1.Perceptions of clients on a university-based drug information service affecting medication safety
Frances Lois U. Ngo ; Kristine Eves S. Garcia ; Monet M. Loquias ; Yolanda R. Robles ; Francis R. Capule
Acta Medica Philippina 2024;58(19):29-36
OBJECTIVES
To assess the clients’ perceptions of the UP College of Pharmacy (UPCP) Telepharmacy Service on their knowledge, decision-making, and medication safety.
METHODSThe study employed a cross-sectional design administered through guided voice-call interviews using an online survey questionnaire as the data collection instrument. The inclusion criteria of the study were as follows: (1) must be at least 18 years old, (2) with no cognitive impairment, (3) must have sent a medication-related query in the UPCP Telepharmacy Service between October 2020 and July 2022, and (4) must be contacted through voice call platforms.
RESULTSA total of 72 respondents participated in the study. Majority were from 30 to 59-year-old age category (51.39%), females (72.22%), from Region IV-A (36.11%), college graduates (44.44%), and with average monthly income of below PhP 11,000 (47.22%). Overall, clients reported very positive perceptions on the drug information advice received (X̅4.510) and were very satisfied with the service (X̅ 4.625). They perceived that the advice influenced their decision-making about their medications (X̅ 4.514) and increased their understanding of medication safety (X̅ 4.522). Multiple regression analysis revealed that clients’ perception on drug information advice is positively associated with perceived effect on decision-making (r = 0.5033; p = 0.000) and medication safety (r = 0.4320; p = 0.004).
The pharmacist-led drug information service, such as the UPCP Telepharmacy Service, is a helpful program to provide accurate and reliable medication information to clients who need them amidst the increasing accessibility of medical information on the internet. It can help improve knowledge of patients about appropriate use of medicines, drug interactions, and adverse drug reactions that will enable them to make informed decisions regarding their medications, identify the need to consult with healthcare providers, and ultimately ensure medication safety.
Human ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Telehealth ; Telemedicine ; Drug Information Services
2.Proposed algorithm on a community-based adverse event reporting system for herbal products in the Philippines
John Nicolas B. Mejia ; Jocelyn S. Bautista-Palacpac
Philippine Journal of Health Research and Development 2024;28(2):34-39
Background:
The pharmacovigilance system in the Philippines aims to ensure the safe use of medicines, including herbal products.
However, there is a lack of reporting on adverse events related to herbal products, indicating a need for an improved monitoring system.
Objectives:
This study seeks to develop a community-based adverse event reporting system for herbal products in Calamba and Los
Baños Laguna to enhance pharmacovigilance practices in the Philippines. The primary objectives include assessing consumer
knowledge, willingness to report adverse events, and evaluating the feasibility of implementing such a system in community pharmacies.
Methodology:
A mixed-methods approach was employed, involving surveys with herbal product consumers and focus group
discussions with community pharmacists. Data analysis utilized Likert scaling for surveys and thematic analysis for discussions,
providing a comprehensive understanding of consumer perceptions and pharmacist experiences.
Results:
The study revealed limited consumer awareness of herbal safety risks but with a positive attitude towards reporting adverse
events through community pharmacies. The developed algorithm, tailored to consumer and pharmacist preferences, demonstrated
potential benefits in enhancing pharmacovigilance and promoting the rational use of herbal products.
Conclusion
The proposed community-based adverse event reporting system for herbal products in the Philippines offers a practical and
accessible solution to improve pharmacovigilance, empower consumers, and ensure the safe utilization of herbal products.
Implementation of this system has the potential to significantly enhance public health outcomes and contribute to the overall well-being of
the Filipino population.
Pharmacovigilance
;
Pharmacies
;
Pharmacists
3.Interpretation of Technical Specifications for Revision of Safety Information in Marketed Chinese Patent Medicine Instructions.
Xiao-Meng ZHANG ; Zhi-Jian LIN ; Bing ZHANG ; Ri-Na SA ; Jin-Tao LYU ; Hao WU ; Yao-Lei LI ; Hui-Zhe XU ; Zheng-Kai HUANG ; Yu-Bo GUO ; Xiang-Fei SU ; Xiao-Jiao DUAN
China Journal of Chinese Materia Medica 2022;47(2):295-300
Technical Specifications for Revision of Safety Information in Marketed Chinese Patent Medicine Instructions,a series of group standards,were proposed by Professor ZHANG Bing from Research Center for Pharmacovigilance and Rational Use of Traditional Chinese Medicine,and underwent centralized management by Chinese Association of Chinese Medicine. They were officially released on July 23 and implemented on July 31,2021. The series of group standards consist of six sections,including general principles,adverse drug events,contraindications,precautions,application for special populations,and warnings. The section of general principles is comprised of holistic and programmatic expressions,which explain the general technical requirements for revising the marketed Chinese patent medicine instructions. The other five sections focus on information collection,screening,transformation,and illustration of specific items,forming a standardized revision technical process. This series of standards is the result of multiple rounds of research and the suggestions of more than 200 experts in different professional fields of " medicine-pharmacy-management-law-enterprise" have been gathered therein to reach a consensus. With the purposes of establishing standardized technical specifications for the revision of safety information in the marketed Chinese patent medicine instructions,guiding marketing authorization holders in revising the instructions,filling the gaps in the research of Chinese patent medicine instructions,promoting the deve-lopment of pharmaceutical care and academic research,and encouraging the rational and safe medication of Chinese patent medicine,the series of group standards is of great significance.
China
;
Drug-Related Side Effects and Adverse Reactions
;
Drugs, Chinese Herbal/adverse effects*
;
Humans
;
Medicine, Chinese Traditional
;
Nonprescription Drugs/adverse effects*
;
Pharmacovigilance
4.Research Progress of Antitumor Pharmacovigilance.
Wenjuan SUN ; Yang HU ; Yan XU ; Bo ZHANG
Chinese Journal of Lung Cancer 2022;25(7):541-545
In 2019, Drug Administration Law of China was first time proposed that the country should establish pharmacovigilance system. In 2021, the first Pharmacovigilance Quality Management Standard of China was released. The proposal and implementation of pharmacovigilance were the initial stage in China, and it needed to improve the aspects of pharmacovigilance include institution, monitoring mechanism and database construction. The number of new diagnosed cancer patients in China ranked first in the world. In recent years, the marketing speed of novel antitumor drugs was accelerated, and there were many clinical trials. Therefore, antitumor pharmacovigilance was imperative. In this article, we summarized pharmacovigilance of the origin, clinical practice objectives, procedures, methods. We described the difficulties in antitumor pharmacovigilance and current characteristics of pharmacovigilance in China, aiming to provide reference for the development of antitumor pharmacovigilance.
.
China
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Humans
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Lung Neoplasms
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Pharmacovigilance
5.Assessing taxane-associated adverse events using the FDA adverse event reporting system database.
Dong-Hui LAO ; Ye CHEN ; Jun FAN ; Jian-Zhong ZHANG
Chinese Medical Journal 2021;134(12):1471-1476
BACKGROUND:
Taxanes are an essential class of antineoplastic agents used to treat various cancers and are a fundamental cause of hypersensitivity reactions. In addition, other adverse events, such as bone marrow toxicity and peripheral neuropathy, can lead to chemotherapy discontinuation. This study aimed to evaluate the safety of taxanes in the real world.
METHODS:
Taxane-associated adverse events were identified by the Medical Dictionary for Regulatory Activities Preferred Terms and analyzed and compared by mining the US Food and Drug Administration Adverse Event Reporting System pharmacovigilance database from January 2004 to December 2019. Reported adverse events, such as hypersensitivity reaction, bone marrow toxicity, and peripheral neuropathy, were analyzed with the following signal detection algorithms: reporting odds ratio (ROR), proportional reporting ratio (PRR), multi-item gamma Poisson shrinker (MGPS), Bayesian confidence propagation neural network (BCPNN), and logistic regression methods. Adverse outcome events and death outcome rates were compared between different taxane groups using Pearson's χ2 test, whereas significance was determined at P < 0.05 with a 95% confidence interval (CI).
RESULTS:
A total of 966 reports of hypersensitivity reactions, 1109 reports of bone marrow toxicity, and 1374 reports of peripheral neuropathy were analyzed. Compared with paclitaxel and docetaxel, bone marrow toxicity following the use of nab-paclitaxel had the highest ROR of 6.45 (95% two-sided CI, 6.05-6.88), PRR of 5.66, (χ2 = 4342.98), information component of 2.50 (95% one-sided CI = 2.34), and empirical Bayes geometric mean of 5.64 (95% one-sided CI = 5.34). Peripheral neuropathy following the use of nab-paclitaxel showed a higher ROR of 12.78 (95% two-sided CI, 11.55-14.14), PRR of 12.16 (χ2 = 4060.88), information component of 3.59 (95% one-sided CI = 3.25), and empirical Bayes geometric mean of 12.07 (95% one-sided CI = 11.09).
CONCLUSIONS
The results showed that bone marrow toxicity and peripheral neuropathy were the major adverse events induced by taxanes. Nab-paclitaxel exhibited the highest potential for taxane-associated adverse events. Further research in the future is warranted to explain taxane-associated adverse effects in real-world circumstances.
Adverse Drug Reaction Reporting Systems
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Bayes Theorem
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Bridged-Ring Compounds
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Taxoids/adverse effects*
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United States
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United States Food and Drug Administration
6.Technical specification for Instructions for Clinical Application of Chinese Patent Medicines in China Association of Chinese Medicine.
Xiao-Meng ZHANG ; Ri-Na SA ; Bing ZHANG ; Dan ZHANG ; Jin-Tao LYU ; Xiao-Jiao DUAN ; Zhi-Jian LIN ; Yu-Bo GUO
China Journal of Chinese Materia Medica 2021;46(17):4563-4568
In order to solve the problems of confusion in clinical medication and imperfect instructions in Chinese patent medicines(CPMs), the Standardization Department of the China Association of Chinese Medicine and Center for Pharmacovigilance and Rational use of Chinese Medicine in Beijing University of Chinese Medicine jointly compiled the Instructions for Clinical Application of Chinese Patent Medicines(CPMs). As the interpretation and supplement of drug instruction information, it aims to guide clinical safety and rational use of CPMs. In addition, the technical specification for clinical application description of CPMs has been formulated, which covers the seven processes of "carding instructions, clinical investigation, data retrieval, data screening, evidence classification, path transformation and writing format". It will enable readers of Instructions for Clinical Application of Chinese Patent Medicines to understand the work behind the compilation.
Beijing
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China
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Drugs, Chinese Herbal
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Medicine, Chinese Traditional
;
Nonprescription Drugs
;
Pharmacovigilance
7.Enlightenment of international pharmacovigilance system on establishment of pharmacovigilance system of Chinese medicine.
Xin CUI ; Lian-Xin WANG ; Guang-Yu LIU ; Yan-Ming XIE
China Journal of Chinese Materia Medica 2021;46(21):5450-5455
Pharmacovigilance system is an extension of the original adverse drug reactions monitoring and reporting system as well as an internationally recognized basic system that must be matched with the whole life cycle supervision of drugs. European Union(EU)pharmacovigilance system, World Health Orgnization(WHO) Uppsala Monitoring Center system and ICH system are internationally recognized pharmacovigilance systems. They all have their own pharmacovigilance characteristics and could provide guarantee for clinical safe drug use. With the deepening of international communication, pharmacovigilance has also been developed in China. Pharmacovigilance of Chinese medicine is a new concept based on the existing pharmacovigilance system of chemical medicine and the characteristics of Chinese medicine. In ancient China, Chinese medicine also had its own ways of early warning. Ancient medical books have records on the toxicity classification, clinical pharmacovigilance and intoxication rescue of Chinese medicine. With the increase of public recognition of Chinese medicine in recent years, especially since the government issued the 13 th Five-Year Plan for the development of Chinese medicine, the pharmaceutical industry in China has paid more and more attention to the pharmacovigilance of Chinese medicine.However, the pharmacovigilance system of Chinese medicine has not yet been established, and it still needs to be explored and improved.Therefore, it is very necessary to develop the system to standardize pharmacovigilance-related activities of Chinese medicine. In this context, this study analyzed and learned the characteristics of pharmacovigilance systems of EU, ICH, and WHO Uppsala Monitoring Center, so as to provide some enlightenment for the establishment and improvement of pharmacovigilance system of Chinese medicine.
Adverse Drug Reaction Reporting Systems
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Books
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Drug-Related Side Effects and Adverse Reactions/epidemiology*
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European Union
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Humans
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Medicine, Chinese Traditional
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Pharmacovigilance
8.Pharmacovigilance of traditional Chinese medicine: an exploration based on prescription sequence analysis and prescription sequence symmetry analysis.
Jian LYU ; Lian-Xin WANG ; Yan-Ming XIE
China Journal of Chinese Materia Medica 2021;46(21):5468-5474
Multiple methods should be incorporated into the research on pharmacovigilance of traditional Chinese medicine(TCM for a comprehensive and objective evaluation. The arrival of the era of medical big data allows it to be deeply integrated into medical research. The real world study(RWS) represented by hospital information system(HIS) provides a data basis for exploring the pharmacovigilance of TCM. Prescription sequence analysis(PSA) and prescription sequence symmetry analysis(PSSA) developed based on the former serve as a methodological basis for clinical safety evaluation of Chinese patent medicines after marketing. By collating the related studies of HIS, PSA and PSSA and employing the propensity score matching( PSM) method and nested case-control study(NCCS), this paper formed a HIS-, PSA-and PSSA-based technical system for clinical safety evaluation of Chinese patent medicines in the real world, in order to provide a methodological demonstration for the future research on the pharmacovigilance of TCM.
Case-Control Studies
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Drugs, Chinese Herbal
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Medicine, Chinese Traditional
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Pharmacovigilance
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Prescriptions
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Sequence Analysis
9.Landscape of Hepatobiliary Adverse Drug Reactions Related to Preparations Containing Psoraleae Fructus and Its Application in Pharmacovigilance.
Fei-Lin GE ; Ming NIU ; Zi-Xin HAN ; Jun-Ling CAO ; Jia-Bo WANG ; Zhao-Fang BAI ; Hai-Bo SONG ; Yu-Ming GUO ; Xiao-He XIAO
Chinese journal of integrative medicine 2021;27(11):832-837
OBJECTIVE:
To analyze clinical feature and information of medication to explore the risk signals of preparations containing Psoraleae Fructus (BGZP) related with hepatobiliary adverse drug reactions (ADR), in order to reinforce pharmacovigilance.
METHODS:
A retrospective study was conducted based on hepatobiliary ADR related with BGZP from the China Adverse Drug Reaction Monitoring System in years from January 2012 to December 2016. Serious and general ADRs were analyzed and assessed.
RESULTS:
There were 355 cases of hepatobiliary ADR related to BGZP. Both the amount of cases and the proportion of serious ADR showed an increasing growth by years (P<0.05). It was found that 10.43% of 355 cases may be involved with irrational drug use, including overdose, repeated medication, and combination of multiple drugs. There were 190 cases which used BGZP (non-combination), and they were mainly for common in diseases caused by abnormal immune activation (accounting for 40.53% of the total cases). Especially at the age group with the most cases with age of 41-50 years, the cases associated with immunological diseases of female were obviously more than that of male (P<0.05). The latency of hepatobiliary ADR related to BGZP ranged from 1 to 386 days, and the median latency was 27.5 days, along with the range of cumulative dose (0.45-520.02 g) as well as the daily dose (0.09-2.64 g/d) after the conversion.
CONCLUSIONS
Cases of hepatobiliary ADR related to BGZP showed significant individual differences, and there was no correlation between drug usage duration and dosage and the occurrence of hepatobiliary ADR. It may be similar with idiosyncratic drug-induced liver injury, and recommended that BGZP should be used with more caution under monitoring liver function, especially in female patients with immunological diseases.
Adult
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Adverse Drug Reaction Reporting Systems
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Chemical and Drug Induced Liver Injury/etiology*
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Drug-Related Side Effects and Adverse Reactions
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Female
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Humans
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Male
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Middle Aged
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Pharmacovigilance
;
Retrospective Studies
10.Adverse Skin Reactions with Antiepileptic Drugs Using Korea Adverse Event Reporting System Database, 2008–2017
Hyun Kyung KIM ; Dae Yeon KIM ; Eun Kee BAE ; Dong Wook KIM
Journal of Korean Medical Science 2020;35(4):17-
drug eruptions include drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). One class of medications that has been highly associated with such drug eruptions is antiepileptic drugs (AEDs). We attempt to investigate drug eruptions associated with AEDs as a class, as well as with individual AEDs, in Korea.METHODS: We used the Korea Institute of Drug Safety and Risk Management - Korea Adverse Event Reporting System (KIDS-KAERS) database, a nationwide database of adverse events reports, between January 2008 and December 2017 to investigate the reporting count of all drug eruptions and calculated the ratio of DRESS/SJS/TEN reports for each AED.RESULTS: Among a total of 2,942 reports, most were of rash/urticaria (2,702, 91.8%), followed by those of DRESS (109, 3.7%), SJS (106, 3.6%), and TEN (25, 0.85%). The common causative AEDs were lamotrigine (699, 23.8%), valproic acid (677, 23%), carbamazepine (512, 17.4%), oxcarbazepine (320, 10.9%), levetiracetam (181, 6.2%), and phenytoin (158, 5.4%). In limited to severe drug eruptions (DRESS, SJS, and TEN; total 241 reports), the causative AEDs were carbamazepine (117, 48.8%), lamotrigine (57, 23.8%), valproic acid (20, 8.3%), phenytoin (15, 6.3%), and oxcarbazepine (10, 4.2%). When comparing aromatic AED with non-aromatic AED, aromatic AEDs were more likely to be associated with severe drug eruption (aromatic AEDs: 204/1,793 versus non-aromatic AEDs: 37/1,149; OR, 3.86; 95% CI, 2.7–5.5). Death was reported in 7 cases; DRESS was the most commonly reported adverse event (n = 5), and lamotrigine was the most common causative AED (n = 5).CONCLUSION: Although most cutaneous drug eruptions in this study were rash or urticaria, approximately 8% of reports were of severe or life-threatening adverse drug reactions, such as SJS, TEN, or DRESS. When hypersensitivity skin reactions occurred, aromatic AEDs were associated with 4 fold the risk of SJS/TEN/DRESS compared with non-aromatic AEDs. Our findings further emphasize that high risk AEDs should be prescribed under careful monitoring, and early detection and prompt interventions are needed to prevent severe complications.]]>
Anticonvulsants
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Carbamazepine
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Drug Eruptions
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Drug Hypersensitivity Syndrome
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Drug-Related Side Effects and Adverse Reactions
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Exanthema
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Hypersensitivity
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Korea
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Pharmacovigilance
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Phenytoin
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Risk Management
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Skin
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Stevens-Johnson Syndrome
;
Urticaria
;
Valproic Acid


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