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Iessa N, Macolic Sarinic V, Ghazaryan L, Romanova N, Alemu A, Rungapiromnan W, Jiamsuchon P, Pokhagul P, Castro JL, Macias Saint-Gerons D, Ghukasyan G, Teferi M, Gupta M, Pal SN. Smart Safety Surveillance (3S): Multi-Country Experience of Implementing the 3S Concepts and Principles. Drug Saf 2021; 44:1085-1098. [PMID: 34331675 PMCID: PMC8325038 DOI: 10.1007/s40264-021-01100-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2021] [Indexed: 11/29/2022]
Abstract
Introduction The Smart Safety Surveillance (3S) concept is based on the understanding that, when faced with competing pharmacovigilance priorities, countries will have to invest judiciously, by focusing on new priority products, sharing work and resources with other countries when possible and building national competence for those activities that cannot be delegated. Method The 3S principles were applied to Armenia, Brazil, Ethiopia, India, Peru and Thailand using three priority products: bedaquiline, rotavirus vaccine and tafenoquine. A baseline assessment of pharmacovigilance preparedness was used to identify gaps and establish a work plan. The impact was measured by comparing pre and post 3S-intervention outcomes, which included the number and quality of reports (completeness scores) in the WHO global database of Individual Case Safety Reports, VigiBase, and number of structural indicators met. The implementation period was 9–18 months, ranging from March 2018 (earliest started) until May 2020 (latest). Result An increase in adverse drug reaction (ADR) reporting was demonstrated in Armenia (bedaquiline), Brazil (TB and malaria medicines), India (rotavirus vaccine) and Ethiopia (TB medicines). Completeness scores were above 0.5 at baseline in all countries, and reports improved in quality for Brazil (TB), Peru (malaria), Thailand (malaria) and India (immunization). The number of structural indicators met increased by more than double for Ethiopia. Ethiopia and India demonstrated an increased capacity for signal detection and signal evaluation. Armenia, Brazil, Peru and Thailand showed increased capacity to assess risk management plans following the implementation of 3S principles. Conclusion The 3S concept has demonstrated success in different ways across the six countries. Activities focused on three products for a proof of concept of the 3S principles, with the expectation that the project impact will be sustained through strengthened systems, to guide pharmacovigilance activities of other products in the future. It is important to continue monitoring the countries to understand if the gains and successes of the current 3S project are sustainable. Supplementary Information The online version contains supplementary material available at 10.1007/s40264-021-01100-z.
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Affiliation(s)
- Noha Iessa
- World Health Organization Headquarters, Geneva, Switzerland
| | | | - Lilit Ghazaryan
- Scientific Centre of Drug and Medical Technology Expertise of MoH, Yerevan, Armenia
| | - Naira Romanova
- Scientific Centre of Drug and Medical Technology Expertise of MoH, Yerevan, Armenia
| | - Asnakech Alemu
- Ethiopian Food and Drug Administration, Addis Ababa, Ethiopia
| | | | - Porntip Jiamsuchon
- Ministry of Public Health, Thai Food and Drug Administration, Nonthaburi, Thailand
| | - Pattreya Pokhagul
- Ministry of Public Health, Thai Food and Drug Administration, Nonthaburi, Thailand
| | | | | | | | | | | | - Shanthi Narayan Pal
- World Health Organization Headquarters, 20 Avenue Appia, 1202, Geneva, Switzerland.
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Radecka A, Loughlin L, Foy M, de Ferraz Guimaraes MV, Sarinic VM, Di Giusti MD, Lesicar M, Straus S, Montero D, Pallos J, Ivanovic J, Raine J. Enhancing Pharmacovigilance Capabilities in the EU Regulatory Network: The SCOPE Joint Action. Drug Saf 2018; 41:1285-1302. [PMID: 30128638 PMCID: PMC6223699 DOI: 10.1007/s40264-018-0708-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In November 2013, a team of European regulators initiated the Strengthening Collaboration for Operating Pharmacovigilance in Europe (SCOPE) Joint Action. Funded by the Health Programme of the European Union, and with contributions from the involved Member States, SCOPE gathered information and expertise on how regulators in Member States run their national pharmacovigilance systems to meet the requirements of the pharmacovigilance legislation that came into effect in June 2012. The SCOPE project evaluated then-current practices and developed tools to further improve the skills and capability in the pharmacovigilance network. The project was divided into eight separate work streams, five of which concentrated on pharmacovigilance topics-collecting information on suspected adverse drug reactions, identifying and managing safety issues (signals), communicating risk and assessing risk minimisation measures, supported by effective quality management systems. The other three work streams focused on the functional aspects-coordination, communication and evaluation of the project. Through the project, SCOPE delivered guidance, training in key aspects of pharmacovigilance, and tools and templates to support best practice. The deliverables provide practical guidance that those working in the European national competent authorities can take to strengthen their national systems. The SCOPE outputs can be useful for other stakeholders involved in pharmacovigilance activities, including the pharmaceutical industry, healthcare professionals, patient and consumer organisations, and academia.
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Affiliation(s)
- Anna Radecka
- Medicines and Healthcare products Regulatory Agency (MHRA), London, UK.
| | - Louise Loughlin
- Medicines and Healthcare products Regulatory Agency (MHRA), London, UK
| | - Mick Foy
- Medicines and Healthcare products Regulatory Agency (MHRA), London, UK
| | | | | | | | - Marina Lesicar
- Agency for Medicinal Products and Medical Devices of Croatia (HALMED), Zagreb, Croatia
| | - Sabine Straus
- Medicines Evaluation Board (MEB), Utrecht, The Netherlands
| | - Dolores Montero
- Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), Madrid, Spain
| | - Julia Pallos
- National Institute of Pharmacy and Nutrition (OGYÉI), Budapest, Hungary
| | | | - June Raine
- Medicines and Healthcare products Regulatory Agency (MHRA), London, UK
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Härmark L, Raine J, Leufkens H, Edwards IR, Moretti U, Sarinic VM, Kant A. Patient-Reported Safety Information: A Renaissance of Pharmacovigilance? Drug Saf 2017; 39:883-90. [PMID: 27379887 DOI: 10.1007/s40264-016-0441-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The role of patients as key contributors in pharmacovigilance was acknowledged in the new EU pharmacovigilance legislation. This contains several efforts to increase the involvement of the general public, including making patient adverse drug reaction (ADR) reporting systems mandatory. Three years have passed since the legislation was introduced and the key question is: does pharmacovigilance yet make optimal use of patient-reported safety information? Independent research has shown beyond doubt that patients make an important contribution to pharmacovigilance signal detection. Patient reports provide first-hand information about the suspected ADR and the circumstances under which it occurred, including medication errors, quality failures, and 'near misses'. Patient-reported safety information leads to a better understanding of the patient's experiences of the ADR. Patients are better at explaining the nature, personal significance and consequences of ADRs than healthcare professionals' reports on similar associations and they give more detailed information regarding quality of life including psychological effects and effects on everyday tasks. Current methods used in pharmacovigilance need to optimise use of the information reported from patients. To make the most of information from patients, the systems we use for collecting, coding and recording patient-reported information and the methodologies applied for signal detection and assessment need to be further developed, such as a patient-specific form, development of a severity grading and evolution of the database structure and the signal detection methods applied. It is time for a renaissance of pharmacovigilance.
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Affiliation(s)
- Linda Härmark
- Netherlands Pharmacovigilance Centre Lareb, WHO Collaborating Center for Pharmacovigilance in Education and Patient Reporting, Goudsbloemvallei 7, 5237 MH, 's-Hertogenbosch, The Netherlands.
| | - June Raine
- Medicines and Healthcare Products Regulatory Agency, 151 Buckingham Palace Road, London, SW1W 9SZ, UK
| | - Hubert Leufkens
- Medicines Evaluation Board, Postbus 8275, 3503 RG, Utrecht, The Netherlands
| | - I Ralph Edwards
- Uppsala Monitoring Centre, Box 1051, 751 40, Uppsala, Sweden
| | - Ugo Moretti
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Agnes Kant
- Netherlands Pharmacovigilance Centre Lareb, WHO Collaborating Center for Pharmacovigilance in Education and Patient Reporting, Goudsbloemvallei 7, 5237 MH, 's-Hertogenbosch, The Netherlands
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Carnovale C, Gentili M, Matacena M, Dimov Di Giusti M, Krnic D, Dolinic B, Kolaric D, Margan Koletic Z, Macolic Sarinic V, Culjak M, Fortino I, Merlino L, Clementi E, Radice S. A retrospective review of paediatric adverse drug reactions reported in Lombardy and Croatia from 2005 to 2013. Expert Opin Drug Saf 2016; 15:35-43. [DOI: 10.1080/14740338.2016.1253678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Carla Carnovale
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital ‘Luigi Sacco’, Università di Milano, Milan, Italy
| | - Marta Gentili
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital ‘Luigi Sacco’, Università di Milano, Milan, Italy
| | - Marco Matacena
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital ‘Luigi Sacco’, Università di Milano, Milan, Italy
| | - Marina Dimov Di Giusti
- Department for Pharmacovigilance and Rational Pharmacotherapy, Agency for Medical Products and Medical Devices of Croatia, Zagreb, Croatia
| | - Darko Krnic
- Department for Pharmacovigilance and Rational Pharmacotherapy, Agency for Medical Products and Medical Devices of Croatia, Zagreb, Croatia
| | - Barbara Dolinic
- Department for Pharmacovigilance and Rational Pharmacotherapy, Agency for Medical Products and Medical Devices of Croatia, Zagreb, Croatia
| | - Darija Kolaric
- Department for Pharmacovigilance and Rational Pharmacotherapy, Agency for Medical Products and Medical Devices of Croatia, Zagreb, Croatia
| | - Zeljana Margan Koletic
- Department for Pharmacovigilance and Rational Pharmacotherapy, Agency for Medical Products and Medical Devices of Croatia, Zagreb, Croatia
| | - Viola Macolic Sarinic
- Department for Pharmacovigilance and Rational Pharmacotherapy, Agency for Medical Products and Medical Devices of Croatia, Zagreb, Croatia
| | - Maja Culjak
- Department for Pharmacovigilance and Rational Pharmacotherapy, Agency for Medical Products and Medical Devices of Croatia, Zagreb, Croatia
| | | | | | - Emilio Clementi
- Scientific Institute, IRCCS E. Medea, Lecco, Italy
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, Consiglio Nazionale delle Ricerche Institute of Neuroscience, University Hospital ‘Luigi Sacco’, Milan, Italy
| | - Sonia Radice
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital ‘Luigi Sacco’, Università di Milano, Milan, Italy
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Mirosevic Skvrce N, Macolic Sarinic V, Mucalo I, Krnic D, Bozina N, Tomic S. Adverse drug reactions caused by drug-drug interactions reported to Croatian Agency for Medicinal Products and Medical Devices: a retrospective observational study. Croat Med J 2012; 52:604-14. [PMID: 21990078 PMCID: PMC3195969 DOI: 10.3325/cmj.2011.52.604] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Aim To analyze potential and actual drug-drug interactions reported to the Spontaneous Reporting Database of the Croatian Agency for Medicinal Products and Medical Devices (HALMED) and determine their incidence. Methods In this retrospective observational study performed from March 2005 to December 2008, we detected potential and actual drug-drug interactions using interaction programs and analyzed them. Results HALMED received 1209 reports involving at least two drugs. There were 468 (38.7%) reports on potential drug-drug interactions, 94 of which (7.8% of total reports) were actual drug-drug interactions. Among actual drug-drug interaction reports, the proportion of serious adverse drug reactions (53 out of 94) and the number of drugs (n = 4) was significantly higher (P < 0.001) than among the remaining reports (580 out of 1982; n = 2, respectively). Actual drug-drug interactions most frequently involved nervous system agents (34.0%), and interactions caused by antiplatelet, anticoagulant, and non-steroidal anti-inflammatory drugs were in most cases serious. In only 12 out of 94 reports, actual drug-drug interactions were recognized by the reporter. Conclusion The study confirmed that the Spontaneous Reporting Database was a valuable resource for detecting actual drug-drug interactions. Also, it identified drugs leading to serious adverse drug reactions and deaths, thus indicating the areas which should be in the focus of health care education.
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Affiliation(s)
- Nikica Mirosevic Skvrce
- Pharmacovigilance Department, Agency for Medicinal Products and Medical Devices, Zagreb, Croatia.
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Erdeljic V, Francetic I, Macolic Sarinic V, Bilusic M, Makar Ausperger K, Huic M, Mercep I. Use of gastroprotective agents in recommended doses in hospitalized patients receiving NSAIDs: a drug utilization study. ACTA ACUST UNITED AC 2006; 28:318-25. [PMID: 17111239 DOI: 10.1007/s11096-006-9062-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2005] [Accepted: 09/13/2006] [Indexed: 11/30/2022]
Abstract
OBJECTIVE In recent years, studies investigated to what extend recommendations for co-prescribing gastroprotective agents in prevention of NSAID-induced gastrointestinal complications are followed in clinical practice. However, only a few studies have also taken into consideration the recommended dose of gastroprotectives prescribed in NSAID-induced ulcer prophylaxis. The aim of our study was to evaluate the prevalence of concomitant use of gastroprotectives with NSAIDs in hospitalized patients, with emphasis on the recommended dose of gastroprotectives for ulcer prophylaxis. METHOD This observational, cross-sectional, drug utilization study included all adult patients receiving NSAIDs hospitalized in the Clinical Hospital Center Zagreb on the day of the study. Data on age, sex, comorbidities, indications for NSAID use, type/dose of NSAIDs and gastroprotectives, history of gastrointestinal events, active gastrointestinal symptoms and risk factors were evaluated. MAIN OUTCOME MEASURE Study outcomes were: (1) prevalence of prescription of gastroprotectives among NSAID-users at risk; (2) prevalence of prescription of gastroprotective in recommended dose; (3) association between risk factors and prescription of GPAs. RESULTS The rates of gastroprotectives prescription were significantly higher in NSAID-users with concomitant risk factors as compared to patients without risk factors [47/70 (67.1%) and 8/22 (36.4%), respectively; p=0.01072]. However, gastroprotection in recommended ulcer-preventive dose was low in both groups [8/70 (11.4%) and 9/92 (9.8%), respectively]. The number of concomitant risk factors did not increase the odds of receiving anti-ulcer therapy (odds ratio 0.7279). Thirty-three percent of patients with concomitant risk factors were not prescribed gastroprotectives. Ibuprofen, NSAID with the lowest risk of inducing gastrointestinal complications, was prescribed in only two patients. CONCLUSION The results indicate high awareness among hospital physicians about possible NSAID-induced gastrointestinal complications, but insufficient knowledge about risk factors related to NSAID-induced gastrointestinal toxicity, recommended dose of gastroprotectives in NSAID-induced ulcer prophylaxis and gastrointestinal toxicity of different types of NSAIDs.
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Affiliation(s)
- Viktorija Erdeljic
- Division of Clinical Pharmacology, Department of Medicine, University Hospital Center Zagreb, Zagreb, 10000, Croatia.
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