CHU Toulouse, Service de Pharmacologie Clinique, Ple Sant-Socit, Radaptation, Toulouse, France.
Drug Saf. 2012 Oct 1;35(10):845-54. doi: 10.1007/BF03261980.
BACKGROUND: Available data concerning the contribution of patient adverse drug reaction (ADR) reporting in practice are scarce. Few studies have compared patients' reports with reports from healthcare professionals (HCPs). During the 2009-10 mass immunization campaign with A (H1N1)v2009 pandemic influenza vaccines, a reinforced pharmacovigilance plan was introduced in France according to European Medicines Agency recommendations. For the first time, patients were offered the opportunity to report suspected ADRs to pandemic vaccines directly to regional pharmacovigilance centres. OBJECTIVE: The aim of the study was to compare the characteristics of patient and HCP ADR reports in order to assess the qualitative and quantitative contribution of patient reporting to the French Pharmacovigilance System. METHODS: All spontaneous ADRs registered into the French Pharmacovigilance Database from 21 October 2009 to 15 June 2010, in which either one of the most frequently administered pandemic vaccines (i.e. Panenza® or Pandemrix®) was involved, were analysed. ADRs were classified as 'serious', 'medically serious' and 'non-serious'. This study focused on 'serious' and 'medically serious' ADRs. An ADR was ranked as 'medically serious' when it required medical intervention or hospitalization within less than 24 hours. In each level of seriousness, frequency of 'unlabelled' ADRs, ADRs of 'special interest', imputability scores and category of ADRs according to Medical Dictionary for Regulatory Activitives (MedDRA®) primary System Organ Class were compared between patient and professional reports. RESULTS: Among the 4746 reports received during the study period, 1006 (21.2%) originated from patients. HCPs reported significantly more 'medically serious' or 'serious' ADRs than patients (15.1% [565/3740] vs 8.4% [85/1006], respectively; p < 0.001). No difference was found in 'unlabelled, serious' ADRs between patients and HCPs (56.5% [n = 13] vs 56.7% [n = 136], respectively). CONCLUSIONS: In this first French experience of formal patient participation to ADR reporting, patient contribution to the total number of ADRs reached 21.2%. This study revealed no major qualitative difference between patient and HCP reports. ADR profiles reported by patients appeared to be consistent with those from professionals. Further investigations are necessary to assess the intrinsic quality of notification forms coming from non-professional reporters. However, this study is of particular interest in the context of publication of the first governmental decree that will formally integrate patient participation to the current French ADR reporting scheme.
背景:关于患者药物不良反应(ADR)报告在实践中的贡献的可用数据很少。很少有研究将患者报告与医疗保健专业人员(HCP)的报告进行比较。在 2009-10 年大规模接种甲型 H1N1 流感疫苗的活动中,根据欧洲药品管理局的建议,法国引入了强化药物警戒计划。这是第一次,患者有机会直接向地区药物警戒中心报告疑似大流行性流感疫苗的 ADR。
目的:本研究旨在比较患者和 HCP 的 ADR 报告特征,以评估患者报告对法国药物警戒系统的定性和定量贡献。
方法:从 2009 年 10 月 21 日至 2010 年 6 月 15 日,分析了在法国药物警戒数据库中登记的所有自发 ADR,其中涉及最常使用的大流行疫苗之一(即 Panenza®或 Pandemrix®)。ADR 被分类为“严重”、“医学上严重”和“非严重”。本研究重点关注“严重”和“医学上严重”的 ADR。当 ADR 在 24 小时内需要医疗干预或住院治疗时,将其评为“医学上严重”。在每个严重程度级别中,比较了患者和专业报告之间“未标记”的 ADR、“特殊关注”的 ADR、归因评分和根据监管活动医学词典(MedDRA®)主要系统器官分类的 ADR 类别。
结果:在研究期间收到的 4746 份报告中,有 1006 份(21.2%)来自患者。HCP 报告的“医学上严重”或“严重”ADR 明显多于患者(分别为 15.1%[565/3740]和 8.4%[85/1006];p<0.001)。患者和 HCP 之间未发现“未标记,严重”ADR 之间存在差异(分别为 56.5%[n=13]和 56.7%[n=136])。
结论:在法国首次正式参与 ADR 报告的患者参与经验中,患者对 ADR 总数的贡献达到了 21.2%。本研究未发现患者报告和 HCP 报告之间存在重大的质量差异。患者报告的 ADR 特征似乎与专业人员的特征一致。需要进一步调查来评估来自非专业报告人的通知表的内在质量。然而,在发布将正式将患者参与纳入当前法国 ADR 报告计划的第一个政府法令的背景下,这项研究具有特别重要的意义。
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