Pharmacovigilance, a blind spot in future prescribers: Is real-life clinical pharmacovigilance education a solution?

Current situation Conclusions: While pharmacovigilance and ADR reporting are considered relevant for future healthcare professionals, healthcare students currently lack appropriate pharmacovigilance knowledge and skills for these tasks. This is probably because they have had inadequate and or insufficient pharmacovigilance education during their training. Although only a few high-quality educational interventions have been described, the competencies learned with these educational interventions appear to fade quickly. Active learning techniques, such as enriched pharmacovigilance education or providing students with responsibility for an authentic and clinical task, could be a more effective way of teaching and increasing the pharmacovigilance competence of healthcare students. Recommendations: In order to improve the pharmacovigilance and ADR reporting competencies of future healthcare professionals, pharmacovigilance education should be developed using active learning techniques, such as a maximally enriched (pharmacovigilance) educational context, and evaluated. Real-life clinical practice Conclusions: Real-life pharmacovigilance education seems more effective than traditional education and has a positive influence on pharmacovigilance in clinical care. Healthcare students who had reported or assessed ADRs themselves had a more favourable attitude to ADR reporting and had more and longer-lasting pharmacovigilance skills and knowledge. By participating in this learning opportunity, they also contributed to pharmacovigilance in individual patient care and thereby increased medication safety. Recommendations: Incorporating real-life pharmacovigilance educational interventions in bachelor degrees and replacing aspects of current clerkships/internships should be seriously considered. Moreover, these interventions should involve students from different healthcare disciplines working in an interprofessional team. Real-life interprofessional practice Conclusions: Interprofessional healthcare teams, learning from and with each other, can contribute to pharmacovigilance in clinical practice by detecting and managing ADRs in real patients. In addition, students have their first opportunity to work in an interprofessional manner and thereby gain insight into the perspectives and qualities of their future colleagues. Recommendations: Although the value of interprofessional education is increasingly appreciated, curricula should try to ensure that students work on clinically relevant, real-life (pharmacovigilance) care. Future intervention studies should further unravel the learning benefits of real-life interprofessional education

Pharmacovigilance, a blind spot in future prescribers: Is real-life clinical pharmacovigilance education a solution?

Current situation Conclusions: While pharmacovigilance and ADR reporting are considered relevant for future healthcare professionals, healthcare students currently lack appropriate pharmacovigilance knowledge and skills for these tasks. This is probably because they have had inadequate and or insufficient pharmacovigilance education during their training. Although only a few high-quality educational interventions have been described, the competencies learned with these educational interventions appear to fade quickly. Active learning techniques, such as enriched pharmacovigilance education or providing students with responsibility for an authentic and clinical task, could be a more effective way of teaching and increasing the pharmacovigilance competence of healthcare students. Recommendations: In order to improve the pharmacovigilance and ADR reporting competencies of future healthcare professionals, pharmacovigilance education should be developed using active learning techniques, such as a maximally enriched (pharmacovigilance) educational context, and evaluated. Real-life clinical practice Conclusions: Real-life pharmacovigilance education seems more effective than traditional education and has a positive influence on pharmacovigilance in clinical care. Healthcare students who had reported or assessed ADRs themselves had a more favourable attitude to ADR reporting and had more and longer-lasting pharmacovigilance skills and knowledge. By participating in this learning opportunity, they also contributed to pharmacovigilance in individual patient care and thereby increased medication safety. Recommendations: Incorporating real-life pharmacovigilance educational interventions in bachelor degrees and replacing aspects of current clerkships/internships should be seriously considered. Moreover, these interventions should involve students from different healthcare disciplines working in an interprofessional team. Real-life interprofessional practice Conclusions: Interprofessional healthcare teams, learning from and with each other, can contribute to pharmacovigilance in clinical practice by detecting and managing ADRs in real patients. In addition, students have their first opportunity to work in an interprofessional manner and thereby gain insight into the perspectives and qualities of their future colleagues. Recommendations: Although the value of interprofessional education is increasingly appreciated, curricula should try to ensure that students work on clinically relevant, real-life (pharmacovigilance) care. Future intervention studies should further unravel the learning benefits of real-life interprofessional education

Factors influencing in-hospital prescribing errors: A systematic review

Aim: In-hospital prescribing errors (PEs) may result in patient harm, prolonged hospitalization and hospital (re)admission. These events are associated with pressure on healthcare services and significant healthcare costs. To develop targeted interventions to prevent or reduce in-hospital PEs, identification and understanding of facilitating and protective factors influencing in-hospital PEs in current daily practice is necessary, adopting a Safety-II perspective. The aim of this systematic review was to create an overview of all factors reported in the literature, both protective and facilitating, as influencing in-hospital PEs. Methods: PubMed, EMBASE.com and the Cochrane Library (via Wiley) were searched, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement, for studies that identified factors influencing in-hospital PEs. Both qualitative and quantitative study designs were included. Results: Overall, 19 articles (6 qualitative and 13 quantitative studies) were included and 40 unique factors influencing in-hospital PEs were identified. These factors were categorized into five domains according to the Eindhoven classification (‘organization-related’, ‘prescriber-related’, ‘prescription-related’, ‘technology-related’ and ‘unclassified’) and visualized in an Ishikawa (Fishbone) diagram. Most of the identified factors (87.5%; n = 40) facilitated in-hospital PEs. The most frequently identified facilitating factor (39.6%; n = 19) was ‘insufficient (drug) knowledge, prescribing skills and/or experience of prescribers’. Conclusion: The findings of this review could be used to identify points of engagement for future intervention studies and help hospitals determine how to optimize prescribing. A multifaceted intervention, targeting multiple factors might help to circumvent the complex challenge of in-hospital PEs

Factors influencing in-hospital prescribing errors: A systematic review

Aim: In-hospital prescribing errors (PEs) may result in patient harm, prolonged hospitalization and hospital (re)admission. These events are associated with pressure on healthcare services and significant healthcare costs. To develop targeted interventions to prevent or reduce in-hospital PEs, identification and understanding of facilitating and protective factors influencing in-hospital PEs in current daily practice is necessary, adopting a Safety-II perspective. The aim of this systematic review was to create an overview of all factors reported in the literature, both protective and facilitating, as influencing in-hospital PEs. Methods: PubMed, EMBASE.com and the Cochrane Library (via Wiley) were searched, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement, for studies that identified factors influencing in-hospital PEs. Both qualitative and quantitative study designs were included. Results: Overall, 19 articles (6 qualitative and 13 quantitative studies) were included and 40 unique factors influencing in-hospital PEs were identified. These factors were categorized into five domains according to the Eindhoven classification (‘organization-related’, ‘prescriber-related’, ‘prescription-related’, ‘technology-related’ and ‘unclassified’) and visualized in an Ishikawa (Fishbone) diagram. Most of the identified factors (87.5%; n = 40) facilitated in-hospital PEs. The most frequently identified facilitating factor (39.6%; n = 19) was ‘insufficient (drug) knowledge, prescribing skills and/or experience of prescribers’. Conclusion: The findings of this review could be used to identify points of engagement for future intervention studies and help hospitals determine how to optimize prescribing. A multifaceted intervention, targeting multiple factors might help to circumvent the complex challenge of in-hospital PEs

Feasibility and Educational Value of a Student-Run Pharmacovigilance Programme: A Prospective Cohort Study

INTRODUCTION: Pharmacovigilance, the monitoring of drug safety after marketing approval, highly depends on the adequate reporting of adverse drug reactions (ADRs). To improve pharmacovigilance awareness and future ADR reporting among medical students, we developed and evaluated a student-run pharmacovigilance programme. METHODS: In this project, teams of medical students (first- to fifth-year) assessed real ADR reports, as submitted to the national pharmacovigilance centre. After assessment of causality, including identification of a potential pharmacological explanation for the ADR, the students wrote a personalized feedback letter to the reporter, as well as a summary for the European Medicines Agency (EMA) and World Health Organization (WHO) pharmacovigilance databases. This student assessment was then verified and evaluated by staff from The Netherlands Pharmacovigilance Centre Lareb (Lareb), using an e-questionnaire. Student attitudes, intentions, skills, and knowledge of ADR reporting were evaluated using the e-questionnaire, before and after participation in the programme. RESULTS: From May 2014 to January 2015, a total of 43 students assessed 100 different ADR reports selected by Lareb staff (n = 3). Student assessments were rated as useful (93%), scientifically substantiated (90%), accurate (92%), and complete (92%), and, on average, did not cost Lareb staff extra time. Medical students were positive about ADR reporting, and their awareness of ADR reporting increased significantly following participation in the programme (p < 0.05). After participation in the programme, the students intended to report serious ADRs in their future practice, and their knowledge of pharmacovigilance and ADR reporting showed they had a high overall level of pharmacological understanding. CONCLUSION: The student-run pharmacovigilance programme is a win-win venture. It offers students a valuable 'pharmacovigilance experience', creates awareness in future doctors, and has the potential to increase pharmacovigilance skills and knowledge