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De Lima B, Nohner M, Drago K. Improving dose-related adverse drug events among hospitalized older adults using a geriatric prescribing context. J Am Geriatr Soc 2024; 72:1501-1507. [PMID: 38240187 DOI: 10.1111/jgs.18754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 11/30/2023] [Accepted: 12/07/2023] [Indexed: 05/14/2024]
Abstract
BACKGROUND Adverse drug events (ADEs) during hospitalization are a serious, yet preventable concern for older adults. Our institution designed a Geriatric Prescribing Context (GPC) to adjust doses for the older adult population but its impact on ADEs was unknown. The goal of this study was to assess any differences in rates of ADEs before and after its implementation in July 2017. METHODS We used relevant ICD-10 codes followed by confirmatory chart review to identify dose-related ADEs from 10 commonly used medications at our institution. We assessed differences in the number of admissions with an ADE before and after the GPC implementation using a test of binomial proportions. The pre-period was from July 2016 through June 2017 and the post-period was from August 2017 through July 2018. We compared the rate of ADEs per 1000 patient days between periods with a Poisson rate test and further examined any differences in harm categories using a Fisher's exact test. RESULTS The proportion of admissions with any dose-related ADEs significantly decreased from 0.0082 to 0.0037 after the GPC (p = 0.04). The rate of dose-related ADEs also declined from 2.5 per 1000 patient days to 1.1 per 1000 patient days (p = 0.001). Harm categories did not change significantly between time points (p = 0.30). CONCLUSIONS Based on our list of relevant ICD-10 codes, the GPC was associated with lower dose-related ADEs for our selected medications among hospitalized older adults.
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Affiliation(s)
- Bryanna De Lima
- Division of General Internal Medicine and Geriatrics, Oregon Health and Science University, Portland, Oregon, USA
| | - Mitchell Nohner
- Department of Internal Medicine- Hospital Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Kathleen Drago
- Division of General Internal Medicine and Geriatrics, Oregon Health and Science University, Portland, Oregon, USA
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Shenoy AK, Kamath A, Chowta MN, Boloor A, Aravind A, Thakur PB, Kumar S. Knowledge of pharmacovigilance among healthcare professionals and the impact of an educational intervention. Med Pharm Rep 2023; 96:406-412. [PMID: 37970197 PMCID: PMC10642735 DOI: 10.15386/mpr-2076] [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: 02/14/2021] [Revised: 03/15/2022] [Accepted: 01/31/2023] [Indexed: 11/17/2023] Open
Abstract
Aim To determine the knowledge regarding various aspects of pharmacovigilance among doctors and nurses of a tertiary care teaching hospital and to evaluate the effect of an educational intervention. Methods A cross-sectional study was conducted among doctors and nurses of a tertiary care teaching hospital. The participants attended a one-hour educational session during which the concept of pharmacovigilance, the Pharmacovigilance Program of India, the need for reporting ADRs, and the method of reporting were explained by a subject expert. A 20-item questionnaire was used to assess their knowledge regarding pharmacovigilance before and after an educational session. The pre-post comparisons were done using Wilcoxon's signed-rank test. A p-value less than 0.05 was considered statistically significant. Results Forty-two doctors and 115 nurses participated in the study. A significant improvement in the participant scores was seen following the educational intervention in both doctors (Z = -5.344, p < 0.001) and nurses (Z = -8.808, p < 0.001). Lack of knowledge/awareness was perceived as the major barrier for ADR reporting among nurses as well as doctors. Conclusion There is need for education and training among doctors and nurses to enhance their knowledge about drug safety and reporting practices. Educational intervention is likely to improve the knowledge regarding pharmacovigilance, and thereby enhance reporting by healthcare professionals.
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Affiliation(s)
- Ashok K Shenoy
- Department of Pharmacology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Ashwin Kamath
- Department of Pharmacology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Mukta N Chowta
- Department of Pharmacology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Archith Boloor
- Department of General Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Ajith Aravind
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Priyamedha Bose Thakur
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Sachin Kumar
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
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García-Abeijon P, Costa C, Taracido M, Herdeiro MT, Torre C, Figueiras A. Factors Associated with Underreporting of Adverse Drug Reactions by Health Care Professionals: A Systematic Review Update. Drug Saf 2023:10.1007/s40264-023-01302-7. [PMID: 37277678 DOI: 10.1007/s40264-023-01302-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2023] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Underreporting is a major limitation of the voluntary reporting system of adverse drug reactions (ADRs). A 2009 systematic review showed the knowledge and attitudes of health professionals were strongly related with underreporting of ADRs. OBJECTIVE Our aim was to update our previous systematic review to determine factors (sociodemographic, knowledge and attitudes) associated with the underreporting of ADRs by healthcare professionals. METHODS We searched the MEDLINE and EMBASE databases for studies published between 2007 and 2021 that met the following inclusion criteria: (1) published in English, French, Portuguese or Spanish; (2) involving health professionals; and (3) the goal was to evaluate factors associated with underreporting of ADRs through spontaneous reporting. RESULTS Overall, 65 papers were included. While health professional sociodemographic characteristics did not influence underreporting, knowledge and attitudes continue to show a significant effect: (1) ignorance (only serious ADRs need to be reported) in 86.2%; (2) lethargy (procrastination, lack of interest, and other excuses) in 84.6%; (3) complacency (the belief that only well tolerated drugs are allowed on the market) in 46.2%; (4) diffidence (fear of appearing ridiculous for reporting merely suspected ADRs) in 44.6%; and (5) insecurity (it is nearly impossible to determine whether or not a drug is responsible for a specific adverse reaction) in 33.8%, and the absence of feedback in 9.2%. In this review, the non-obligation to reporting and confidentiality emerge as new reasons for underreporting. CONCLUSIONS Attitudes regarding the reporting of adverse reactions continue to be the main determinants of underreporting. Even though these are potentially modifiable factors through educational interventions, minimal changes have been observed since 2009. CLINICAL TRIALS REGISTRATION PROSPERO registration number CRD42021227944.
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Affiliation(s)
- Patricia García-Abeijon
- Department of Public Health, Faculty of Farmacy, University of Santiago de Compostela, Praza do Seminario de Estudos Galegos, s/n, 15705, Santiago de Compostela, Spain
| | - Catarina Costa
- Faculdade de Farmácia da, Universidade de Lisboa, Lisbon, Portugal
| | - Margarita Taracido
- Department of Public Health, Faculty of Farmacy, University of Santiago de Compostela, Praza do Seminario de Estudos Galegos, s/n, 15705, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), Madrid, Spain
| | - Maria Teresa Herdeiro
- Department of Medical Sciences, Institute of Biomedicine-iBiMED, University of Aveiro, Aveiro, Portugal
| | - Carla Torre
- Faculdade de Farmácia da, Universidade de Lisboa, Lisbon, Portugal
- Laboratory of Systems Integration Pharmacology, Clinical and Regulatory Science, Research Institute for Medicines (iMED.ULisboa), Lisbon, Portugal
| | - Adolfo Figueiras
- Department of Public Health, Faculty of Farmacy, University of Santiago de Compostela, Praza do Seminario de Estudos Galegos, s/n, 15705, Santiago de Compostela, Spain.
- Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), Madrid, Spain.
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Delgado-Pérez G, Dávila-Espinoza C, Beltran-Noblega C. Impact of the Role of the Clinical Pharmacist on the Underreporting of Adverse Drug Reactions at a Peruvian hospital. Hosp Pharm 2023; 58:295-303. [PMID: 37216081 PMCID: PMC10192994 DOI: 10.1177/00185787221138006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
Background: The clinical pharmacists play a key role in the Pharmacovigilance System. They are integrated to the health team performing pharmacotherapeutic follow-up (PF), drug information, at third level care hospital. The objective of this study was to assess the impact of the clinical pharmacists' role in increasing the reporting of suspected adverse drug reactions (SADRs) after including in-service training (IST) in their role, as well as to characterize the reported ADRs. Methods: A longitudinal study was performed, reports of SADRs received through medical interconsultations were evaluated, before and after applying IST, in 2 periods: January 2017 to June 2018 and July 2018 to December 2019. Results: Interconsultations after IST were increased by 168,4%; of these, 75 were ADRs reported to the Dirección General de Medicamentos, Insumos y Drogas (DIGEMID). Internal Medicine and Pneumology services reported more SADR in both periods. There was significant statistical difference in ADRs' causality (P = .001) and type (P = .009). Severe ADRs highlighted after IST (4 vs 12). The most affected organ and system in both periods was skin and appendages. Conclusion: The reporting of SADRs augmented, reflected in an increase in medical interconsultations as a modality of SADR notification, after including IST to the role of the clinical pharmacist, allowing the development of convenient FP, which led to the evaluation of SARs. A higher number of serious ADRs were reported.
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Affiliation(s)
- Gladys Delgado-Pérez
- Universidad Nacional Mayor de San
Marcos Facultad de Farmacia y Bioquimica, Lima, Peru
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Khan Z, 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.
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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
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Ferreira-da-Silva R, Alves JM, Vieira C, Silva AM, Marques J, Morato M, Polónia JJ, Ribeiro-Vaz I. Motivation and Knowledge of Portuguese Community Pharmacists Towards the Reporting of Suspected Adverse Reactions to Medicines: A Cross-Sectional Survey. J Community Health 2022; 48:295-308. [PMID: 36401737 PMCID: PMC9676890 DOI: 10.1007/s10900-022-01168-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2022] [Indexed: 11/21/2022]
Abstract
The close contact between patients and community pharmacists, along with the extensive geographical distribution of pharmacies in Portugal, offer exceptional conditions to detect and report adverse drug reactions (ADR). This study aimed to evaluate the motivation and knowledge of spontaneous reporting of ADR by community pharmacists of Porto, Portugal. Secondly, we aimed to generate real-world evidence on the main factors determining ADR report and at raising potential alternatives to the current reporting procedure in community pharmacy. We performed a descriptive, cross-sectional, observational, anonymous web survey-based study. Between April and July 2021, a web survey was implemented, targeting community pharmacists in the Porto district, Portugal. We validated 217 surveys from pharmacists. Regular notifiers seem to be more familiarised than non-regular notifiers with the Portuguese Pharmacovigilance System (PPS), with the Portal RAM for reporting suspected ADR, and with the update of the concept of ADR. Moreover, regular notifiers seem to be more proactive with their care in questioning patients about ADR and have more self-knowledge to identify suspected ADR. Conversely, non-regular notifiers, seem to be more reluctant to be judged by their ADR reporting activities. Respondents suggested to simplify and optimise the reporting process (31% of the suggestions), or to integrate a reporting platform into the pharmacy's software (27%). This study identified opportunities to promote the ADR reporting process by community pharmacists, namely receiving feedback from the PPS on the reported case and its regulatory implications, implementing training programs in pharmacovigilance, and creating solutions to simplify the reporting process.
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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
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Khan MAA, Hamid S, Khan SA, Sarfraz M, Babar ZUD. A Qualitative Study of Stakeholders' Views on Pharmacovigilance System, Policy, and Coordination in Pakistan. Front Pharmacol 2022; 13:891954. [PMID: 35754475 PMCID: PMC9218668 DOI: 10.3389/fphar.2022.891954] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/03/2022] [Indexed: 11/21/2022] Open
Abstract
Objectives: Due to the absence of necessary rules, poor coordination, and various challenges, the pharmacovigilance system of Pakistan is not optimally functional at all levels of the health system. The objective of the study was to assess the stakeholders’ perceptions of the current ADR reporting system and to identify the pharmacovigilance policy issues and problems of effective coordination. Methodology: Stakeholders from a broad range of disciplines, academia, regulatory authorities, the pharmaceutical industry, international health organizations, as well as pharmacovigilance experts, and healthcare professionals were included in the study. A total of 25 stakeholders throughout Pakistan were interviewed during exploratory semi-structured interviews. The interviews were recorded digitally, transcribed, coded, compared, and grouped according to their similarity of themes. Participants provided insights into gaps, limitations, and challenges of Pakistan’s current ADR reporting system, issues with proposed pharmacovigilance rules, and coordination difficulties. Results: The majority of the participants considered the ADR reporting system in Pakistan to be improving but in a nascent phase. The identified gaps, challenges, limitations of the system, and barriers to reporting were labeled as reasons for limited functioning. Almost all stakeholders were aware of the existence of draft pharmacovigilance rules; however, participants in the industry were familiar with the contents and context of draft pharmacovigilance rules. Bureaucratic red tape and lack of political will appeared to be the top reasons for delaying the approval of the pharmacovigilance rules. Wider consultation, advocacy, and awareness sessions of policymakers and HCPs were suggested for early approval of rules. Participants unanimously agreed that the approval of rules shall improve the quality of life and reduce the economic burden along with morbidity and mortality rates. The need for greater and collaborative coordination among the stakeholders in promoting medicines’ safety was highlighted. All participants suggested the use of media and celebrities to disseminate the safety information. Conclusion: Participants showed partial satisfaction with the way pharmacovigilance in Pakistan is moving forward. However, stakeholders believed that engagement of multi-stakeholders, approval of pharmacovigilance rules, and the establishment of pharmacovigilance centers in provinces, hospitals, and public health programs (PHPs) shall support in achieving the desired results.
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Affiliation(s)
| | - Saima Hamid
- Health Services Academy Islamabad, Islamabad, Pakistan.,Fatima Jinnah Women University, Rawalpindi, Pakistan
| | | | | | - Zaheer-Ud-Din Babar
- Center for Pharmaceutical Policy and Practice Research, Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, United Kingdom
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Health Literacy Level and Comprehension of Prescription and Nonprescription Drug Information. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116665. [PMID: 35682249 PMCID: PMC9180079 DOI: 10.3390/ijerph19116665] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 11/16/2022]
Abstract
The aim of this study was to investigate the level of misunderstanding of medication information in Korean adults after stratifying by level of health literacy and to identify the factors influencing the misunderstanding of medication information and reading amounts of information on OTC drug labels. A cross-sectional survey was performed with 375 adult participants using the survey instrument. Multiple linear regression analyses were performed to identify factors which influence misunderstanding of medication information. Participants misunderstood 20% of words on OTC drug labels, 9% of prescription drug instructions, and 9% of pictograms. Participants on average read 59% of the overall contents of the OTC drug labels. As prescription drugs’ dosing regimens became more complicated, the level of misunderstanding instructions increased. The level of misunderstanding words on OTC drug labels significantly decreased as participants had adequate health literacy (β = −18.11, p < 0.001) and higher education levels (β = −6.83, p < 0.001), after adjusting for the study variables. The level of misunderstanding instructions for prescription drugs increased as participants became older (β = 8.81, p < 0.001) and had lower education levels (β = −5.05, p < 0.001), after adjusting for the study variables. The level of misunderstanding pictograms was similar to that of misunderstanding instructions for prescription drug labels. The amount of reading information on OTC drug labels significantly increased as respondents had adequate health literacy (β = 9.27, p < 0.001), were older (β = 12.49, p < 0.001), or had chronic diseases (β = 7.49, p = 0.007). Individuals’ health literacy level, reading behaviors, and complexity of medication instructions are associated with misunderstanding of medication information. Appropriate word choices in drug labels and an improved format of medication instructions could increase understanding of medication information and prevent adverse drug reactions.
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Fukushima A, Iessa N, Balakrishnan MR, Pal SN. Smartphone-based mobile applications for adverse drug reactions reporting: global status and country experience. BMC Med Inform Decis Mak 2022; 22:118. [PMID: 35501745 PMCID: PMC9063059 DOI: 10.1186/s12911-022-01832-7] [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: 09/26/2021] [Accepted: 03/30/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Smartphone technology can support paperless reporting of adverse drug reactions (ADRs). The aims of this study were to systematically assess smartphone ADR-reporting applications, understand their qualitative and quantitative impact on ADR reporting, and garner key lessons from owners and developers. METHODS This study had three components: (1) An assessment of ADR-reporting apps, (2) an online survey on the impact of app implementation on ADR reporting and the experiences of app developers and owners, and (3) a search of VigiBase, the World Health Organization global database of individual case safety reports (ICSRs), to observe trends in the number of ADR reports targeting countries where the apps were implemented. RESULTS Twenty-two apps were included. Eight out of the 22 apps were for countries in the WHO African region. Features observed included E2B data elements (E stands for efficacy) and functions supporting reporting and user engagement. Seventeen app developers and owners answered to the survey and reported overall positive experiences with app features, and post-launch increases in the total number of ICSRs. User type and user environment were cited as factors influencing app use: Respondents said younger people and/or those with an inclination to use technology were more likely to use apps compared to older or more technology-averse people, while respondents in countries with limited internet connectivity reported persistent difficulties in app use. CONCLUSIONS Smartphone apps for reporting ADRs offer added value compared to conventional reporting tools. Reporting tools should be selected based on interface features and factors that may influence app usage.
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Affiliation(s)
- Ayako Fukushima
- grid.3575.40000000121633745Regulation and Safety, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland
| | - Noha Iessa
- grid.3575.40000000121633745Regulation and Safety, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland
| | - Madhava Ram Balakrishnan
- grid.3575.40000000121633745Regulation and Safety, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland
| | - Shanthi Narayan Pal
- grid.3575.40000000121633745Regulation and Safety, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland
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De Wit LE, Wilting I, Souverein PC, van der Pol P, Egberts TCG. Impulse control disorders associated with dopaminergic drugs: A disproportionality analysis using vigibase. Eur Neuropsychopharmacol 2022; 58:30-38. [PMID: 35189453 DOI: 10.1016/j.euroneuro.2022.01.113] [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: 05/26/2021] [Revised: 01/24/2022] [Accepted: 01/28/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Dopamine receptor agonist drugs, which are used, for example, to treat Parkinson's disease (PD), increase the risk for impulse control disorders (ICDs), potentially resulting in devastating psychosocial consequences. It is unknown whether other drugs with dopaminergic properties also increase the risk for ICDs. This study assesses the disproportionality of reporting ICDs between drugs with dopaminergic properties and selected non-dopaminergic drugs. METHODS A case/non-case disproportionality analysis was performed, using data from VigiBase (1968-2020). Reports on ICDs as suspected adverse drug reactions (ADRs) were cases (n=852), and those with ADRs other than ICDs were non-cases (n=281,720). Relative reporting frequencies were expressed as adjusted reporting odds ratios (aRORs). Within the dopamine receptor agonists, the relationship between reporting odds ratios and dopamine receptor occupancy was explored. RESULTS A high disproportionality was found for reporting ICDs for all dopaminergic drugs (aROR 20.4 [95% CI 17.4-24.1]) compared to non-dopaminergic drugs. In pharmacotherapeutic subgroups, a high disproportionality was found for primary dopaminergic agents used in PD (aROR 52.1 [95% CI 44.1-61.5]), and to a lesser extent for ADHD psychostimulants and antidepressants (aROR 5.8 [95% 4.1-8.3] and aROR 3.9 [95% CI 2.9-5.6], respectively). There was no difference in reporting by consumers and healthcare professionals. The highest disproportionality was found for the dopamine receptor agonists pramipexole and ropinirole. CONCLUSIONS A signal of disproportion in ICD occurrence was found among all investigated drugs with dopaminergic properties, highlighting the importance of counselling and monitoring for ICDs when prescribing dopaminergic drugs.
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Affiliation(s)
- Laura E De Wit
- Dept. of Psychiatry, University Medical Center Utrecht, the Netherlands; Dept. of Psychiatry, Sint Antonius Hospital, Utrecht, the Netherlands.
| | - Ingeborg Wilting
- Dept. of Clinical Pharmacy, University Medical Center Utrecht, the Netherlands
| | - Patrick C Souverein
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Siences, Utrecht University, the Netherlands
| | | | - Toine C G Egberts
- Dept. of Clinical Pharmacy, University Medical Center Utrecht, the Netherlands; Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Siences, Utrecht University, the Netherlands
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Estimation of the Under-Reporting of Suspected Serious Adverse Drug Reactions in Japan Using An Interrupted Time Series Analysis. Ther Innov Regul Sci 2022; 56:358-365. [DOI: 10.1007/s43441-022-00379-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 01/20/2022] [Indexed: 11/25/2022]
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13
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Desai M. Pharmacovigilance and spontaneous adverse drug reaction reporting: Challenges and opportunities. Perspect Clin Res 2022; 13:177-179. [PMID: 36337368 PMCID: PMC9635349 DOI: 10.4103/picr.picr_169_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/12/2022] [Indexed: 11/12/2022] Open
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Wasylewicz A, van de Burgt B, Weterings A, Jessurun N, Korsten E, Egberts T, Bouwman A, Kerskes M, Grouls R, van der Linden C. Identifying adverse drug reactions from free-text electronic hospital health record notes. Br J Clin Pharmacol 2021; 88:1235-1245. [PMID: 34468999 PMCID: PMC9292762 DOI: 10.1111/bcp.15068] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 11/30/2022] Open
Abstract
Background Adverse drug reactions (ADRs) are estimated to be the fifth cause of hospital death. Up to 50% are potentially preventable and a significant number are recurrent (reADRs). Clinical decision support systems have been used to prevent reADRs using structured reporting concerning the patient's ADR experience, which in current clinical practice is poorly performed. Identifying ADRs directly from free text in electronic health records (EHRs) could circumvent this. Aim To develop strategies to identify ADRs from free‐text notes in electronic hospital health records. Methods In stage I, the EHRs of 10 patients were reviewed to establish strategies for identifying ADRs. In stage II, complete EHR histories of 45 patients were reviewed for ADRs and compared to the strategies programmed into a rule‐based model. ADRs were classified using MedDRA and included in the study if the Naranjo causality score was ≥1. Seriousness was assessed using the European Medicine Agency's important medical event list. Results In stage I, two main search strategies were identified: keywords indicating an ADR and specific prepositions followed by medication names. In stage II, the EHRs contained a median of 7.4 (range 0.01‐18) years of medical history covering over 35 000 notes. A total of 318 unique ADRs were identified of which 63 were potentially serious and 179 (sensitivity 57%) were identified by the rule. The method falsely identified 377 ADRs (positive predictive value 32%). However, it also identified an additional eight ADRs. Conclusion Two key strategies were developed to identify ADRs from hospital EHRs using free‐text notes. The results appear promising and warrant further study.
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Affiliation(s)
- Arthur Wasylewicz
- Department of Healthcare Intelligence, Catharina Hospital, Eindhoven, the Netherlands
| | - Britt van de Burgt
- Department of Healthcare Intelligence, Catharina Hospital, Eindhoven, the Netherlands
| | - Aniek Weterings
- Department of Geriatrics, Catharina Hospital, Eindhoven, the Netherlands
| | - Naomi Jessurun
- Netherlands Pharmacovigilance Centre LAREB,'s-Hertogenbosch, the Netherlands
| | - Erik Korsten
- Department of Healthcare Intelligence, Catharina Hospital, Eindhoven, the Netherlands.,Department of Signal Processing Systems, Faculty of Electronic Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Toine Egberts
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Department of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, the Netherlands.,Department of Clinical Pharmacy, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Arthur Bouwman
- Department of Signal Processing Systems, Faculty of Electronic Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.,Department of Anesthesiology, Catharina Hospital, Eindhoven, the Netherlands
| | - Marieke Kerskes
- Department of Clinical Pharmacy, Catharina Hospital, Eindhoven, the Netherlands
| | - René Grouls
- Department of Clinical Pharmacy, Catharina Hospital, Eindhoven, the Netherlands
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