The most frequently reported adverse events were "general disorders and administration site conditions" (n = 667, 21%). CONCLUSIONS Despite the continuous efforts carried out by the Central Portugal Regional Pharmacovigilance Unit in promoting spontaneous reports of suspected adverse drug reactions, the results, although representing a contribution to the postmarketing safety monitoring of drugs, are still modest illustrating the need to promote the adherence of health-care professionals to the pharmacovigilance system and to increase their reporting rates of suspected ADRs.
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11
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Vaismoradi M, Griffiths P, Turunen H, Jordan S. Transformational leadership in nursing and medication safety education: a discussion paper. J Nurs Manag 2016; 24:970-980. [DOI: 10.1111/jonm.12387] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2016] [Indexed: 11/28/2022]
Affiliation(s)
| | - Pauline Griffiths
- College of Human and Health Sciences; Swansea University; Swansea UK
| | - Hannele Turunen
- Department of Nursing Science; University of Eastern Finland; Kuopio University Hospital; Kuopio Finland
| | - Sue Jordan
- College of Human and Health Sciences; Swansea University; Swansea UK
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12
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De Angelis A, Colaceci S, Giusti A, Vellone E, Alvaro R. Factors that condition the spontaneous reporting of adverse drug reactions among nurses: an integrative review. J Nurs Manag 2015; 24:151-63. [PMID: 25974355 DOI: 10.1111/jonm.12310] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2015] [Indexed: 11/28/2022]
Abstract
AIM To describe and synthesise previous research on factors conditioning the spontaneous reporting of adverse drug reactions among nurses. BACKGROUND Spontaneous reports of adverse drug reactions by health-care providers, are a main instrument for the continuous evaluation of the risk-benefit ratio of every drug. Under-reporting of adverse drug reactions by all health-care providers, in particular by nurses, is a major limitation to this system. EVALUATION An integrated review of the literature was conducted using MEDLINE, CINAHL, Embase, Scopus databases and Google Scholar. After evaluation for appropriateness related to inclusion/exclusion criteria, 16 studies were included in the final analysis and synthesis. KEY ISSUES Two factors emerged from the study: (1) intrinsic factors related to nurses' knowledge and attitudes; (2) extrinsic factors related to nurses' interaction with health-care organisations and to the relationship between nurses and physicians. Nurses' attitudes that hinder reporting include ignorance, insecurity, fear and lethargy. CONCLUSIONS Nurses are not fully aware of their role in adverse drug reaction reporting. Nurses must acquire greater knowledge to implement specific skills into their daily clinical practice. IMPLICATIONS FOR NURSING MANAGEMENT To improve nurses' reporting of adverse drug reactions, it is necessary to develop management approaches that modify both intrinsic and extrinsic factors.
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Affiliation(s)
- Alessia De Angelis
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Sofia Colaceci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Angela Giusti
- National Centre of Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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The impact of a changed legislation on reporting of adverse drug reactions in Sweden, with focus on nurses' reporting. Eur J Clin Pharmacol 2015; 71:631-6. [PMID: 25845655 DOI: 10.1007/s00228-015-1839-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 03/24/2015] [Indexed: 12/16/2022]
Abstract
PURPOSE In March 2007, a legislative amendment was issued in Sweden compelling nurses to report all suspected adverse drug reactions (ADRs) to the national pharmacovigilance system. The aims of this study were to describe the status of ADR reporting, before and after the implementation of the legislative changes, and to describe the general characteristics of suspected ADRs reported by nurses. METHODS The Swedish pharmacovigilance system during the study period constituted six regional centres responsible for the handling of all spontaneous ADR reports within their region. In this study, we identified all individual ADR reports from 2005 and 2010, analysed in depth the ADR reports from two regional centres and collated information about the reporter and the nature of the reported ADR. RESULTS From the two regional centres, a total of 898 and 1074 reports were submitted in 2005 and 2010 respectively. Nurses submitted 31% (275 reports) of the reports in 2005 and 24% (260 reports) in 2010. Nurses' reporting of serious ADRs was 3% (seven reports) in 2005 and 7% (17 reports) in 2010 with reporting of unlabelled ADRs at 4% (11 reports) in 2005 and 17% (45 reports) in 2010. Most of the serious and/or unlabelled reactions were related to vaccine administration (14 reports in 2005 and 36 reports in 2010). CONCLUSIONS The overall ADR reporting by nurses did not appear to increase after the change in reporting legislation. The proportion of serious and/or unlabelled ADRs reported by nurses did however appear to increase during the same period. Taken together, our data suggests that further pro-active measures should be considered in order to involve nurses in the reporting of suspected ADRs.
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Johansson-Pajala RM, Martin L, Fastbom J, Jorsäter Blomgren K. Nurses' self-reported medication competence in relation to their pharmacovigilant activities in clinical practice. J Eval Clin Pract 2015; 21:145-52. [PMID: 25327625 DOI: 10.1111/jep.12263] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2014] [Indexed: 11/29/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES Adverse drug reactions (ADRs) represent a major health problem and previous studies show that nurses can have an active role in promoting medication safety. The aim of this study was to describe and evaluate nurses' self-reported competence and pharmacovigilant activities in clinical practice and also to explore the impact of age, education, workplace and nursing experience on these matters. METHODS This cross-sectional study was based on a questionnaire covering areas related to nurses' medication competence, including knowledge, assessment and information retrieval, and pharmacovigilant activities within these areas, for example, the detection and assessment of ADRs. A 45-item questionnaire was 2013 sent out to 296 nurses in different settings and counties in Sweden. They were selected on the basis of having applied to a university course including pharmacovigilance during 2008-2011. One hundred twenty-four had participated in the courses (exposed) and 172 had applied to the courses but not participated (unexposed). RESULTS Completed questionnaires were obtained from 75 exposed (60%) and 93 unexposed (54%) nurses. Overall nurses rated themselves high in medication competence but low in pharmacovigilant activities. Significant (P ≤ 0.001) differences between groups were observed regarding medication competence. The exposure of completed dedicated courses in pharmacovigilance was the strongest factor for self-reported medication competence when adjusted for age, other education, workplace and experience. No significant differences between the groups were found regarding the number of pharmacovigilant activities during the 6 months prior to answering the questionnaire. CONCLUSION Dedicated university courses improved nurses' self-reported competence in pharmacovigilance but did not increase the number of related activities. Education per se seems to be not sufficient to generate pharmacovigilant activities among nurses.
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