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患者报告是否会导致药物安全信号的更早检测?在一个全球数据库中,对患者和医疗保健专业人员之间报告时间的回顾性比较。

Does patient reporting lead to earlier detection of drug safety signals? A retrospective comparison of time to reporting between patients and healthcare professionals in a global database.

机构信息

Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands.

University of Groningen, Groningen Research Institute of Pharmacy, Unit of PharmacoTherapy, Epidemiology & Economics, University of Groningen, Groningen, The Netherlands.

出版信息

Br J Clin Pharmacol. 2018 Jul;84(7):1514-1524. doi: 10.1111/bcp.13576. Epub 2018 Apr 19.

Abstract

AIMS

To explore if there is a difference between patients and healthcare professionals (HCPs) in time to reporting drug-adverse drug reaction (ADR) associations that led to drug safety signals.

METHODS

This was a retrospective comparison of time to reporting selected drug-ADR associations which led to drug safety signals between patients and HCPs. ADR reports were selected from the World Health Organization Global database of individual case safety reports, VigiBase. Reports were selected based on drug-ADR associations of actual drug safety signals. Primary outcome was the difference in time to reporting between patients and HCPs. The date of the first report for each individual signal was used as time zero. The difference in time between the date of the reports and time zero was calculated. Statistical differences in timing were analysed on the corresponding survival curves using a Mann-Whitney U test.

RESULTS

In total, 2822 reports were included, of which 52.7% were patient reports, with a median of 25% for all included signals. For all signals, median time to signal detection was 10.4 years. Overall, HCPs reported earlier than patients: median 7.0 vs. 8.3 years (P < 0.001).

CONCLUSIONS

Patients contributed a large proportion of reports on drug-ADR pairs that eventually became signals. HCPs reported 1.3 year earlier than patients. These findings strengthen the evidence on the value of patient reporting in signal detection and highlight an opportunity to encourage patients to report suspected ADRs even earlier in the future.

摘要

目的

探讨在导致药物安全信号的药物不良反应(ADR)报告时间方面,患者和医疗保健专业人员(HCP)之间是否存在差异。

方法

这是一项回顾性比较,比较了导致药物安全信号的选定药物-ADR 报告时间,比较了患者和 HCP 之间的时间。ADR 报告是从世界卫生组织全球个体病例安全报告数据库(VigiBase)中选择的。根据实际药物安全信号的药物-ADR 关联选择报告。主要结果是患者和 HCP 之间报告时间的差异。每个信号的首次报告日期用作时间零。报告日期与时间零之间的时间差计算。使用曼-惠特尼 U 检验在相应的生存曲线上分析时间差异的统计学差异。

结果

总共纳入了 2822 份报告,其中 52.7%是患者报告,所有纳入信号的中位数为 25%。对于所有信号,信号检测的中位时间为 10.4 年。总体而言,HCP 比患者更早报告:中位数为 7.0 年对 8.3 年(P<0.001)。

结论

患者对最终成为信号的药物-ADR 对报告做出了很大贡献。HCP 比患者早报告了 1.3 年。这些发现加强了患者报告在信号检测中的价值的证据,并强调了鼓励患者在未来更早报告可疑 ADR 的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fd4/6005587/af8f09724117/BCP-84-1514-g001.jpg

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