Disproportionality Analysis and Characterisation of Medication Errors in EudraVigilance: Exploring Findings on Sexes and Age Groups.

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Tác giả: Marcel de Wilde, Jan A Kors, Victor Pera, Peter R Rijnbeek, Erik M van Mulligen, Katia M C Verhamme

Ngôn ngữ: eng

Ký hiệu phân loại: 343.081 Retail and wholesale trade, interstate commerce

Thông tin xuất bản: New Zealand : Drug safety , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 735717

 BACKGROUND: While medication errors (MEs) have been studied in the European Medicines Agency's EudraVigilance, extensive characterisation and signal detection based on sexes and age groups have not been attempted. OBJECTIVES: The aim of this study was to characterise all ME-related individual case safety reports in EudraVigilance and explore notable signals of disproportionate reporting (SDRs) among sexes and age groups for the 30 most frequently reported drugs. METHODS: Individual case safety reports were used from EudraVigilance reported between 2002 and 2021. An ME was defined as any Preferred Term from the narrow Standardised Medical Dictionary for Regulatory Activities RESULTS: Of the 9,662,345 EudraVigilance reports, 267,262 (2.8%) contained at least one ME, with a total of 300,324 MEs, for 429,554 drugs. The most reported ME was "Inappropriate schedule of product administration" (52,646
  17.5%), followed by "Incorrect dose administered" (32,379
  10.8%) and "Wrong technique in product usage process" (26,831
  8.9%). Individual case safety reports with MEs were most frequently related to female individuals (148,009
  55.4%), most often submitted by healthcare professionals (155,711
  58.3%), originated predominantly from the USA (98,716
  36.9%), followed by France (26,678
  10.0%), and showed a median reported age of 50 years (interquartile range: 26-68). Most ME individual case safety reports (158,991
  59.5%) were associated with a serious health outcome. A total of 847 SDRs were identified, based on the entire EudraVigilance database
  for subgroups, the number of SDRs ranged from 84 for the age group 0-1 month to 749 for female individuals. Signals of disproportionate reporting for female individuals and male individuals were very similar. Most MEs were reported for the vaccine against human papillomavirus (Anatomical Therapeutic Chemical [ATC]: J07BM01
  11,086 MEs, 57% being "inappropriate schedule of product administration"), with reporting odds ratios that range from 1.5 to 47.0 among age groups. The SDR for the live-attenuated vaccine against herpes zoster (ATC: J07BK02) had a reporting odds ratio that ranged from 26.6 to 78.1 among all subgroups. Signals of disproportionate reporting for oxycodone (ATC: N02AA05
  847 cases of "Accidental overdose", 35%), risperidone (ATC: N05AX08
  469 cases "Inappropriate schedule of product administration", 22.3%) and rivaroxaban (ATC: B01AF01
  1,377 cases of "Incorrect dose administered", 34.6%) stood out with higher magnitude SDRs for the age group 2 months to 2 years, with an reporting odds ratio range between 8.2 and 10.7, while for the entire EudraVigilance the reporting odds ratio ranged between 1.3 and 1.6 for the same drugs. CONCLUSIONS: This exploratory research provides an overview of characterised ME individual case safety reports and SDRs from the EudraVigilance database. Most conspicuous SDRs were identified in specific age groups. Signals of disproportionate reporting, not described in the literature, were found for vaccines, oxycodone, rivaroxaban and risperidone, and may prompt further examination by stakeholders. Top-reported MEs ("Inappropriate schedule of product administration", "Incorrect dose administered" and "Wrong technique in product usage process") emerged as a general priority focus to perform a further root-cause analysis involving healthcare providers, manufacturers and regulatory bodies, to improve the understanding and prevention of MEs.
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