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Pediatric Pharmacovigilance: Enhancing Adverse Drug Reaction Reporting in a Tertiary Care Children’s Hospital

  • Special Section: Maternal and Child Health Therapeutics
  • Published:
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Abstract

Background

Adverse drug reactions (ADRs) are notoriously underreported within health care facilities. In 2009–2010, ADRs were detected in only 0.5% of patients at the authors’ institution, a pediatric hospital in the Midwestern United States. Additionally, historical ADRs were often inaccurately or incompletely documented in the medical record. An integrative Drug Safety Service (DSS) was implemented to improve the detection and accurate documentation of ADRs.

Methods

The DSS incorporated standardized ADR terminology, computerized triggers to identify ADRs, and a simplified voluntary reporting system within the facility. The DSS staff provided extensive hospital staff education on ADR reporting and the role of the DSS. The primary aim of this report was to assess the impact of the DSS on the number of ADRs reported at the authors’ institution. The secondary aims were to evaluate the mechanisms by which patients with ADRs were identified and to assess the accuracy of ADR documentation after implementation of the DSS.

Results

A significant increase was observed (slope, 6.01; P <.001) in ADR detection after implementation of the DSS, with a greater than 4-fold increase from 10 cases per 10,000 admissions before initiation to 41 cases per 10,000 admissions after DSS implementation. Computerized triggers, International Classification of Diseases, 9th Edition (ICD-9) codes associated with ADRs, and the DSS identified 33%, 33%, and 24% of ADRs, respectively, while voluntary reporting only detected 9% of ADRs.

Conclusions

Implementation of a multifaceted, interdisciplinary DSS was more effective in detecting ADRs than voluntary reporting alone. A proactive approach to ADR detection resulted in a significant increase in the identification and evaluation of ADRs.

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Authors and Affiliations

  1. Division of Clinical Pharmacology and Medical Toxicology, University of Missouri-Kansas City, Kansas City, MO, USA

    Jennifer L. Goldman MD, Amanda Sullins PharmD, BCPS, Tracy Sandritter PharmD, J. Steven Leeder PharmD, PhD & Jennifer Lowry MD

  2. Pediatric Infectious Diseases and Clinical Pharmacology, Children’s Mercy Hospitals & Clinics, University of Missouri-Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA

    Jennifer L. Goldman MD, Amanda Sullins PharmD, BCPS, Tracy Sandritter PharmD, J. Steven Leeder PharmD, PhD & Jennifer Lowry MD

Authors
  1. Jennifer L. Goldman MD
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  2. Amanda Sullins PharmD, BCPS
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  3. Tracy Sandritter PharmD
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  4. J. Steven Leeder PharmD, PhD
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  5. Jennifer Lowry MD
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Corresponding author

Correspondence to Jennifer L. Goldman MD.

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Goldman, J.L., Sullins, A., Sandritter, T. et al. Pediatric Pharmacovigilance: Enhancing Adverse Drug Reaction Reporting in a Tertiary Care Children’s Hospital. Ther Innov Regul Sci 47, 566–571 (2013). https://doi.org/10.1177/2168479013499153

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  • DOI: https://doi.org/10.1177/2168479013499153

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