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      Pharmacovigilance and drug safety in Calabria (Italy): 2012 adverse events analysis

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          Abstract

          Introduction:

          Pharmacovigilance (PV) is designed to monitor drugs continuously after their commercialization, assessing and improving their safety profile. The main objective is to increase the spontaneous reporting of adverse drug reactions (ADRs), in order to have a wide variety of information. The Italian Drug Agency (Agenzia Italiana del Farmaco [AIFA]) is financing several projects to increase reporting. In Calabria, a PV information center has been created in 2010.

          Materials and Methods:

          We obtained data using the database of the National Health Information System AIFA relatively to Italy and Calabria in the year 2012. Descriptive statistics were performed to analyze the ADRs.

          Results:

          A total number of 461 ADRs have been reported in the year 2012 with an increase of 234% compared with 2011 (138 reports). Hospital doctors are the main source of this reporting (51.62%). Sorafenib (Nexavar ®), the combination of amoxicillin/clavulanic acid and ketoprofen represent the drugs most frequently reported causing adverse reactions. Adverse events in female patients (61.83%) were more frequently reported, whereas the age groups “41-65” (39.07%) and “over 65” (27.9%) were the most affected.

          Conclusions:

          Calabria has had a positive increase in the number of ADRs reported, although it has not yet reached the gold standard set by World Health Organization (about 600 reports), the data have shown that PV culture is making inroads in this region and that PV projects stimulating and increasing PV knowledge are needed.

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          Most cited references20

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          Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies.

          To estimate the incidence of serious and fatal adverse drug reactions (ADR) in hospital patients. Four electronic databases were searched from 1966 to 1996. Of 153, we selected 39 prospective studies from US hospitals. Data extracted independently by 2 investigators were analyzed by a random-effects model. To obtain the overall incidence of ADRs in hospitalized patients, we combined the incidence of ADRs occurring while in the hospital plus the incidence of ADRs causing admission to hospital. We excluded errors in drug administration, noncompliance, overdose, drug abuse, therapeutic failures, and possible ADRs. Serious ADRs were defined as those that required hospitalization, were permanently disabling, or resulted in death. The overall incidence of serious ADRs was 6.7% (95% confidence interval [CI], 5.2%-8.2%) and of fatal ADRs was 0.32% (95% CI, 0.23%-0.41%) of hospitalized patients. We estimated that in 1994 overall 2216000 (1721000-2711000) hospitalized patients had serious ADRs and 106000 (76000-137000) had fatal ADRs, making these reactions between the fourth and sixth leading cause of death. The incidence of serious and fatal ADRs in US hospitals was found to be extremely high. While our results must be viewed with circumspection because of heterogeneity among studies and small biases in the samples, these data nevertheless suggest that ADRs represent an important clinical issue.
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            Determinants of under-reporting of adverse drug reactions: a systematic review.

            A voluntary reporting system of adverse drug reactions (ADRs) is fundamental to drug safety surveillance but under-reporting is its major limitation. This bibliographic review sought to assess the influence of personal and professional characteristics on ADR reporting and to identify knowledge and attitudes associated with ADR reporting. A systematic review was conducted using the MEDLINE and EMBASE databases. We included papers that were published in English, French and Spanish, and covered a study population made up of health professionals. In each case, the following data were extracted: study population; workplace; study type; sample size; type of questionnaire; type of scale for measuring knowledge; response rate; personal and professional factors; and knowledge and attitudes (based on Inman's 'seven deadly sins') associated with reporting. Based on a search of computerized databases, we identified a total of 657 papers in MEDLINE and 973 in EMBASE. In all, the review covered 45 papers that fulfilled the inclusion criteria. Medical specialty was the professional characteristic most closely associated with under-reporting in 76% of studies involving physicians. Other factors associated with under-reporting were ignorance (only severe ADRs need to be reported) in 95%; diffidence (fear of appearing ridiculous for reporting merely suspected ADRs) in 72%; lethargy (an amalgam of procrastination, lack of interest or time to find a report card, and other excuses) in 77%; indifference (the one case that an individual doctor might see could not contribute to medical knowledge) and insecurity (it is nearly impossible to determine whether or not a drug is responsible for a particular adverse reaction) in 67%; and complacency (only safe drugs are allowed on the market) in 47% of studies. While personal and professional factors display a weak influence, the knowledge and attitudes of health professionals appear to be strongly related with reporting in a high proportion of studies. This result may have important implications in terms of public health, if knowledge and attitudes are viewed as potentially modifiable factors.
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              Pharmacovigilance: methods, recent developments and future perspectives.

              Pharmacovigilance, defined by the World Health Organisation as 'the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problem' plays a key role in ensuring that patients receive safe drugs. Our knowledge of a drug's adverse reactions can be increased by various means, including spontaneous reporting, intensive monitoring and database studies. New processes, both at a regulatory and a scientific level, are being developed with the aim of strengthening pharmacovigilance. On a regulatory level, these include conditional approval and risk management plans; on a scientific level, transparency and increased patient involvement are two important elements. To review and discuss various aspects of pharmacovigilance, including new methodological developments.
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                Author and article information

                Journal
                J Pharmacol Pharmacother
                J Pharmacol Pharmacother
                JPP
                Journal of Pharmacology & Pharmacotherapeutics
                Medknow Publications & Media Pvt Ltd (India )
                0976-500X
                0976-5018
                December 2013
                : 4
                : Suppl1
                : S55-S60
                Affiliations
                [1] Department of Science of Health, School of Medicine, University of Catanzaro, Italy and Pharmacovigilance's Centre Calabria Region, University Hospital Mater Domini, Catanzaro, Italy
                Author notes
                Address for correspondence: Emilio Russo, Department of Science of Health, Chair of Pharmacology, School of Medicine, University of Catanzaro, Via T. Campanella, 115, 88100 Catanzaro, Italy. E-mail: erusso@ 123456unicz.it

                UNIVIGIL CZ Group members

                Abossida Rosa, Aiello Rossana, Aloisio Mariateresa, Altomare Federica, Ammendola Michele, Avenoso Tiziana, Barbagallo Giuseppe, Barreca Massimo, Bellantoni Antonella, Bitonte Carla, Bombardiere Giuseppe Nicodemo, Borelli Carmela, Borello Giuseppe, Boscarelli Giuseppe, Braghò Salvatore, Bruno Maria Cristina, Burdino Elisabetta, Caloiero, Mimma, Capozza M. Giuseppina, Carnovale Domenico, Carullo Bruno, Carullo Giuseppe, Ceravolo Antonio, Cerullo Andrea, Chiappetta Olga, Chiarella Giuseppe, Chiarella Sergio, Ciliberto Domenico, Cirillo Maria Antonia, Cirisano Anastasia, Corabi Caterina Raffaella, Corasaniti Francesco, Cordiano Alessandro, Cosenza Salvatore Mario, Costante Giuseppe, Costanzo Maria Giovanna, Crispino Antonio, Cristofaro Brunello, Cusato Gennaro, David Domenico Carlo Francesco, De Fazio Salvatore, De Luca Giampaolo, De Marco Giuseppe, De Siena Antonia, De Vuono Antonio Domenico, Devito Antonia, Di Cianni Giorgio, Dolceamore Rita, Falbo Maurizio, Falbo Tania, Forciniti Angelo Antonio, Gaetano Raffaele, Galasso Maria Pia, Gallo Mirella, Gallucci Michele, Gallucci Pasquale, Garo Amalia Grazia, Genovese Concetta, Gentile Innocenza, Gentile Pierpaolo, Giglio Alfonso, Golia Marisa, Golia Sonia, Gratteri Santo, Grembiale Alessandro, Grillo Nadia, Ierullo Giuseppe, Imbrogno Pietro Pasquale, Impieri Salvatore, Infusino Stefania, La Gattuta Gaetana, Labate Angelo, Lamonica Marialisa, Larussa Filippo Maria, Leo Antonio, Leuzzi Giacomo, Lopez Emilia, Lucia Maria, Luposella Maria, Macri’ Demartino Riccardo, Macrina Alessandro, Maretta Alessia, Maviglia Annunziata, Mazzaferro Erminia, Mazzei Anna, Mazzitello Giovanni, Megna Angela, Merigliano Giovanna, Mesuraca Luigi, Migliaccio Maria Teresa, Miniero Roberto, Montalto Franco, Montebianco Abenavoli Ludovico, Monteleone Salvatore, Morano Espedito, Muraca Maria Rita, Murone Maria Cristina, Natale Vincenzo, Olivadese Francesco, Oliverio Antonella Chiara, Palmieri Silvana, Pascale Francesca, Passafari Gioacchino, Pensabene Licia, Perrone Sabrina, Pingitore Amedeo, Piscitelli Antonio, Prestinenzi Marinella, Puntoriero Caterina, Quero Michele, Rotundo Pietropaolo, Rubino Mario, Russo Gaetano, Salerno Valentina, Saullo Ernesto, Sciacqua Angela, Scicchitano Maria, Scicchitano Michele, Siciliani Maurizio, Sorrentino Antonio, Squillace Aida, Stranieri Danilo, Succurro Elena, Tiriolo Concetta, Torcasio Giovanni, Tornatora Antonella, Tosto Luigi, Vasapollo Piero, Verre Concetta, Vettese Ada, Zampogna Stefania, Zappia Maria.

                Article
                JPP-4-55
                10.4103/0976-500X.120963
                3853671
                24347984
                1227f401-14cc-4ba8-9796-e4dadb1f97ca
                Copyright: © Journal of Pharmacology and Pharmacotherapeutics

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Research Article

                Pharmacology & Pharmaceutical medicine
                adverse drug reaction,italy,ketoprofen,safety,pharmacovigilance

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