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德国医生、药师和消费者上报的药品不良反应报告中信息的比较分析。

Comparative Analysis of Information Provided in German Adverse Drug Reaction Reports Sent by Physicians, Pharmacists and Consumers.

机构信息

Research Division, Federal Institute for Drugs and Medical Devices, Bonn, Germany.

Institute for Medical Biometry, Informatics and Epidemiology, University Hospital of Bonn, Bonn, Germany.

出版信息

Drug Saf. 2023 Dec;46(12):1363-1379. doi: 10.1007/s40264-023-01355-8. Epub 2023 Nov 21.

Abstract

INTRODUCTION

Adverse drug reactions (ADRs) can be reported by Health Care Professionals (HCPs; e.g., physicians, pharmacists) and non-Health Care Professionals (non-HCPs; e.g., consumers). Previous studies investigating differences between reports from HCPs and non-HCPs rarely considered the completeness of information provided. In addition, they mostly did not distinguish between physicians and pharmacists or were performed years ago. The aim of our study was to analyse and compare the completeness of information provided in reports from physicians, pharmacists and consumers from Germany in a more recent dataset.

MATERIALS AND METHODS

We analysed all spontaneous reports from Germany received between 2018 and 2021 in the ADR database EudraVigilance exclusively reported by physicians (n = 69,976), pharmacists (n = 42,396) or consumers (n = 121,144). Demographical parameters of the patients were analysed descriptively. Completeness of reports was evaluated applying an established score (vigiGrade). Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using logistic regression analysis in order to identify report, patient, drug or ADR-specific information provided more often in reports from physicians, pharmacists or consumers.

RESULTS

Within the study period the number of reports per year by physicians and pharmacists decreased steadily, while an opposite trend was observed for consumer reports. The proportion of female patients was higher in reports from pharmacists (64.4%) and consumers (64.8%) compared to those from physicians (55.3%). On average, patients in reports from pharmacists (58.7) were older compared to those from physicians (53.5) and consumers (52.6). As an example for the presence of specific information, the time to onset of the ADR could be calculated more often in consumer compared to physician (OR 1.9 [1.8-1.9]) and pharmacist reports (OR 1.7 [1.6-1.7]). In contrast, pharmacist (OR 0.5 [0.4-0.5]) and consumer (OR 0.5 [0.5-0.5]) reports included the indication of the suspected drug less often than physician reports. Physician reports on average (mean = 0.5) were slightly more complete according to the vigiGrade score compared to reports from consumers (mean = 0.4) and pharmacists (mean = 0.4).

CONCLUSION

The ADR reports from consumers were comparable with regard to the completeness score with those from physicians and pharmacists underlining their value. Differences in completeness of specific information between the reporter types were found, suggesting that a common reporting of interactions between the three reporters may further improve the completeness of ADR reports. Furthermore, stratified analysis of ADR reports per reporter type may be helpful for certain objectives in scientific research.

摘要

简介

药物不良反应(ADR)可由医疗保健专业人员(例如医生、药剂师)和非医疗保健专业人员(例如消费者)报告。先前研究调查了医疗保健专业人员和非医疗保健专业人员报告之间的差异,很少考虑所提供信息的完整性。此外,它们大多没有区分医生和药剂师,或者是多年前进行的。我们研究的目的是在最近的数据集中分析和比较德国医生、药剂师和消费者报告中提供信息的完整性。

材料和方法

我们分析了 2018 年至 2021 年期间在 EudraVigilance 药物警戒数据库中仅由医生(n = 69,976)、药剂师(n = 42,396)或消费者(n = 121,144)报告的所有自发报告。对患者的人口统计学参数进行描述性分析。使用既定评分(vigiGrade)评估报告的完整性。使用逻辑回归分析计算比值比(OR)及其 95%置信区间(CI),以确定医生、药剂师或消费者报告中更常提供的报告、患者、药物或 ADR 特定信息。

结果

在研究期间,医生和药剂师每年的报告数量稳步下降,而消费者报告则呈相反趋势。与医生报告(55.3%)相比,药剂师(64.4%)和消费者(64.8%)报告中的女性患者比例更高。平均而言,药剂师报告中的患者(58.7 岁)比医生(53.5 岁)和消费者(52.6 岁)报告中的患者年龄更大。作为存在特定信息的一个例子,与医生(OR 1.9 [1.8-1.9])和药剂师(OR 1.7 [1.6-1.7])报告相比,消费者报告中更常计算 ADR 发病时间。相比之下,药剂师(OR 0.5 [0.4-0.5])和消费者(OR 0.5 [0.5-0.5])报告中报告的可疑药物适应症较少。根据 vigiGrade 评分,医生报告的平均(平均值 = 0.5)比消费者(平均值 = 0.4)和药剂师(平均值 = 0.4)报告更完整。

结论

消费者的 ADR 报告在完整性评分方面与医生和药剂师报告相当,这强调了它们的价值。在报告类型之间发现了特定信息完整性的差异,这表明三种报告者之间的共同报告可能会进一步提高 ADR 报告的完整性。此外,按报告者类型对 ADR 报告进行分层分析可能有助于某些科学研究目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fab/10684666/1134de05a799/40264_2023_1355_Fig1_HTML.jpg

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