Department of Pharmacy, University Hospital of Besançon, 25030 Besançon, France.
French Franche-Comté Regional Pharmacovigilance Centre, 25030 Besançon, France.
Therapie. 2022 May-Jun;77(3):291-300. doi: 10.1016/j.therap.2021.12.007. Epub 2021 Dec 15.
Serious adverse drug reactions account for 3.6% of French hospital admissions. Of these, 48.5% are, at least potentially, preventable. The first aim of post-marketing pharmacovigilance is to detect adverse drug reactions as a safety signal to improve patients' safety. Thus, this study describes the epidemiology of "serious" adverse drug reactions reported between 2015 and 2018 to a regional pharmacovigilance centre and assesses their economic burden.
All "serious" adverse drug reactions reported to a regional pharmacovigilance centre during the four-year study period were collected and cost associated. Only congenital anomalies related to "serious" adverse drug reactions were excluded.
All 2585 "serious" adverse drug reactions reported are related to 1242 "serious" individual case safety reports. Among 58.1% of them, patients required hospital admission or a visit to the emergency room with a median cost estimated to €3725 per "serious" individual case safety report. The most "serious" adverse drug reactions reported involved gastrointestinal disorders. Fifteen percent of the imputed drugs had a narrow therapeutic index and the most frequently drug was fluindione. Finally, high relationships with an economic burden were observed for ages over or equal to 65, and imputed drugs from "Blood and Blood-Forming Organs" and "Anti-infectives for systemic use" therapeutic groups.
This study provides news data on epidemiology and cost of "serious" adverse drug reactions completing the existing literature. On a regional scale, pharmacovigilance real world data could be interesting for pharmacist clinicians in common practice to improve the good use of drugs.
法国住院患者中严重药物不良反应占 3.6%。其中,至少有 48.5%是潜在可预防的。上市后药物警戒的首要目标是发现药物不良反应信号,以提高患者安全性。因此,本研究描述了 2015 年至 2018 年期间向区域药物警戒中心报告的“严重”药物不良反应的流行病学,并评估了其经济负担。
收集并评估了四年研究期间向区域药物警戒中心报告的所有“严重”药物不良反应的成本。仅排除与“严重”药物不良反应相关的先天性异常。
共报告了 2585 例“严重”药物不良反应,涉及 1242 例“严重”个体病例安全报告。其中 58.1%的患者需要住院或到急诊室就诊,估计每例“严重”个体病例安全报告的中位数费用为 3725 欧元。报告的最“严重”药物不良反应涉及胃肠道疾病。有 15%的推断药物具有较窄的治疗指数,最常涉及的药物是华法林。最后,观察到与经济负担高度相关的因素包括年龄大于或等于 65 岁,以及来自“血液和造血器官”和“全身抗感染药物”治疗组的推断药物。
本研究提供了“严重”药物不良反应的流行病学和成本的新数据,补充了现有文献。在区域范围内,药物警戒真实世界数据对于药师临床医生在常规实践中改善药物合理使用可能具有重要意义。