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药品效益-风险沟通工具:文献综述

Pharmaceutical Benefit-Risk Communication Tools: A Review of the Literature.

作者信息

Way Dominic, Blazsin Hortense, Löfstedt Ragnar, Bouder Frederic

机构信息

King's Centre for Risk Management, King's College London, Strand, London, WC2R 2LS, UK.

MINES ParisTech, Research Center on Risk and Crisis, rue Claude Daunesse, B.P 207, 06904, Sophia Antipolis Cedex, France.

出版信息

Drug Saf. 2017 Jan;40(1):15-36. doi: 10.1007/s40264-016-0466-1.

Abstract

This paper reviews the main tools for communicating benefit-risk medicines information to patients that are used, or could be used, by pharmaceutical regulators. One highly successful tool from the food safety sector (front-of-package traffic-light labelling) and the mental models approach (which provides a framework for developing new tools) are also reviewed as they show great promise for being usefully adapted to the pharmaceutical context. The evolution of benefit-risk medicines communication is first contextualised within the broader risk communication literature. Three distinct goals are then made explicit before critically examining the evidence for and against tools developed in the US (e.g. at the Food and Drug Administration [FDA]) and Europe (e.g. at the European Medicines Agency [EMA]). These goals are (i) sharing information (e.g. publishing clinical trial and adverse event data online); (ii) changing patients' beliefs by conveying factual knowledge (e.g. patient information leaflets and the drugs facts box); and (iii) changing behaviour (e.g. patient alert cards and warning labels). The mental models approach and traffic-light labelling, developed outside the pharmaceutical context, are then examined. Ultimately, the paper provides a helicopter view of the variety of benefit-risk communication tools that are used, or could be used, by pharmaceutical regulators in the US and Europe.

摘要

本文回顾了药品监管机构使用或可能使用的向患者传达药品获益-风险信息的主要工具。还回顾了食品安全领域一种非常成功的工具(包装正面的红绿灯标签)和心智模型方法(为开发新工具提供了一个框架),因为它们在适用于制药领域方面显示出巨大潜力。药品获益-风险沟通的演变首先在更广泛的风险沟通文献背景中进行了阐述。然后明确了三个不同的目标,接着批判性地审视了支持和反对在美国(如食品药品监督管理局[FDA])和欧洲(如欧洲药品管理局[EMA])开发的工具的证据。这些目标是:(i)分享信息(如在线发布临床试验和不良事件数据);(ii)通过传达事实性知识改变患者的信念(如患者信息单和药品事实框);以及(iii)改变行为(如患者警示卡和警示标签)。然后研究了在制药领域之外开发的心智模型方法和红绿灯标签。最终,本文全面审视了美国和欧洲药品监管机构使用或可能使用的各种获益-风险沟通工具。

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