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Dsouza VS, Leyens L, Brand A. Employing bibliometrics and natural language processing (NLP) to analyse real-world applications of adverse drug reaction. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2025; 18:100592. [PMID: 40207140 PMCID: PMC11979945 DOI: 10.1016/j.rcsop.2025.100592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2025] [Revised: 03/08/2025] [Accepted: 03/12/2025] [Indexed: 04/11/2025] Open
Abstract
Introduction Adverse Drug Reactions (ADRs) pose significant health and economic burdens, yet underreporting and inconsistent standards persist. Digital health innovations, particularly mobile and web-based ADR reporting applications, offer potential to enhance pharmacovigilance by improving data accuracy and patient-reported outcomes. Objectives The study provides a comprehensive mapping of ADR mobile and web application literature, analysing publication trends, key contributors, and core themes through bibliometric and NLP-based content analysis. Methods A systematic two-stage approach was applied to 289 Web of Science articles on ADR reporting applications. Bibliometric analysis explored publication trends, co-authorship networks, and keyword occurrences, while NLP-based topic modelling identified prevalent themes, ensuring thematic coherence and interpretability. Results Bibliometric analysis showed a rise in ADR application-related publications, primarily from the United Kingdom, United States of America, and Switzerland. Content analysis identified ten key themes, including pharmacovigilance, chemotherapy adherence, and psychiatry research. A distinct focus on digital tools in ADR reporting and management was evident, with keywords such as "mobile," "application," and "patient" becoming increasingly prominent in recent years. Co-authorship and collaboration networks, however, showed limited cross-national research partnerships. Discussion The study highlights the transformative role of digital solutions in pharmacovigilance, demonstrating the potential of ADR applications to enhance reporting accuracy and improve patient safety. However, adoption remains early-stage and fragmented by regional affiliations. Future research should focus on patient-centric app development, effectiveness assessment, and fostering global collaboration. Strengthening digital literacy and robust investment in ADR reporting applications is crucial for optimizing their impact in healthcare.
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Affiliation(s)
- Viola Savy Dsouza
- Faculty of Health, Medicine, and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
| | - Lada Leyens
- Centre for Regulatory Science, Department of Health Information, Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Angela Brand
- Faculty of Health, Medicine, and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
- United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology, the Netherlands
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Mongkhonmath N, Olson PS, Puttarak P, Keokinnaly S, Sawangjit R. Effectiveness of the modified TaWai mobile application for reporting adverse drug reaction in Lao PDR: a cluster randomized controlled trial. Sci Rep 2024; 14:31161. [PMID: 39730897 DOI: 10.1038/s41598-024-82474-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Accepted: 12/05/2024] [Indexed: 12/29/2024] Open
Abstract
Spontaneous adverse drug reactions (ADRs) reporting by health care professionals (HCPs) plays a vital role in pharmacovigilance (PV). However, under-reporting remain a major challenge worldwide, especially in low and middle-income countries, including Lao PDR. This cluster-randomized controlled trial evaluated the effectiveness of the modified TaWai mobile app for ADR reporting compared with the usual practice in hospitals. Two tertiary hospitals in Lao PDR (cluster units) were randomized into two groups: the intervention group (16 HCPs), which used the modified TaWai mobile app along with an educational workshop, and the control group (18 HCPs), which followed usual practice with the same educational workshop. The intervention group reported more ADR cases (28 vs. 3), and produced a higher number of high-quality reports (28 vs. 2) than the control group. The modified TaWai mobile app was highly rated by all participating HCPs. Questionnaire responses indicated that the tool is user-friendly, time-efficient, and well-suited for ADR reporting in hospitals in Lao PDR. In conclusion, these findings highlight the potential of the modified TaWai mobile app to enhance ADR reporting practices in hospitals, and its features make it a promising solution for strengthening PV in Lao PDR and similar settings.
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Affiliation(s)
- Niphonh Mongkhonmath
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand
| | - Phayom Sookaneknun Olson
- International Primary Care Practice Research Unit, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand
- Faculty of Pharmaceutical Sciences, UCSI University, No. 1, Jalan UCSI, UCSI Heights, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Panupong Puttarak
- Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hatyai, Songkhla, 90110, Thailand
- Innovation Unit for Consumer Protection in Healthcare Products (TaWai for Health Unit), Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hatyai, Songkhla, 90110, Thailand
| | - Soulyvanh Keokinnaly
- Hospital Pharmacy Management Division, Ministry of Health, Lao PDR, Vientiane, Laos
| | - Ratree Sawangjit
- Clinical Trials and Evidence-Based Syntheses Research Unit (CTEBs RU), Department of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, 44150, Thailand.
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Kiguba R, Olsson S, Waitt C. Pharmacovigilance in low- and middle-income countries: A review with particular focus on Africa. Br J Clin Pharmacol 2023; 89:491-509. [PMID: 34937122 DOI: 10.1111/bcp.15193] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 12/03/2021] [Accepted: 12/15/2021] [Indexed: 01/25/2023] Open
Abstract
Low- and middle-income countries (LMIC) face unique challenges with regard to the establishment of robust pharmacovigilance systems capable of generating data to inform healthcare policy and practice. These include the limited integration and reliability of pharmacovigilance systems across LMIC despite recent efforts to harmonize pharmacovigilance rules and regulations in several regional economic communities. There are particular challenges relating to the need to translate reporting tools into numerous local languages and the low numbers of healthcare providers relative to number of patients, with very short consultation times. Additional factors frequent in LMIC include high uptake of herbal and traditional medication, mostly by self-medication; disruptive political conflicts jeopardizing fragile systems; and little or no access to drug utilization data, which makes it difficult to reliably estimate the true risks of medicines use. Pharmacovigilance activities are hindered by the scarcity of well-trained personnel with little or no budgetary support from national governments; high turnover of pharmacovigilance staff whose training involves a substantial amount of resources; and little awareness of pharmacovigilance among healthcare workers, decision makers and consumers. Furthermore, little collaboration between public health programmes and national medicines regulatory authorities coupled with limited investment in pharmacovigilance activities, especially during mass drug administration for neglected tropical diseases and mass vaccinations, produces major challenges in establishing a culture where pharmacovigilance is systematically embedded. Very low spontaneous reporting rates with poor quality reports hinders robust signal detection analyses. This review summarises the specific challenges and areas of progress in pharmacovigilance in LMIC with special focus on the situation in Africa.
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Affiliation(s)
- Ronald Kiguba
- Department of Pharmacology and Therapeutics, Makerere University, Kampala, Uganda
| | - Sten Olsson
- Pharmacovigilance Consulting, Uppsala, Sweden
| | - Catriona Waitt
- Department of Pharmacology and Therapeutics, University of Liverpool, UK.,Infectious Diseases Institute, Makerere University College of Health Sciences, Uganda
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Leskur D, Bozic J, Rusic D, Seselja Perisin A, Cohadzic T, Pranic S, Modun D, Bukic J. Adverse drug reaction reporting via mobile applications: A narrative review. Int J Med Inform 2022; 168:104895. [DOI: 10.1016/j.ijmedinf.2022.104895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 10/01/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022]
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Zhou TT, Wang R, Gu SJ, Xie LL, Zhao QH, Xiao MZ, Chen YL. Effectiveness of Mobile Medical Apps in Ensuring Medication Safety Among Patients With Chronic Diseases: Systematic Review and Meta-analysis. JMIR Mhealth Uhealth 2022; 10:e39819. [PMID: 36413386 PMCID: PMC9727690 DOI: 10.2196/39819] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/22/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Along with the rapid growth of the global aging society, the mobile and health digital market has expanded greatly. Countless mobile medical apps (mmApps) have sprung up in the internet market, aiming to help patients with chronic diseases achieve medication safety. OBJECTIVE Based on the medication safety action plans proposed by the World Health Organization, we aimed to explore the effectiveness of mmApps in ensuring the medication safety of patients with chronic diseases, including whether mmApps can improve the willingness to report adverse drug events (ADEs), improve patients' medication adherence, and reduce medication errors. We hoped to verify our hypothesis through a systematic review and meta-analysis. METHODS The meta-analysis was performed in strict accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and included literature searched from 7 databases-PubMed, Web Of Science, Embase, CINAHL, China National Knowledge Infrastructure, Wanfang, and SinoMed. The publication time was limited to the time of database establishment to April 30, 2022. Studies were screened based on inclusion and exclusion criteria. The data extracted included authors, years of publication, countries or regions, participants' characteristics, intervention groups, and control groups, among others. Our quality assessment followed the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions, Version 6.3. RevMan 5.2 software (Cochrane Collaboration) was used to analyze the statistical data, and a sensitivity analysis was performed to assess data stability. The degree of stability was calculated by using a different statistical method and excluding large-sample studies from the analysis. RESULTS We included 8 studies from 5 countries (China, the United States, France, Canada, and Spain) that were published from January 1, 2014, to December 31, 2021. The total number of participants was 1355, and we analyzed the characteristics of included studies, each app's features, the risk of bias, and quality. The results showed that mmApps could increase ADE reporting willingness (relative risk [RR] 2.59, 95% CI 1.26-5.30; P=.009) and significantly improve medication adherence (RR 1.17, 95% CI 1.04-1.31; P=.007), but they had little effect on reducing medication errors (RR 1.54, 95% CI 0.33-7.29; P=.58). CONCLUSIONS We analyzed the following three merits of mmApps, with regard to facilitating the willingness to report ADEs: mmApps facilitate more communication between patients and physicians, patients attach more importance to ADE reporting, and the processing of results is transparent. The use of mmApps improved medication adherence among patients with chronic diseases by conveying medical solutions, providing educational support, tracking medications, and allowing for remote consultations. Finally, we found 3 potential reasons for why our medication error results differed from those of other studies. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42022322072; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=322072.
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Affiliation(s)
- Ting Ting Zhou
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Rui Wang
- Hepatobiliary Surgery, The Second Affliated Hospital of Chongqing Medical University, Chongqing, China
| | - Si Jia Gu
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Ling Xie
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qing Hua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ming Zhao Xiao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yu Lu Chen
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Kiguba R, Ndagije HB, Nambasa V, Katureebe C, Zakumumpa H, Nanyonga SM, Ssanyu JN, Tregunno P, Harrison K, Merle CS, Raguenaud ME, Kitutu FE. Implementation of a peer support intervention to promote the detection, reporting and management of adverse drug reactions in people living with HIV in Uganda: a protocol for a quasi-experimental study. BMJ Open 2022; 12:e056039. [PMID: 35589351 PMCID: PMC9121495 DOI: 10.1136/bmjopen-2021-056039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 04/22/2022] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Patients have contributed <1% of spontaneous adverse drug reaction (ADR) reports in Uganda's pharmacovigilance database. Peer support combined with mobile technologies could empower people living with HIV (PLHIV) to report ADRs and improve ADR management through linkage to care. We seek to test the feasibility and effect of a peer support intervention on ADR reporting by PLHIV receiving combination antiretroviral therapy (cART) in Uganda; identify barriers and facilitators to the intervention; and characterise ADR reporting and management. METHODS AND ANALYSIS This is a quasi-experimental study to be implemented over 4 months at 12 intervention and 12 comparison cART sites from four geographical regions of Uganda. Per region, two blocks each with a tertiary, secondary and primary care cART site will be selected by simple random sampling. Blocks per region will be randomly assigned to intervention and comparison arms.Study units will include cART sites and PLHIV receiving cART. PLHIV at intervention sites will be assigned to peer supporters to empower them to report ADRs directly to the National Pharmacovigilance Centre (NPC). Peer supporters will be expert clients from among PLHIV and/or recognised community health workers.Direct patient reporting of ADRs to NPC will leverage the Med Safety App and toll-free unstructured supplementary service data interface to augment traditional pharmacovigilance methods.The primary outcomes are attrition rate measured by number of study participants who remain in the study until the end of follow-up at 4 months; and number of ADR reports submitted to NPC by PLHIV as measured by questionnaire and data abstraction from the national pharmacovigilance database at baseline and 4 months. ETHICS AND DISSEMINATION The study received ethical approval from: School of Health Sciences Research and Ethics Committee at Makerere University (MAKSHSREC-2020-64) and Uganda National Council for Science and Technology (HS1206ES). Results will be shared with PLHIV, policy-makers, the public and academia. TRIAL REGISTRATION NUMBER ISRCTN75989485.
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Affiliation(s)
- Ronald Kiguba
- Department of Pharmacology and Therapeutics, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Victoria Nambasa
- Directorate of Product Safety, National Drug Authority, Kampala, Uganda
| | | | - Henry Zakumumpa
- School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Stella Maris Nanyonga
- Clinical Epidemiology Unit, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Phil Tregunno
- Vigilance and Risk Management of Medicines, Medicines and Healthcare Products Regulatory Agency, London, UK
| | - Kendal Harrison
- Vigilance and Risk Management of Medicines, Medicines and Healthcare Products Regulatory Agency, London, UK
| | - Corinne S Merle
- Special Programme for Research & Training In Tropical Diseases (TDR), World Health Organization, Geneve, Switzerland
| | - Marie-Eve Raguenaud
- Special Programme for Research & Training In Tropical Diseases (TDR), World Health Organization, Geneve, Switzerland
| | - Freddy Eric Kitutu
- Department of Pharmacy, College of Health Sciences, Makerere University, Kampala, Uganda
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Golan D, Sagiv S, Glass-Marmor L, Miller A. Mobile-phone-based e-diary derived patient reported outcomes: Association with clinical disease activity, psychological status and quality of life of patients with multiple sclerosis. PLoS One 2021; 16:e0250647. [PMID: 33951061 PMCID: PMC8099126 DOI: 10.1371/journal.pone.0250647] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 04/12/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The applicability of mobile digital technology to promote clinical care of people with multiple sclerosis (pwMS) is gaining increased interest as part of the implementation of patient-centered approaches. We aimed at assessing adherence to a smartphone-based e-diary, which was designed to collect patient-reported outcomes (PROs). Secondary objectives were to evaluate the construct and predictive validity of e-diary derived PROs and to explore the various factors that were associated with changes in PROs over time. MATERIALS AND METHODS In this observational cohort study patients downloaded an MS tailored e-diary into their personal smartphones. Report of PROs was enquired once monthly for a period of one year through a smartphone-based application, using previously validated tools. An e-diary derived bodily function summary score (eBF) was defined as the sum of scores depicting vision, limbs function, pain, bowl/ bladder dysfunction, pseudobulbar affect and spasticity. Multiple linear regression and analysis of covariance were used to determine the association between PROs, clinician-reported outcomes (ClinROs) of disease activity and quality of life (QoL). Regression coefficient analysis was used to compare the slope of change in eBF before and after a relapse. RESULTS 97 pwMS downloaded the e-diary [Female: 64 (66%), EDSS 3.4±2.1]. 76 patients (78%) completed the 12-month study period. 53 patients (55%) submitted ≥75% of requested surveys. Anxiety was negatively associated with adherence to periodic PROs assessments by the e-diary. E-diary derived PROs were significantly correlated with corresponding functional system scores (0.38< r <0.8, P<0.001). eBF score significantly predicted QoL (β = -0.36, P = 0.001) while EDSS did not. Change in eBF score over time was independently associated with the occurrence of an MS relapse (F = 4.4, P = 0.04), anxiety (F = 6.4, P = 0.01) and depression (F = 5.1, P = 0.03). Individual regression slopes of eBF scores were significantly higher pre-relapse than post-relapse (3.0±3.3 vs. -0.8±2.0, P = 0.007). CONCLUSION Adherence of pwMS to recording in an e-diary collecting PROs was high. Changes in e-diary derived PROs over time predict clinical MS relapses on the group level and thus carry the potential of usage in clinical research as well as for improved MS care in real world setting.
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Affiliation(s)
- Daniel Golan
- Multiple Sclerosis Center & Department of Neurology, Lady Davis Carmel Medical Center, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Smadar Sagiv
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Lea Glass-Marmor
- Multiple Sclerosis Center & Department of Neurology, Lady Davis Carmel Medical Center, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ariel Miller
- Multiple Sclerosis Center & Department of Neurology, Lady Davis Carmel Medical Center, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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