Balsamo Claudia, Del Bono Chiara, Pagano Gennaro, Valastro Valentina, Ghizzi Chiara, Lombardi Francesca
Pediatric Department (CB, CG, FL), Maggiore Hospital Carlo Alberto Pizzardi, Ospedale Maggiore Carlo Alberto Pizzardi, Bologna AUSL, Bologna, Italy.
Specialty School of Paediatrics (CDB, GP), Alma Mater Studiorum, Università di Bologna, Bologna, Italy.
J Pediatr Pharmacol Ther. 2022;27(4):324-329. doi: 10.5863/1551-6776-27.4.324. Epub 2022 May 9.
Adverse drug reactions (ADRs) in children are an important but underestimated public health issue. This study describes ADRs in a registered pediatric population of Bologna and demonstrates that ADRs might be better detected after health care personnel training.
A prospective cohort was recruited from July 1, 2016, to June 30, 2019, after health care worker sensitization, and compared to a retrospective cohort enrolled from 2013 to 2016. The ADRs are classified by system organ classes and drugs are categorized according to the Anatomical Therapeutic Chemical classification system.
We retrospectively recruited 78 pediatric patients with ADRs in the 2013 to 2016 period, and we prospectively enrolled 127 children in the 2016 to 2019 period. In both periods, most of the ADRs reported were classified as non-serious reactions (68.8%). The most frequent ADRs were general and administration site disorders. During 2013 to 2016 vaccines were the most frequent cause of ADRs (83.3%;) and the main reporters were health care workers other than physicians (84.6%), whereas during the second period, medical doctors become the main signalers (65.4%) and ADRs related to vaccines significantly decreased (55.1%). During the 2016 to 2019 period the number of drug categories was higher than in the 2013 to 2016 period (24 vs 8). Patients with ADRs due to vaccinations present more frequently a favourable outcome (63%).
This study demonstrates that active pharmacovigilance and health care personnel sensitization are associated with improved ADR detection, providing valuable information about drugs' safety profile in pediatric patients.
儿童药物不良反应(ADR)是一个重要但被低估的公共卫生问题。本研究描述了博洛尼亚登记的儿科人群中的ADR,并表明在医护人员培训后可能能更好地检测到ADR。
在医护人员提高认识后,于2016年7月1日至2019年6月30日招募了一个前瞻性队列,并与2013年至2016年登记的回顾性队列进行比较。ADR按系统器官类别分类,药物根据解剖治疗化学分类系统进行分类。
我们回顾性招募了2013年至2016年期间78例有ADR的儿科患者,并前瞻性纳入了2016年至2019年期间127名儿童。在两个时期,报告的大多数ADR被分类为非严重反应(68.8%)。最常见的ADR是全身性和给药部位疾病。在2013年至2016年期间,疫苗是ADR最常见的原因(83.3%),主要报告者是医生以外的医护人员(84.6%),而在第二个时期,医生成为主要报告者(65.4%),与疫苗相关的ADR显著减少(55.1%)。在2016年至2019年期间,药物类别数量高于2013年至2016年期间(24种对8种)。因接种疫苗出现ADR的患者更常呈现良好结局(63%)。
本研究表明,积极的药物警戒和医护人员提高认识与改善ADR检测相关,为儿科患者药物安全性概况提供了有价值的信息。