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Orangzeb S, Desalegn A, Trinh NTH, Zhao J, Nordeng H, Lupattelli A. COVID-19 vaccine uptake among children and adolescents in Norway: A comprehensive registry-based cohort study of over 800,000 individuals. Vaccine 2024:S0264-410X(24)00464-X. [PMID: 38641494 DOI: 10.1016/j.vaccine.2024.04.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 04/09/2024] [Accepted: 04/12/2024] [Indexed: 04/21/2024]
Abstract
Factors related with COVID-19 vaccine uptake in children and adolescents in Norway remain unclear, despite this being useful knowledge for future pandemic preparedness. This study aimed to comprehensively examine individual and familial factors associated with vaccine uptake in children and adolescents in Norway. We utilized nationwide registry-data from various health registries and Statistics Norway, encompassing all children and adolescents living in Norway during the pandemic, until 31-Dec-2022. Vaccine uptake is defined as receiving at least one dose of COVID-19 vaccine. We employed a forward stepwise logistic regression model and a random forest machine-learning algorithm to explore the relationship between vaccine uptake and socio-cultural, demographic, and health-related factors. We included 423,548 5-11-year-olds, 269,830 12-15-year-olds, and 120,854 16-17-year-olds. Vaccine uptake in these three groups was respectively 2.6 %, 73.3 %, and 87.3 %. Factors associated with vaccine uptake varied by age group. In youngest children, immigrant background (Odds-ratio (OR) = 1.58, 95 % confidence interval (CI) (1.14-2.19)), born extremely preterm (OR = 2.38, 95 % CI (1.60-3.54)), having risk of severe COVID-19 (OR = 5.40, 95 % CI (4.69-6.23) and maternal COVID-19 vaccination (OR = 6.34, 95 % CI (5.35-7.53)) were positively associated with vaccine uptake. The latter two factors were also strongly, positively associated with vaccine uptake in 12-15-year-olds, while previous SARS-CoV-2 infection was negatively associated (OR = 0.12, 95 % CI (0.11-0.14). Similar findings were observed in 16-17-year-olds. COVID-19 vaccine uptake differed markedly by age group, and major associated factors included socio-demographics and parental COVID-19 vaccination status, prior SARS-CoV-2 infection, but also being born premature and having moderate or high risk of severe COVID-19.
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Affiliation(s)
- Saima Orangzeb
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Anteneh Desalegn
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Nhung T H Trinh
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Jing Zhao
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Hedvig Nordeng
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway; Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Angela Lupattelli
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway.
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Català M, Mercadé-Besora N, Kolde R, Trinh NTH, Roel E, Burn E, Rathod-Mistry T, Kostka K, Man WY, Delmestri A, Nordeng HME, Uusküla A, Duarte-Salles T, Prieto-Alhambra D, Jödicke AM. The effectiveness of COVID-19 vaccines to prevent long COVID symptoms: staggered cohort study of data from the UK, Spain, and Estonia. Lancet Respir Med 2024; 12:225-236. [PMID: 38219763 DOI: 10.1016/s2213-2600(23)00414-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/13/2023] [Accepted: 10/30/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND Although vaccines have proved effective to prevent severe COVID-19, their effect on preventing long-term symptoms is not yet fully understood. We aimed to evaluate the overall effect of vaccination to prevent long COVID symptoms and assess comparative effectiveness of the most used vaccines (ChAdOx1 and BNT162b2). METHODS We conducted a staggered cohort study using primary care records from the UK (Clinical Practice Research Datalink [CPRD] GOLD and AURUM), Catalonia, Spain (Information System for Research in Primary Care [SIDIAP]), and national health insurance claims from Estonia (CORIVA database). All adults who were registered for at least 180 days as of Jan 4, 2021 (the UK), Feb 20, 2021 (Spain), and Jan 28, 2021 (Estonia) comprised the source population. Vaccination status was used as a time-varying exposure, staggered by vaccine rollout period. Vaccinated people were further classified by vaccine brand according to their first dose received. The primary outcome definition of long COVID was defined as having at least one of 25 WHO-listed symptoms between 90 and 365 days after the date of a PCR-positive test or clinical diagnosis of COVID-19, with no history of that symptom 180 days before SARS-Cov-2 infection. Propensity score overlap weighting was applied separately for each cohort to minimise confounding. Sub-distribution hazard ratios (sHRs) were calculated to estimate vaccine effectiveness against long COVID, and empirically calibrated using negative control outcomes. Random effects meta-analyses across staggered cohorts were conducted to pool overall effect estimates. FINDINGS A total of 1 618 395 (CPRD GOLD), 5 729 800 (CPRD AURUM), 2 744 821 (SIDIAP), and 77 603 (CORIVA) vaccinated people and 1 640 371 (CPRD GOLD), 5 860 564 (CPRD AURUM), 2 588 518 (SIDIAP), and 302 267 (CORIVA) unvaccinated people were included. Compared with unvaccinated people, overall HRs for long COVID symptoms in people vaccinated with a first dose of any COVID-19 vaccine were 0·54 (95% CI 0·44-0·67) in CPRD GOLD, 0·48 (0·34-0·68) in CPRD AURUM, 0·71 (0·55-0·91) in SIDIAP, and 0·59 (0·40-0·87) in CORIVA. A slightly stronger preventative effect was seen for the first dose of BNT162b2 than for ChAdOx1 (sHR 0·85 [0·60-1·20] in CPRD GOLD and 0·84 [0·74-0·94] in CPRD AURUM). INTERPRETATION Vaccination against COVID-19 consistently reduced the risk of long COVID symptoms, which highlights the importance of vaccination to prevent persistent COVID-19 symptoms, particularly in adults. FUNDING National Institute for Health and Care Research.
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Affiliation(s)
- Martí Català
- Pharmaco- and Device Epidemiology Group, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Núria Mercadé-Besora
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Barcelona, Spain
| | - Raivo Kolde
- Institute of Computer Science, University of Tartu, Tartu, Estonia
| | - Nhung T H Trinh
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Elena Roel
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Barcelona, Spain
| | - Edward Burn
- Pharmaco- and Device Epidemiology Group, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Trishna Rathod-Mistry
- Pharmaco- and Device Epidemiology Group, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Kristin Kostka
- Pharmaco- and Device Epidemiology Group, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Wai Yi Man
- Pharmaco- and Device Epidemiology Group, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Antonella Delmestri
- Pharmaco- and Device Epidemiology Group, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Hedvig M E Nordeng
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway; Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Anneli Uusküla
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Barcelona, Spain; Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Daniel Prieto-Alhambra
- Pharmaco- and Device Epidemiology Group, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Oxford National Institute for Health and Care Research Biomedical Research Centre, University of Oxford, Oxford, UK; Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands.
| | - Annika M Jödicke
- Pharmaco- and Device Epidemiology Group, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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de Visme S, Korevaar DA, Gras-Le Guen C, Flamant A, Bevacqua M, Stanzelova A, Trinh NTH, Ciobanu DA, Carvalho AA, Kyriakoglou I, Fuentes M, Refes Y, Briand-Huchet E, Sellier AL, Harrewijn I, Cohen JF, Chalumeau M. Inconsistency Between Pictures on Baby Diaper Packaging in Europe and Safe Infant Sleep Recommendations. J Pediatr 2024; 264:113763. [PMID: 37778411 DOI: 10.1016/j.jpeds.2023.113763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE To describe the level of inconsistency between pictures on baby diaper packaging and safe infant sleep recommendations (SISRs) in Europe. STUDY DESIGN We attempted to identify all packaging of baby diapers sold in 11 European countries for infants weighing less than 5 kg through internet searches from July 2022 through February 2023. For each type of package, we extracted whether there was a picture depicting a baby, whether the baby was sleeping, and whether the picture of the sleeping baby was inconsistent with ≥1 of 3 SISRs: (i) nonsupine sleeping position, (ii) soft objects or loose bedding, or (iii) sharing a sleep surface with another person. Data were aggregated at the country level, and a random-effects meta-analysis of proportions was used to obtain summary estimates. The outcome was the summary estimate of the proportion of pictures that were inconsistent with SISRs. RESULTS We identified 631 baby diaper packaging types of which 49% (95% CI: 42-57; n = 311) displayed a picture of a sleeping baby. Among those 311 packages, 79% (95% CI 73-84) were inconsistent with ≥1 SISR, including a nonsupine sleeping position, 45% (95% CI 39-51), soft objects or loose bedding such as pillows or blankets, 51% (95% CI 46-57), and sharing a sleep surface with another person, 10% (95% CI 4-18). CONCLUSIONS Pictures on baby diaper packaging in Europe are often inconsistent with SISRs. The prevention of sudden unexpected death in infancy requires action from manufacturers and legislators to stop parents' exposure to misleading images that may lead to dangerous practices.
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Affiliation(s)
- Sophie de Visme
- Epidemiology and Statistics Research Center, Obstetrical Perinatal and Pediatric Epidemiology Research Team, INSERM, Université Paris Cité, Paris, France; CHU de Nantes, INSERM, Department of General Pediatrics and Pediatric Emergencies, CIC1413, Nantes Université, Nantes, France
| | - Daniel A Korevaar
- Department of Pulmonary Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Christèle Gras-Le Guen
- Epidemiology and Statistics Research Center, Obstetrical Perinatal and Pediatric Epidemiology Research Team, INSERM, Université Paris Cité, Paris, France; CHU de Nantes, INSERM, Department of General Pediatrics and Pediatric Emergencies, CIC1413, Nantes Université, Nantes, France; CHU de Nantes, Department of General Pediatrics and Pediatric Emergencies, Nantes Université, Nantes, France
| | - Alix Flamant
- Department of General Pediatrics, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - Martina Bevacqua
- Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France; Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Anna Stanzelova
- Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France; Independent Researcher, Galway, Ireland
| | - Nhung T H Trinh
- Department of Pharmacy, PharmacoEpidemiology and Drug Safety Research Group, University of Oslo, Oslo, Norway
| | - Dalia-Alexandra Ciobanu
- Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France; Children's Hospital "Doctor Victor Gomoiu", Bucharest, Romania
| | - Ana Araújo Carvalho
- Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France; Centro Hospitalar e Universitário de Lisboa Central, Hospital Dona Estefânia, Paediatric Department, Lisboa, Portugal
| | - Ifigeneia Kyriakoglou
- Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France; Department of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Fuentes
- Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France; Department of Pediatric Emergencies, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - Yacine Refes
- Epidemiology and Statistics Research Center, Obstetrical Perinatal and Pediatric Epidemiology Research Team, INSERM, Université Paris Cité, Paris, France
| | - Elisabeth Briand-Huchet
- Naître et Vivre, National Association for the Support of Bereaved Parents and the Fight Against Sudden Unexpected Death in Infancy, Paris, France
| | | | - Inge Harrewijn
- Department of Neonatal Pediatrics and Intensive Care, Montpellier University Hospital, University of Montpellier, Montpellier, France.
| | - Jérémie F Cohen
- Epidemiology and Statistics Research Center, Obstetrical Perinatal and Pediatric Epidemiology Research Team, INSERM, Université Paris Cité, Paris, France; Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - Martin Chalumeau
- Epidemiology and Statistics Research Center, Obstetrical Perinatal and Pediatric Epidemiology Research Team, INSERM, Université Paris Cité, Paris, France; Department of General Pediatrics and Pediatric Infectious Diseases, Assistance Publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
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Gauffin O, Brand JS, Vidlin SH, Sartori D, Asikainen S, Català M, Chalabi E, Dedman D, Danilovic A, Duarte-Salles T, García Morales MT, Hiltunen S, Jödicke AM, Lazarevic M, Mayer MA, Miladinovic J, Mitchell J, Pistillo A, Ramírez-Anguita JM, Reyes C, Rudolph A, Sandberg L, Savage R, Schuemie M, Spasic D, Trinh NTH, Veljkovic N, Vujovic A, de Wilde M, Zekarias A, Rijnbeek P, Ryan P, Prieto-Alhambra D, Norén GN. Supporting Pharmacovigilance Signal Validation and Prioritization with Analyses of Routinely Collected Health Data: Lessons Learned from an EHDEN Network Study. Drug Saf 2023; 46:1335-1352. [PMID: 37804398 PMCID: PMC10684396 DOI: 10.1007/s40264-023-01353-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2023] [Indexed: 10/09/2023]
Abstract
INTRODUCTION Individual case reports are the main asset in pharmacovigilance signal management. Signal validation is the first stage after signal detection and aims to determine if there is sufficient evidence to justify further assessment. Throughout signal management, a prioritization of signals is continually made. Routinely collected health data can provide relevant contextual information but are primarily used at a later stage in pharmacoepidemiological studies to assess communicated signals. OBJECTIVE The aim of this study was to examine the feasibility and utility of analysing routine health data from a multinational distributed network to support signal validation and prioritization and to reflect on key user requirements for these analyses to become an integral part of this process. METHODS Statistical signal detection was performed in VigiBase, the WHO global database of individual case safety reports, targeting generic manufacturer drugs and 16 prespecified adverse events. During a 5-day study-a-thon, signal validation and prioritization were performed using information from VigiBase, regulatory documents and the scientific literature alongside descriptive analyses of routine health data from 10 partners of the European Health Data and Evidence Network (EHDEN). Databases included in the study were from the UK, Spain, Norway, the Netherlands and Serbia, capturing records from primary care and/or hospitals. RESULTS Ninety-five statistical signals were subjected to signal validation, of which eight were considered for descriptive analyses in the routine health data. Design, execution and interpretation of results from these analyses took up to a few hours for each signal (of which 15-60 minutes were for execution) and informed decisions for five out of eight signals. The impact of insights from the routine health data varied and included possible alternative explanations, potential public health and clinical impact and feasibility of follow-up pharmacoepidemiological studies. Three signals were selected for signal assessment, two of these decisions were supported by insights from the routine health data. Standardization of analytical code, availability of adverse event phenotypes including bridges between different source vocabularies, and governance around the access and use of routine health data were identified as important aspects for future development. CONCLUSIONS Analyses of routine health data from a distributed network to support signal validation and prioritization are feasible in the given time limits and can inform decision making. The cost-benefit of integrating these analyses at this stage of signal management requires further research.
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Affiliation(s)
| | | | | | | | | | - Martí Català
- Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | | | - Daniel Dedman
- Clinical Practice Research Datalink (CPRD), The Medicines and Healthcare Products Regulatory Agency, London, UK
| | | | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Maria Teresa García Morales
- Instituto de Investigación Sanitaria Hospital 12 de Octubre, CIBER de Epidemiología y Salud Pública, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Annika M Jödicke
- Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Milan Lazarevic
- Clinic for cardiac and transplant surgery, University Clinical Center Nis, Nis, Serbia
| | - Miguel A Mayer
- Hospital del Mar Medical Research Institute, Parc de Salut Mar, Barcelona, Spain
| | - Jelena Miladinovic
- Clinic for infectious diseases, University Clinical Center Nis, University Clinical Center Nis, Nis, Serbia
| | | | - Andrea Pistillo
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | | | - Carlen Reyes
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | | | | | - Ruth Savage
- Uppsala Monitoring Centre, Uppsala, Sweden
- Department of General Practice, University of Otago, Christchurch, New Zealand
| | - Martijn Schuemie
- Epidemiology Department, Johnson & Johnson, Titusville, NJ, USA
- Department of Biostatistics, UCLA, Los Angeles, CA, USA
| | - Dimitrije Spasic
- Clinic for cardiac and transplant surgery, University Clinical Center Nis, Nis, Serbia
| | - Nhung T H Trinh
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Nevena Veljkovic
- Heliant Ltd, Belgrade, Serbia
- Vinca Institute of Nuclear Sciences, National Institute of the Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Ankica Vujovic
- Clinic for Infectious and Tropical Diseases, University Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marcel de Wilde
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Peter Rijnbeek
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Patrick Ryan
- Epidemiology Department, Johnson & Johnson, Titusville, NJ, USA
- Department of Biomedical Informatics, Columbia University Medical Center, New York, NY, USA
| | - Daniel Prieto-Alhambra
- Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
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Kostka K, Roel E, Trinh NTH, Mercadé-Besora N, Delmestri A, Mateu L, Paredes R, Duarte-Salles T, Prieto-Alhambra D, Català M, Jödicke AM. "The burden of post-acute COVID-19 symptoms in a multinational network cohort analysis". Nat Commun 2023; 14:7449. [PMID: 37978296 PMCID: PMC10656441 DOI: 10.1038/s41467-023-42726-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 10/19/2023] [Indexed: 11/19/2023] Open
Abstract
Persistent symptoms following the acute phase of COVID-19 present a major burden to both the affected and the wider community. We conducted a cohort study including over 856,840 first COVID-19 cases, 72,422 re-infections and more than 3.1 million first negative-test controls from primary care electronic health records from Spain and the UK (Sept 2020 to Jan 2022 (UK)/March 2022 (Spain)). We characterised post-acute COVID-19 symptoms and identified key symptoms associated with persistent disease. We estimated incidence rates of persisting symptoms in the general population and among COVID-19 patients over time. Subsequently, we investigated which WHO-listed symptoms were particularly differential by comparing their frequency in COVID-19 cases vs. matched test-negative controls. Lastly, we compared persistent symptoms after first infections vs. reinfections.Our study shows that the proportion of COVID-19 cases affected by persistent post-acute COVID-19 symptoms declined over the study period. Risk for altered smell/taste was consistently higher in patients with COVID-19 vs test-negative controls. Persistent symptoms were more common after reinfection than following a first infection. More research is needed into the definition of long COVID, and the effect of interventions to minimise the risk and impact of persistent symptoms.
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Affiliation(s)
- Kristin Kostka
- Pharmaco- and Device Epidemiology Group, CSM, NDORMS, University of Oxford, Oxford, United Kingdom
| | - Elena Roel
- I Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain
| | - Nhung T H Trinh
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Núria Mercadé-Besora
- I Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Antonella Delmestri
- Pharmaco- and Device Epidemiology Group, CSM, NDORMS, University of Oxford, Oxford, United Kingdom
| | - Lourdes Mateu
- Department of Infectious Diseases, Hospital Germans Trias i Pujol, Badalona, Spain
- Fundació Lluita contra les Infeccions, Badalona, Spain
| | - Roger Paredes
- Department of Infectious Diseases, Hospital Germans Trias i Pujol, Badalona, Spain
- Fundació Lluita contra les Infeccions, Badalona, Spain
- irsiCaixa AIDS Research Institute, Badalona, Spain
- Center for Global Health and Diseases, Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Talita Duarte-Salles
- I Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Daniel Prieto-Alhambra
- Pharmaco- and Device Epidemiology Group, CSM, NDORMS, University of Oxford, Oxford, United Kingdom.
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Martí Català
- Pharmaco- and Device Epidemiology Group, CSM, NDORMS, University of Oxford, Oxford, United Kingdom
| | - Annika M Jödicke
- Pharmaco- and Device Epidemiology Group, CSM, NDORMS, University of Oxford, Oxford, United Kingdom
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Lupattelli A, Corrao G, Gatti C, Rea F, Trinh NTH, Cantarutti A. Antidepressant continuation and adherence in pregnancy, and risk of antenatal hospitalization for unipolar major depressive and/or anxiety disorders. J Affect Disord 2023; 339:502-510. [PMID: 37459974 DOI: 10.1016/j.jad.2023.07.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 06/18/2023] [Accepted: 07/14/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Knowledge about the effectiveness of antidepressants in pregnancy is limited. We aimed to evaluate the association of antidepressant continuation in pregnancy and adherence with the risk of antenatal hospitalization for depression/anxiety. METHODS In a population-based study based on the healthcare databases of the Lombardy region, Italy (2010-2020), we included 17,033 live-birth pregnancies within 16,091 women with antidepressant use before pregnancy. Antidepressant exposure was classified as continued in pregnancy versus discontinued proximal to pregnancy. Outcome measure was antenatal hospitalization for depression/anxiety. Propensity score matching analysis was performed to control for measured confounding. Stratification by pre-pregnancy antidepressant adherence based on the proportion of days covered (PDC) with antidepressants served to address confounding by disease severity. We applied 60 days lag-time for antidepressant exposure to minimize the risk of protopathic bias. RESULTS There were 362 (2.1 %) antenatal hospitalizations for depression/anxiety. Among the matched pairs, the cumulative incidence was 3.5 (continued antidepressant) versus 2.1 (discontinued antidepressant) per 1000 person-months, yielding a hazard ratio (HR) of 1.76 (95 % confidence interval (CI): 1.34-2.33)). The HR declined to the null (1.02, 95 % CI: 0.62-1.69) in the stratified analysis of pregnancies with moderate-high adherence pre-pregnancy. Moderate-high adherence in pregnancy was associated with 85 % greater risk of the antenatal outcome, but the HR decreased with the 60 days lag-time (HR: 1.40, 95 % CI: 0.79-2.50). LIMITATIONS Lack of information regarding antidepressant dosage. CONCLUSION We found no difference in risk for antenatal hospitalization for depression/anxiety with antidepressant continuation or higher adherence in pregnancy, relative to discontinuation or lower adherence.
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Affiliation(s)
- Angela Lupattelli
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Norway.
| | - Giovanni Corrao
- Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
| | - Chiara Gatti
- Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
| | - Federico Rea
- Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
| | - Nhung T H Trinh
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Norway
| | - Anna Cantarutti
- Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
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Tran HN, Nguyen TNT, Tran NTK, Nguyen LT, Vu HD, Nguyen AH, Trinh NTH. Preventability of Adverse Drug Reactions Related to Antibiotics: An Assessment Based on Spontaneous Reporting System. Ther Innov Regul Sci 2023:10.1007/s43441-023-00552-y. [PMID: 37389792 DOI: 10.1007/s43441-023-00552-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 06/13/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Antibiotics are commonly used in both outpatient and inpatient settings and are responsible for the majority of adverse drug reaction (ADR) reports. We aimed to characterize spontaneously reported ADRs associated with antibiotics and assessing the preventability of these ADRs in a Vietnamese setting. MATERIALS AND METHODS We conducted a retrospective descriptive study based on ADRs related to antibiotics spontaneously reported by healthcare workers to the National Pharmacovigilance Database of Vietnam (NPDV) between June 2018 and May 2019. The characteristics of included reports were descriptively analyzed. The preventability of reported ADRs was assessed using a standardized preventability scale. We identified the leading causes and described the characteristics associated with preventable ADRs (pADRs). RESULTS We included 6385 antibiotic-related reports from a total of 12,056 reports submitted to the NPDV during the study period. Beta-lactam antibiotics, mostly broad-spectrum with parenteral route, were suspected in the majority cases. The most commonly reported pADRs were allergic reactions, mostly classified under skin and subcutaneous tissue disorders. Of all included cases, 537 cases (8.4%) were deemed as associated with pADRs. Major causes of pADRs include potentially inappropriate prescribing (352/537, 65.5%) and re-administration of antibiotics causing prior allergy/allergies (99/537, 18.4%). The majority of pADRs involved the use of beta-lactam antibiotics with inappropriate indications. CONCLUSION ADRs related to antibiotic use represent more than half of ADRs spontaneously reported in Vietnam. Approximately one in every ten reported cases is associated with pADRs. The majority pADRs can be prevented through simple improvement in antibiotic prescribing practices.
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Affiliation(s)
- Ha N Tran
- National Drug Information and Adverse Drug Reaction Monitoring Centre, Hanoi University of Pharmacy, Hanoi, Vietnam
| | - Tien N T Nguyen
- National Drug Information and Adverse Drug Reaction Monitoring Centre, Hanoi University of Pharmacy, Hanoi, Vietnam
| | - Ngan T K Tran
- National Drug Information and Adverse Drug Reaction Monitoring Centre, Hanoi University of Pharmacy, Hanoi, Vietnam
| | - Ly T Nguyen
- National Drug Information and Adverse Drug Reaction Monitoring Centre, Hanoi University of Pharmacy, Hanoi, Vietnam
| | - Hoa D Vu
- National Drug Information and Adverse Drug Reaction Monitoring Centre, Hanoi University of Pharmacy, Hanoi, Vietnam
| | - Anh H Nguyen
- National Drug Information and Adverse Drug Reaction Monitoring Centre, Hanoi University of Pharmacy, Hanoi, Vietnam.
| | - Nhung T H Trinh
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, and, PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
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Trinh NTH, Semark BD, Munk-Olsen T, Liu X, Thapa SB, Yilmaz Z, Petersen LV, Lupattelli A. Antidepressant treatment in pregnancy: a Danish registry linkage study in pregnant women with pre-existing obsessive-compulsive disorder. Transl Psychiatry 2023; 13:223. [PMID: 37353477 DOI: 10.1038/s41398-023-02516-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 06/25/2023] Open
Abstract
The association between antidepressant continuation during pregnancy and postpartum mental health in women with obsessive-compulsive disorder (OCD) is uncertain. We identified 1317 women with live-birth singleton pregnancies and having outpatient/inpatient visits for OCD in the 4 years pre-pregnancy from the Danish registries. We defined three groups based on antidepressant prescriptions filled in the 2 years before pregnancy to delivery: (i) unexposed (n = 449); (ii) discontinuers (n = 346), i.e., with pre-pregnancy antidepressant fills only; (iii) continuers (n = 522), i.e., with antidepressant fills before and during pregnancy. We estimated crude and propensity score weighted hazard ratio (HRs) of postpartum visit for OCD and mood/anxiety disorders using Cox proportional hazard models. In weighted analyses, we found no difference in the probability of a postpartum visit for OCD or MADs with antidepressant continuation compared to unexposed and discontinuers. The likelihood of a postpartum OCD visit was higher in pregnancies having only one prescription fill during pregnancy compared to unexposed (HR = 3.44, 95% CI: 1.24, 9.54) or discontinuers (HR = 2.49, 95% CI: 0.91, 6.83). Continuers in pregnancy without antidepressant fill in the first three months postpartum had higher probability for postpartum visit for mood/anxiety disorders compared to discontinuers (HR = 3.84, 95% CI: 1.49, 9.92). Among pregnant women with pre-existing OCD, we found similar probabilities of a postpartum visit for OCD or mood/anxiety disorders in antidepressant continuers compared to unexposed and discontinuers. Continuers with a single prescription fill during pregnancy or no fill postpartum may have higher risks for these outcomes. Our findings highlight the importance of continuity of treatment throughout the perinatal period.
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Affiliation(s)
- Nhung T H Trinh
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Oslo, Norway.
| | - Birgitte Dige Semark
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - Trine Munk-Olsen
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Department of Clinical Research, University of Southern Denmark, Aarhus, Denmark
| | - Xiaoqin Liu
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Suraj Bahadur Thapa
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Zeynep Yilmaz
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Angela Lupattelli
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Oslo, Norway
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Lupattelli A, Trinh NTH, Nordeng H. Association of maternal personality traits with medication use during pregnancy to appraise unmeasured confounding in long-term pharmacoepidemiological safety studies. Front Pharmacol 2023; 14:1160168. [PMID: 37256227 PMCID: PMC10225644 DOI: 10.3389/fphar.2023.1160168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/26/2023] [Indexed: 06/01/2023] Open
Abstract
Maternal personality is a possible confounder on the association between prenatal medication exposure and long-term developmental outcomes in offspring, but it is often unmeasured. This study aimed to (i) estimate the association between five maternal personality traits and prenatal use of acetaminophen (including extended use), opioid analgesics, antidepressants, benzodiazepines/z-hypnotics, and antipsychotics; (ii) evaluate, using an applied example, whether unmeasured confounding by maternal neuroticism would make the association between prenatal antidepressant-child ADHD null, using the E-value framework. We used data from 8,879 pregnant women and recent mothers who participated in the Multinational Medication Use in Pregnancy Study, a web-based cross-sectional study performed within the period from 1-Oct-2011 to 29-Feb-2012 in Europe, North America and Australia. Medication use in pregnancy was self-reported by the women. Personality was assessed with the Big Five Inventory, capturing the dimensions of neuroticism, extraversion, openness, agreeableness, and conscientiousness. Adjusted logistic regression analyses were conducted for each trait-medication pair, using the survey weighting. There was a strong association between having high neuroticism and prenatal use of antidepressants (Odds Ratio (OR): 5.63, 95% Confidence Interval (CI): 3.96-8.01), benzodiazepines/z-hypnotics (OR: 6.66, 95% CI: 4.05-10.95), and analgesic opioids (OR: 2.24, 95% CI: 1.41-3.56), but not with antipsychotics. Among women with mental illness, this association attenuated for benzodiazepines/z-hypnotics, but decreased to the null for antidepressants. High neuroticism (OR: 1.31, 95% CI: 1.08-1.59) and high openness (OR: 0.77, 95% CI: 0.64-0.93) were associated with extended use of acetaminophen. The E-value for the Hazard Ratio 1.93 in the applied example was 3.27. If the example study was conducted using a population comparison group, high maternal neuroticism could have explained away the association antidepressant-ADHD. Because the example study included only women with a mental illness, this risk of bias was assessed as minimal. Various personality dispositions in the mother are associated, with a different degree, to prenatal use of medication. The strength of these association can aid researchers in evaluating the influence of uncontrolled confounding by maternal personality in long-term safety studies in pregnancy, using the E-value. This assessment should always be performed in addition to a rigorous study design using approaches to triangulate the evidence.
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Affiliation(s)
- Angela Lupattelli
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Nhung T. H. Trinh
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Hedvig Nordeng
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
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Trinh NTH, Munk-Olsen T, Wray NR, Bergink V, Nordeng HME, Lupattelli A, Liu X. Timing of Antidepressant Discontinuation During Pregnancy and Postpartum Psychiatric Outcomes in Denmark and Norway. JAMA Psychiatry 2023; 80:441-450. [PMID: 36884236 PMCID: PMC9996461 DOI: 10.1001/jamapsychiatry.2023.0041] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
Importance Approximately one-half of women treated for affective disorders discontinue antidepressant use during pregnancy, yet this discontinuation could lead to relapse post partum. Objective To investigate the associations between longitudinal antidepressant fill trajectories during pregnancy and postpartum psychiatric outcomes. Design, Setting, and Participants This cohort study used nationwide registers in Denmark and Norway. The sample included 41 475 live-born singleton pregnancies in Denmark (1997-2016) and 16 459 in Norway (2009-2018) for women who filled at least 1 antidepressant prescription within 6 months before pregnancy. Exposures Antidepressant prescription fills were obtained from the prescription registers. Antidepressant treatment during pregnancy was modeled using the k-means longitudinal method. Main Outcomes and Measures Initiation of psycholeptics, psychiatric emergencies, or records of self-harm within 1 year post partum. Between April 1 and October 30, 2022, hazard ratios (HRs) for each psychiatric outcome were estimated using Cox proportional hazards regression models. Inverse probability of treatment weighting was used to control for confounding. Country-specific HRs were pooled using random-effects meta-analytic models. Results Among 57 934 pregnancies (mean [SD] maternal age, 30.7 [5.3] years in Denmark and 29.9 [5.5] years in Norway), 4 antidepressant fill trajectories were identified: early discontinuers (31.3% and 30.4% of the included pregnancies in Denmark and Norway, respectively), late discontinuers (previously stable users) (21.5% and 27.8%), late discontinuers (short-term users) (15.9% and 18.4%), and continuers (31.3% and 23.4%). Early discontinuers and late discontinuers (short-term users) had a lower probability of initiating psycholeptics and having postpartum psychiatric emergencies vs continuers. A moderately increased probability of initiation of psycholeptics was found among late discontinuers (previously stable users) vs continuers (HR, 1.13; 95% CI, 1.03-1.24). This increase in late discontinuers (previously stable users) was more pronounced among women with previous affective disorders (HR, 1.28; 95% CI, 1.12-1.46). No association between antidepressant fill trajectories and postpartum self-harm risk was found. Conclusions and Relevance Based on pooled data from Denmark and Norway, a moderately elevated probability of initiation of psycholeptics in late discontinuers (previously stable users) vs continuers was found. These findings suggest that women with severe mental illness who are currently on stable treatment may benefit from continuing antidepressant treatment and personalized treatment counseling during pregnancy.
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Affiliation(s)
- Nhung T H Trinh
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Trine Munk-Olsen
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Naomi R Wray
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Veerle Bergink
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Hedvig M E Nordeng
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Oslo, Norway
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Angela Lupattelli
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Xiaoqin Liu
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
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Trinh NTH, Nordeng HME, Bandoli G, Palmsten K, Eberhard-Gran M, Lupattelli A. Antidepressant Fill and Dose Trajectories in Pregnant Women with Depression and/or Anxiety: A Norwegian Registry Linkage Study. Clin Epidemiol 2022; 14:1439-1451. [PMID: 36506004 PMCID: PMC9733444 DOI: 10.2147/clep.s379370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/18/2022] [Indexed: 12/08/2022] Open
Abstract
Background Few studies investigated longitudinal antidepressant exposure during pregnancy and included dosage in the assessment. Methods We conducted a nationwide, registry-linkage study in Norway using data on antidepressant prescription fills in pregnancies lasting ≥32 weeks in women with a delivery between 2009 and 2018 who had a depression/anxiety diagnosis and antidepressant fills prior to pregnancy. Information on antidepressant exposure by week (measured by filled prescriptions) and prescribed average daily dose was used in longitudinal k-means trajectory modelling for a 108-week time window from six months prior to pregnancy to one year after delivery. Factors associated with trajectory group membership were examined using multinomial logistic regression models. Results We included 8,460 pregnancies in 8,092 women. Four antidepressant fill trajectories were identified based on filled antidepressant prescriptions: two distinct discontinuing patterns, one at around the start of pregnancy (30.4%) and one around the end of pregnancy (33.8%); one continuing pattern (20.6%); and one interrupting pattern (15.2%). Using average usual daily dose, we identified low dose discontinuing (60.3%), medium dose reducing (20.6%) and high dose continuing (15.2%) patterns. The multinomial logistic regressions showed that the fill trajectory group membership was strongly associated with: antidepressant type and dose prior to pregnancy and co-medication prior to pregnancy, maternal age, marital status, parity, previous pregnancy loss, and pregnancy planning. Conclusion Longitudinal trajectory modelling revealed distinct antidepressant fill and dosage patterns in the period around pregnancy. Knowledge about factors associated with utilization trajectories might be useful for health-care personnel counselling women about antidepressant use in pregnancy.
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Affiliation(s)
- Nhung T H Trinh
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway,Correspondence: Nhung TH Trinh, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Post box 1068 Blindern, Oslo, 0316, Norway, Email
| | - Hedvig M E Nordeng
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway,Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Gretchen Bandoli
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA,Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | | | - Malin Eberhard-Gran
- Norwegian Research Centre for Women’s Health, Women’s and Children’s Division, Oslo University Hospital, Rikshospitalet, Oslo, Norway,Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Angela Lupattelli
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
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Burvenich R, Dillen H, Trinh NTH, Freer J, Wynants L, Heytens S, De Sutter A, Verbakel JY. Antibiotic use in ambulatory care for acutely ill children in high-income countries: a systematic review and meta-analysis. Arch Dis Child 2022; 107:1088-1094. [PMID: 35948405 PMCID: PMC9685710 DOI: 10.1136/archdischild-2022-324227] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/29/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine the rate and appropriateness of antibiotic prescribing for acutely ill children in ambulatory care in high-income countries. DESIGN On 10 February 2021, we systematically searched articles published since 2000 in MEDLINE, Embase, CENTRAL, Web Of Science and grey literature databases. We included cross-sectional and longitudinal studies, time-series analyses, randomised controlled trials and non-randomised studies of interventions with acutely ill children up to and including 12 years of age in ambulatory care settings in high-income countries. Pooled antibiotic prescribing and appropriateness rates were calculated using random-effects models. Meta-regression was performed to describe the relationship between the antibiotic prescribing rate and study-level covariates. RESULTS We included 86 studies comprising 11 114 863 children. We found a pooled antibiotic prescribing rate of 45.4% (95% CI 38.2% to 52.8%) for all acutely ill children, and 85.6% (95% CI 73.3% to 92.9%) for acute otitis media, 37.4% (95% CI 30.9% to 44.3%) for respiratory tract infections, and 40.4% (95% CI 29.9% to 51.9%) for other diagnoses. Considerable heterogeneity can only partly be explained by differences in diagnoses. The overall pooled appropriateness rate is 68.5% (95% CI 55.8% to 78.9%, I²=99.8%; 19 studies, 119 995 participants). 38.3% of all prescribed antibiotics were aminopenicillins. CONCLUSIONS Antibiotic prescribing rates for acutely ill children in ambulatory care in high-income countries remain high. Large differences in prescription rates between studies can only partly be explained by differences in diagnoses. Better registration and further research are needed to investigate patient-level data on diagnosis and appropriateness.
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Affiliation(s)
- Ruben Burvenich
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium .,Department of Family Medicine and Primary Healthcare, Ghent University, Ghent, Belgium
| | - Hannelore Dillen
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Nhung T H Trinh
- Department of Pharmacy, and PharmaTox Strategic Research Initiative, University of Oslo, Oslo, Norway
| | - Joseph Freer
- Institute of Population Health Sciences, Queen Mary University of London, London, UK
| | - Laure Wynants
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Stefan Heytens
- Department of Family Medicine and Primary Healthcare, Ghent University, Ghent, Belgium
| | - An De Sutter
- Department of Family Medicine and Primary Healthcare, Ghent University, Ghent, Belgium
| | - Jan Y Verbakel
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium,Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Trinh NTH, Nordeng HME, Bandoli G, Eberhard-Gran M, Lupattelli A. Antidepressant and mental health care utilization in pregnant women with depression and/or anxiety: An interrupted time-series analysis. J Affect Disord 2022; 308:458-465. [PMID: 35461816 DOI: 10.1016/j.jad.2022.04.101] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 04/10/2022] [Accepted: 04/13/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Little is known about mental health care utilization patterns in pregnant women with depression/anxiety in Norway according to antidepressant fill trajectories in pregnancy. METHOD We conducted a registry-linkage cohort study of pregnancies within women having outpatient visit for depression/anxiety and antidepressant fills prior to pregnancy identified from four national registries of Norway (2009-2018). Number of consultations for depression/anxiety per 100 pregnancies as proxy of mental health care utilization was modelled using interrupted time-series analysis with first month into pregnancy and first month after delivery as interruption points. We investigated the time window spanning from six months prior to one year postpartum. Antidepressant fill trajectories in the corresponding time window were identified using longitudinal k-means trajectory modelling. RESULTS The cohort included 8460 pregnancies within 8062 women with depression/anxiety. We observed reduced mental health care utilization when pregnant women entered the course of pregnancy (negative slopes during pregnancy for psychiatric specialists and psychologists). The declines were observed for all antidepressant fill trajectories (i.e., discontinuers and continuers) except interrupters (i.e., discontinued then resumed treatment). We found increased mental health care utilization in the postpartum year, notably in interrupters (positive slopes in consultation rates with specialists of outpatient clinics and public-contracted psychiatrists). LIMITATIONS It was not possible to measure directly the use of psychosocial interventions and psychotherapy. CONCLUSIONS Pregnancy was associated with reduced mental health care utilization regardless of whether antidepressant treatment was maintained during pregnancy or not. Increases in mental health care utilization were observed in the postpartum year, especially in interrupters.
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Affiliation(s)
- Nhung T H Trinh
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, and PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway.
| | - Hedvig M E Nordeng
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, and PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway; Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Gretchen Bandoli
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA; Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | - Malin Eberhard-Gran
- Norwegian Research Centre for Women's Health, Women's and Children's Division, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Angela Lupattelli
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, and PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
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Yang S, Trinh NTH, Chalumeau M, Kaguelidou F, Ruemmele FM, Milic D, Lemaitre M, Cohen JF, Taine M. Pediatric Prescriptions of Proton Pump Inhibitors in France (2009-2019): A Time-Series Analysis of Trends and Practice Guidelines Impact. J Pediatr 2022; 245:158-164.e4. [PMID: 35120983 DOI: 10.1016/j.jpeds.2022.01.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/28/2021] [Accepted: 01/25/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To describe the ambulatory proton pump inhibitor (PPI) prescription in French children, its trends, and the impact of French (2014) and international (2018) clinical guidelines. STUDY DESIGN We described PPI prescription rates based on national dispensation data in French children (IQVIA's Xponent database, 2009-2019). Using a segmented linear regression, we assessed the impact of clinical guidelines on PPI prescription rates. Analyses were performed for the overall pediatric population and by age subgroups (infants <2 years old, children 2-11 years old, adolescents 12-17 years old). RESULTS During the study period, 8 060 288 pediatric PPI prescriptions were filled, with a mean PPI prescription rate of 52.5 per 1000 inhabitants per year. Between 2009 and 2019, the PPI prescription rate increased by 41% in the overall pediatric population (+110% in infants). The PPI prescription rate showed seasonal patterns with peaks in winter. After the release of French guidelines, significant decreases in trends of prescription rates occurred overall (change in trend -0.28, 95% CI -0.34;-0.23) and across all age groups. In infants, this change in trend was not sufficient to reverse the PPI prescription rate that was still increasing over time. In children, the PPI prescription rate slightly decreased and in adolescents, it was stable. After the release of international guidelines, a significant decrease in trend occurred in adolescents only (change in trend -0.26, 95% CI -0.47; -0.04). CONCLUSIONS The pediatric PPI prescription rate in France was high, displayed a major increase over the last decade, mainly among infants, and was modestly affected by clinical guidelines.
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Affiliation(s)
- Shuai Yang
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Research Centre for Epidemiology and Statistics (CRESS), Université de Paris, Paris, France
| | - Nhung T H Trinh
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Research Centre for Epidemiology and Statistics (CRESS), Université de Paris, Paris, France; IQVIA, La Défense, France
| | - Martin Chalumeau
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Research Centre for Epidemiology and Statistics (CRESS), Université de Paris, Paris, France; Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants malades Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France.
| | - Florentia Kaguelidou
- Department of Pediatric Pharmacology and Pharmacogenetics, Robert-Debré Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France; Inserm, Clinical Investigation Center, Paris, France
| | - Frank M Ruemmele
- Pediatric Gastroenterology Hepatology and Nutrition, Necker-Enfants malades Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France; Institut Imagine, Inserm U 1163, Paris, France
| | | | | | - Jérémie F Cohen
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Research Centre for Epidemiology and Statistics (CRESS), Université de Paris, Paris, France; Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants malades Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Marion Taine
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Research Centre for Epidemiology and Statistics (CRESS), Université de Paris, Paris, France
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Lupattelli A, Trinh NTH. Polysubstance Exposure During Pregnancy and Attention-Deficit/Hyperactivity Disorder in Offspring-Methodological Challenges and Opportunities for Future Research. JAMA Netw Open 2022; 5:e221964. [PMID: 35275170 DOI: 10.1001/jamanetworkopen.2022.1964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Angela Lupattelli
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Nhung T H Trinh
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Oslo, Norway
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16
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Ngo ATL, Le HM, Trinh NTH, Jun APG, Bach TQ, Bui HTH, Hoang VT, Bui AV, Nguyen LT, Hoang DM. Clinically relevant preservation conditions for mesenchymal stem/stromal cells derived from perinatal and adult tissue sources. J Cell Mol Med 2021; 25:10747-10760. [PMID: 34708529 PMCID: PMC8581317 DOI: 10.1111/jcmm.17016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/22/2021] [Accepted: 09/30/2021] [Indexed: 12/14/2022] Open
Abstract
The interplay between mesenchymal stem/stromal cells (MSCs) and preservation conditions is critical to maintain the viability and functionality of these cells before administration. We observed that Ringer lactate (RL) maintained high viability of bone marrow–derived MSCs for up to 72 h at room temperature (18°C–22°C), whereas adipose‐derived and umbilical cord‐derived MSCs showed the highest viability for 72 h at a cold temperature (4°C–8°C). These cells maintained their adherence ability with an improved recovery rate and metabolic profiles (glycolysis and mitochondrial respiration) similar to those of freshly harvested cells. Growth factor and cytokine analyses revealed that the preserved cells released substantial amounts of leukaemia inhibitory factors (LIFs), hepatocyte growth factor (HGF) and vascular endothelial growth factor‐A (VEGF‐A), as well as multiple cytokines (eg IL‐4, IL‐6, IL‐8, MPC‐1 and TNF‐α). Our data provide the simplest clinically relevant preservation conditions that maintain the viability, stemness and functionality of MSCs from perinatal and adult tissue sources.
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Affiliation(s)
- Anh T L Ngo
- Vinmec Institute of Applied Science and Regenerative Medicine, Vinmec Health Care System, Hanoi, Vietnam
| | - Hang M Le
- Vinmec Institute of Applied Science and Regenerative Medicine, Vinmec Health Care System, Hanoi, Vietnam
| | - Nhung T H Trinh
- Vinmec Research Institute of Stem Cell and Gene Technology, Vinmec Healthcare System, Hanoi, Vietnam
| | - Adriel Peng Guo Jun
- Vinmec Research Institute of Stem Cell and Gene Technology, Vinmec Healthcare System, Hanoi, Vietnam
| | - Trung Q Bach
- Vinmec Research Institute of Stem Cell and Gene Technology, Vinmec Healthcare System, Hanoi, Vietnam
| | - Hue T H Bui
- Vinmec Institute of Applied Science and Regenerative Medicine, Vinmec Health Care System, Hanoi, Vietnam
| | - Van T Hoang
- Vinmec Research Institute of Stem Cell and Gene Technology, Vinmec Healthcare System, Hanoi, Vietnam
| | - Anh V Bui
- Vinmec Institute of Applied Science and Regenerative Medicine, Vinmec Health Care System, Hanoi, Vietnam
| | - Liem T Nguyen
- Vinmec Research Institute of Stem Cell and Gene Technology, Vinmec Healthcare System, Hanoi, Vietnam
| | - Duc M Hoang
- Vinmec Research Institute of Stem Cell and Gene Technology, Vinmec Healthcare System, Hanoi, Vietnam
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Trinh NTH, Cohen R, Lemaitre M, Chahwakilian P, Coulthard G, Bruckner TA, Milic D, Levy C, Chalumeau M, Cohen JF. Community antibiotic prescribing for children in France from 2015 to 2017: a cross-sectional national study. J Antimicrob Chemother 2021; 75:2344-2352. [PMID: 32449915 DOI: 10.1093/jac/dkaa162] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES To assess recent community antibiotic prescribing for French children and identify areas of potential improvement. METHODS We analysed 221 768 paediatric (<15 years) visits in a national sample of 680 French GPs and 70 community paediatricians (IQVIA's EPPM database), from March 2015 to February 2017, excluding well-child visits. We calculated antibiotic prescription rates per 100 visits, separately for GPs and paediatricians. For respiratory tract infections (RTIs), we described broad-spectrum antibiotic use and duration of treatment. We used Poisson regression to identify factors associated with antibiotic prescribing. RESULTS GPs prescribed more antibiotics than paediatricians [prescription rate 26.1 (95% CI 25.9-26.3) versus 21.6 (95% CI 21.0-22.2) per 100 visits, respectively; P < 0.0001]. RTIs accounted for more than 80% of antibiotic prescriptions, with presumed viral RTIs being responsible for 40.8% and 23.6% of all antibiotic prescriptions by GPs and paediatricians, respectively. For RTIs, antibiotic prescription rates per 100 visits were: otitis, 68.1 and 79.8; pharyngitis, 67.3 and 53.3; sinusitis, 67.9 and 77.3; pneumonia, 80.0 and 99.2; bronchitis, 65.2 and 47.3; common cold, 21.7 and 11.6; bronchiolitis 31.6 and 20.1; and other presumed viral RTIs, 24.1 and 11.0, for GPs and paediatricians, respectively. For RTIs, GPs prescribed more broad-spectrum antibiotics [49.8% (95% CI 49.3-50.3) versus 35.6% (95% CI 34.1-37.1), P < 0.0001] and antibiotic courses of similar duration (P = 0.21). After adjustment for diagnosis, antibiotic prescription rates were not associated with season and patient age, but were significantly higher among GPs aged ≥50 years. CONCLUSIONS Future antibiotic stewardship campaigns should target presumed viral RTIs, broad-spectrum antibiotic use and GPs aged ≥50 years.
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Affiliation(s)
- Nhung T H Trinh
- Université de Paris, Epidemiology and Statistics Research Center - CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology research team, F-75004 Paris, France.,IQVIA, La Défense, France
| | - Robert Cohen
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Saint-Maur-des-Fossés, France.,Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | | | | | | | - Tim A Bruckner
- Program in Public Health, University of California, Irvine, CA, USA
| | | | - Corinne Levy
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Saint-Maur-des-Fossés, France.,Clinical Research Centre, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Martin Chalumeau
- Université de Paris, Epidemiology and Statistics Research Center - CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology research team, F-75004 Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Hôpital Necker - Enfants malades, Université de Paris, Paris, France
| | - Jérémie F Cohen
- Université de Paris, Epidemiology and Statistics Research Center - CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology research team, F-75004 Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Hôpital Necker - Enfants malades, Université de Paris, Paris, France
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Trinh NTH, Chalumeau M, Bruckner TA, Levy C, Bessou A, Milic D, Cohen R, Lemaitre M, Cohen JF. Monitoring outpatient antibiotic utilization using reimbursement and retail sales data: a population-based comparison in France, 2012-17. J Antimicrob Chemother 2021; 76:2446-2452. [PMID: 34120188 DOI: 10.1093/jac/dkab185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 04/26/2021] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES To assess whether a retail sales database could be used to monitor antibiotic utilization in the outpatient setting at the national level. METHODS We extracted 2012-17 outpatient antibiotic extrapolated retail sales (IQVIA's Xponent) and reimbursement data from the National Health Insurance (SNDS) in metropolitan France. We compared estimates of antibiotic use and consumption [number of antibiotic drug deliveries (DrID) and defined daily doses (DID) per 1000 inhabitants per day]. We relied on relative differences, Pearson's r statistics and time series using autoregressive integrated moving average (ARIMA) modelling to study: (i) differences in point estimates, (ii) correlation, and (iii) consistency in time trends between Xponent and SNDS. The analysis was conducted overall and in subgroups (age groups, therapeutic classes, major antimicrobial agents and regions). RESULTS We analysed approximately 377 million antibiotic drug deliveries, comprising nearly 3.4 billion DDDs. Overall, Xponent slightly overestimated SNDS point estimates with yearly relative differences of +3.5% for DrID and +3.3% for DID. Peaks in relative differences were observed for July and August months. Relative differences were <5% in most subgroups, except for fosfomycin and three French regions. Overall and across most subgroups, the correlation between Xponent and SNDS monthly aggregated estimates was almost perfect (r ≥ 0.992 for all subgroups, except for one region). ARIMA modelling showed high consistency between Xponent's and SDNS's DrID time series, but detected timepoints where the series significantly diverged. CONCLUSIONS IQVIA's Xponent and SNDS data were highly consistent. Xponent database seems suitable for monitoring outpatient antibiotic utilization in France.
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Affiliation(s)
- Nhung T H Trinh
- Université de Paris, Epidemiology and Statistics Research Center-CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology research team, F-75004, Paris, France.,IQVIA, La Défense, France
| | - Martin Chalumeau
- Université de Paris, Epidemiology and Statistics Research Center-CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology research team, F-75004, Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Hôpital Necker-Enfants malades, Université de Paris, Paris, France
| | - Tim A Bruckner
- Program in Public Health, University of California, Irvine, CA, USA
| | - Corinne Levy
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Saint-Maur-des-Fossés, France.,Clinical Research Centre, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | | | | | - Robert Cohen
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Saint-Maur-des-Fossés, France.,Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | | | - Jérémie F Cohen
- Université de Paris, Epidemiology and Statistics Research Center-CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology research team, F-75004, Paris, France.,Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Hôpital Necker-Enfants malades, Université de Paris, Paris, France
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Martin GC, Robert MP, Challe G, Trinh NTH, Attié-Bitach T, Brémond-Gignac D, Bodaghi B, Abadie V. Functional Vision Analysis in Patients With CHARGE Syndrome. J Pediatr Ophthalmol Strabismus 2020; 57:120-128. [PMID: 32203596 DOI: 10.3928/01913913-20200207-02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 01/13/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate functional vision in patients with CHARGE syndrome (coloboma, heart defects, atresia of the choanae, retardation of growth and development, genital and urinary anomalies, and ear anomalies) by using a new questionnaire entitled VISIOCHARGE. METHODS Ophthalmological data including fundus description and visual acuity, when available, were extracted from the charts of 83 patients with CHARGE syndrome, and the VISIOCHARGE questionnaire was prospectively mailed to 55 of those patients. The answers from the 36 responders (18 males) allowed for the calculation of three scores that assessed distance vision, near vision, and overall ability scores. RESULTS Visual acuity measurements were extracted from the charts of 20 of the 36 patients. The mean visual acuity was 20/50. The mean distance vision score of 0.62 ± 0.30 and near vision score of 0.78 ± 0.23 were correlated with visual acuity in the 20 patients (ρ = 0.64, P = .002 and ρ = 0.61, P = .005, respectively) and were associated with the severity of colobomatous malformation (P = .049 and P = .008, respectively). Severity of the ocular malformation was not associated with the overall ability score (P = .64). CONCLUSIONS The VISIOCHARGE questionnaire is feasible for patients with CHARGE syndrome and may help in the assessment of visual function. The mean visual acuity and answers to the VISIOCHARGE questionnaire showed relatively good visual skills in patients with CHARGE syndrome in everyday life, even in those with bilateral colobomas, which contrasts with the pessimistic conclusions usually resulting from the initial fundus examination. [J Pediatr Ophthalmol Strabismus. 2020;57(2):120-128.].
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Trinh NTH, Solé E, Benkebil M. Benefits of combining change-point analysis with disproportionality analysis in pharmacovigilance signal detection. Pharmacoepidemiol Drug Saf 2018; 28:370-376. [PMID: 29992679 DOI: 10.1002/pds.4613] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 01/08/2018] [Accepted: 06/04/2018] [Indexed: 11/08/2022]
Abstract
BACKGROUND Change-point analysis (CPA) is a powerful method to analyse pharmacovigilance data but it has never been used on the disproportionality metric. OBJECTIVES To optimize signal detection investigating the interest of time-series analysis in pharmacovigilance and the benefits of combining CPA with the proportional reporting ratio (PRR). METHODS We investigated the couple benfluorex and aortic valve incompetence (AVI) using the French National Pharmacovigilance and EudraVigilance databases: CPA was applied on monthly counts of reports and the lower bound of monthly computed PRR (PRR-). We stated a CPA hypothesis that the substance-event combination is more likely to be a signal when the 2 following criteria are fulfilled: PRR- is greater than 1 with at least 5 cases, and CPA method detects at least 2 successive change points of PRR- which made consecutively increasing segments. We tested this hypothesis by 95 test cases identified from a drug safety reference set and 2 validated signals from EudraVigilance database: CPA was applied on PRR-. RESULTS For benfluorex and AVI, change points detected by CPA on PRR- were more meaningful compared with monthly counts of reports: More change points detected and detected earlier. In the reference set, 14 positive controls satisfied CPA hypothesis, 6 positive controls only met first requirements, 3 negative controls only met first requirement, and 2 validated signals satisfied CPA hypothesis. CONCLUSIONS The combination of CPA and PRR represents a significant advantage in detecting earlier signals and reducing false-positive signals. This approach should be confirmed in further studies.
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Affiliation(s)
- Nhung T H Trinh
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Research Center for Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS), Paris Descartes University, Paris, France.,Adverse Events and incidents Department-Surveillance Division, Agence nationale de sécurité du médicament et des produits de santé (ANSM), Saint Denis, France
| | - Elodie Solé
- Adverse Events and incidents Department-Surveillance Division, Agence nationale de sécurité du médicament et des produits de santé (ANSM), Saint Denis, France
| | - Mehdi Benkebil
- Adverse Events and incidents Department-Surveillance Division, Agence nationale de sécurité du médicament et des produits de santé (ANSM), Saint Denis, France
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Trinh NTH, Chahwakilian P, Bruckner TA, Sclison S, Levy C, Chalumeau M, Milic D, Cohen R, Cohen JF. Discrepancies in national time trends of outpatient antibiotic utilization using different measures: a population-based study in France. J Antimicrob Chemother 2018; 73:1395-1401. [DOI: 10.1093/jac/dky018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 01/03/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Nhung T H Trinh
- Inserm UMR 1153, Obstetrical, Perinatal and Paediatric Epidemiology Research Team, Research Centre for Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS), Paris Descartes University, Paris, France
| | | | - Tim A Bruckner
- Program in Public Health, University of California, Irvine, CA, USA
| | | | - Corinne Levy
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Saint-Maur-des-Fossés, France
- Clinical Research Centre, Centre Hospitalier Intercommunal de Créteil, Créteil, France
- Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | - Martin Chalumeau
- Inserm UMR 1153, Obstetrical, Perinatal and Paediatric Epidemiology Research Team, Research Centre for Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS), Paris Descartes University, Paris, France
- Department of General Paediatrics and Paediatric Infectious Disease, Necker—Enfants malades hospital, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France
| | | | - Robert Cohen
- Association Clinique et Thérapeutique Infantile du Val-de-Marne (ACTIV), Saint-Maur-des-Fossés, France
- Université Paris Est, IMRB-GRC GEMINI, Créteil, France
- Unité Court Séjour, Petits Nourrissons, Service de Néonatalogie, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Jérémie F Cohen
- Inserm UMR 1153, Obstetrical, Perinatal and Paediatric Epidemiology Research Team, Research Centre for Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS), Paris Descartes University, Paris, France
- Department of General Paediatrics and Paediatric Infectious Disease, Necker—Enfants malades hospital, Assistance Publique—Hôpitaux de Paris, Paris Descartes University, Paris, France
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