Abstract

Background Monitoring adverse drug reactions (ADRs) through pharmacovigilance are vital to patient safety. Spontaneous ADR reporting is one method of pharmacovigilance, and in Canada all reporter types admitted to report an ADR to the Canadian Vigilance Program at Health Canada. Reports are submitted to Health Canada by post, telephone, or via the internet. The Canada Vigilance Program electronically records submitted information to detect medication safety alerts. Although previous studies have shown differences between patients and healthcare professionals (HCPs) on the types of drugs and reactions reported, relatively little is known about the importance of patient reports to pharmacovigilance activities. This article proposed a multi-method approach to evaluate the importance of patient ADR reporting on pharmacovigilance activities, by systematically review the available literature, comparing patient—versus HCPs-generated ADR reports that were submitted to the Canada Vigilance Program, and exploring patient views and experiences regarding the Canadian ADR reporting system. MethodsGuided by a risk-perception theoretical lens, the proposed multi-methods research study will involve three phases. Phase I is a systematic review of all studies that analyse the factors influence ADR reporting by patients to the pharmacovigilance schemes. Phase II is a descriptive statistical analysis of all ADR reports received by the Canada Vigilance Program database between 1 January 2000 and 31 December 2014 from patients and HCPs to compare ADRs reported by patients with those reported by HCP reports in terms of ADR seriousness, ADR classification by system organ class, and the medication involved based on the anatomical therapeutic class system. In phase III, an interpretative descriptive approach will be used to explore patient’s views and experiences on ADR reporting and usability of the Canadian Vigilance ADR report. Participants will be purposefully selected to ensure diverse backgrounds and experiences. Interviews will be digitally-recorded, transcribed verbatim, and inductively analysed to identify themes. Patients will be interviewed until theoretical saturation is achieved. DiscussionFindings from this research will highlight the role of the patients in directly reporting ADRs, and provide information that may guide streamline and optimizing patient ADR reporting. Policy makers, public health officials, and regulatory agencies will require this critical information in order to improve medication safety in Canada and worldwide.

Highlights

  • Monitoring adverse drug reactions (ADRs) through pharmacovigilance are vital to patient safety

  • Understanding how patients are involved in ADR reporting can provide new insights into the importance and limitations of integrating patient-generated ADR reports into pharmacovigilance approaches which might help in improving medication use safety in Canada

  • This study aimed to provide new insights into the importance of patients ADR reporting

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Summary

Methods

Study design An observational—retrospective cross-sectional study design will be used. The Canadian Vigilance database ADR search criteria include either the trade names or generic name of medications reported to cause ADRs. it will be necessary to manually translate the trade names and generic names in the pharmacological/therapeutic subgroup of ATC level 1 to present the ADR data in a comprehensive format (Aagaard et al 2009). In case the null hypothesis is rejected and to ensure that any reporting differences between patients and HCPs will be significant and not due to chance, the data will be analysed using the Chi-squared test for independence This test is used to determine whether the frequency of each group is different from what would be expected. The semi-structured interview guide was developed based on key sensitizing concepts from the literature on ADR reporting and with review by experts in pharmacy, knowledge translation to patients, and health policy. The third criterion of assessment is transferability of the data by presenting enough details on the finding that will allow others in the discipline to determine the relevance of the study finding for their own practice, research, and theory development

Discussion
Background
Study Design Population
Strengths and limitations
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