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There is a statutory obligation for pharmaceutical companies to record reports of adverse reactions to their drugs. The storage and retrieval of these reports, within an operating post‐coordinate information retrieval system poses a number of problems due to their multidimensional nature. The use of links and roles to solve this problem is proscribed on economic grounds and so a system, currently being developed, is described using ‘generic role indicators’ as a primary device for preventing false drops followed by a rapid visual sort using an intermediate file on cards. Considerable time savings have been achieved by the unification of retrieval sources.

The purpose of this paper is to propose a framework to detect adverse drug reactions (ADRs) using internet user search data, so that ADR events can be identified early. Empirical investigation of Avandia, a type II diabetes treatment, is conducted to illustrate how to implement the proposed framework.

Typical ADR identification measures and time series processing techniques are used in the proposed framework. Google Trends Data are employed to represent user searches. The baseline model is a disproportionality analysis using official drug reaction reporting data from the US Food and Drug Administration’s Adverse Event Reporting System.

Results show that Google Trends series of Avandia side effects search reveal a significant early warning signal for the side effect emergence of Avandia. The proposed approach of using user search data to detect ADRs is proved to have a longer leading time than traditional drug reaction discovery methods. Three more drugs with known adverse reactions are investigated using the selected approach, and two are successfully identified.

Validation of Google Trends data’s representativeness of user search is yet to be explored. In future research, user search in other search engines and in healthcare web forums can be incorporated to obtain a more comprehensive ADR early warning mechanism.

Using internet data in drug safety management with a proper early warning mechanism may serve as an earlier signal than traditional drug adverse reaction. This has great potential in public health emergency management.

The research work proposes a novel framework of using user search data in ADR identification. User search is a voluntary drug adverse reaction exploration behavior. Furthermore, user search data series are more concise and accurate than text mining in forums. The proposed methods as well as the empirical results will shed some light on incorporating user search data as a new source in pharmacovigilance.

Adverse drug reactions (ADRs) are increasingly recognised as an important cause of morbidity and mortality. Psychiatric patients, and especially those in forensic units, may be at increased risk of ADRs. Detection and documentation of previous ADRs are essential in reducing the risk of future ADRs. A baseline audit was undertaken, and subsequently the recording of ADRs on the drug cards of patients in a forensic psychiatry unit was re‐audited. Poor levels of documentation of ADRs were found. Following the baseline audit, a number of simple measures were undertaken which improved performance at re‐audit.

Adverse drug events and medication errors can occur because of decisions made during prescribing. The New Zealand Herald reported that preventable medical errors by doctors and other health workers are thought to be killing more than 1,500 patients a year in New Zealand. This article is a small‐scale case study which examines the perceptions of paediatric doctors in a New Zealand hospital regarding adverse drug events/reactions and their views on how they may or may not be avoided with the use of a clinical decision support system (CDSS) in a prescribing environment. It was found that doctors welcomed the use of a CDSS for prescribing. The doctors stated three critical factors for their use of such a system: time constraint, limited knowledge, and misreading.

It is now universally recognized that although doctors and pharmacists need accurate objective information about the drugs they prescribe and dispense, an entirely satisfactory method of supplying it has not been found. This deficiency may have resulted in the inappropriate use of drugs and an unacceptable frequency of adverse reactions.

The purpose of this paper is to determine the prevalence of polypharmacy and drug–drug interactions (DDIs) in older and younger prisoners, and compared if age group is associated with risks of polypharmacy and DDIs.

For 380 prisoners from Switzerland (190 were 49 years and younger; 190 were 50 years and older), data concerning their medication use were gathered. MediQ identified if interactions of two or more substances could lead to potentially adverse DDI. Data were analysed using descriptive statistics and generalised linear mixed models.

On average, older prisoners took 3.8 medications, while younger prisoners took 2.1 medications. Number of medications taken on one reference day was higher by a factor of 2.4 for older prisoners when compared to younger prisoners (p = 0.002). The odds of polypharmacy was significantly higher for older than for younger prisoners (>=5 medications: odds ratio = 5.52, p = 0.035). Age group analysis indicated that for potentially adverse DDI there was no significant difference (odds ratio = 0.94; p = 0.879). However, when controlling for the number of medication, the risk of adverse DDI was higher in younger than older prisoners, but the result was not significant.

Older prisoners are at a higher risk of polypharmacy but their risk for potentially adverse DDI is not significantly different from that of younger prisoners. Special clinical attention must be given to older prisoners who are at risk for polypharmacy. Careful medication management is also important for younger prisoners who are at risk of very complex drug therapies.

The purpose of this paper is to contribute to the literature by assessing factors that typically engender adverse drug reactions (ADRs) jeopardizing medical safety. These factors are population knowledge, clarity in disclosure of the risks inhering ADRs and ADRs incidence. It seeks to minimize negative effect by early identification of drug reactions.

On the one hand, the study employs a model that shows relationships between various factors, and on the other hand, ADRs medical safety in the public healthcare sector.

Clarity of consultancy services in public healthcare significantly impact ADR medical safety. Population and healthcare provider education on ADRs medical safety are necessities. Implementation of an ADR reporting system in every healthcare institute is essential. This helps service providers to give a clear and accurate information to patients. It also makes patients more aware of consequences of ADRs.

Time, place and sampling method are found to be the main study limitations. Researchers should take into their consideration the significant relationships between the factors and ADRs medical safety to improve level of awareness in the healthcare public sector.

Ways to improve ADR medical safety in healthcare sector are underscored. Healthcare service providers and professionals need to take into account the stipulated study factors in order to improve medical safety and reduce unnecessary medical costs.

Very few studies have been conducted on this topic; most of those that have been conducted were undertaken in western countries. This study assesses the level of healthcare safety in the country and suggests mechanisms to elevate that level.

Newly marketed drugs present unavoidable risks, no matter how diligent the level of pre-market review. Numerous adverse drug events attest to the need for post-market vigilance. However, the Food and Drug Administration monitors drugs with considerably less rigor after launch than before. This burdens both public health and public trust in the safety of new medicines. As new technologies such as genomics guide a larger share of drug development, the issue will become more acute. Most reform proposals present considerable logistical challenges. A promising alternative is to harness existing managed care databases to search for drug effects.

Polypharmacy is common in older people, who are more likely to have multiple co‐morbidities. Coupled with age‐related physiological decline, undoubtedly this carries the risk of adverse drug reactions, drug interactions and multiple adverse symptoms, with consequent increased hospital admissions. This article discusses a recent audit on polypharmacy in older people conducted by the authors in a district general hospital.

Adverse drug reactions (ADR) and interactions for patients who use substances and have a mental health problem is an area that lacks attention in research, practice and policy. The purpose of this paper is to examine what is currently known about this topic.

The paper explores the available literature and specialist information available on this subject.

This is a complex area, which is compounded by limited empirical evidence. However, information is available which when combined with individual patient assessment there is the potential to reduce the risk of detrimental ADR and improve concordance to medication.

The paper offers pragmatic suggestions which aim to improve the knowledge of practitioners and lessen the potential harm to patients.