Introduction: Drug-induced adverse events have been accessible to patient's spontaneous reporting in France and such notifications have been steadily increasing since 2011. However, these notifications are still shrouded with medical perplexity and are sometimes subjected to partial caution in their interpretation by the patient's physician. We aimed to evaluate and compare prospectively the relevance of such spontaneous notifications with those provided by healthcare professionals to the French Pharmacovigilance Center of Nice-Alpes-Côte d'Azur.
Methods: Spontaneous reporting of drug adverse events notified by patients and health care professionals were compared in terms of critical (name, date, effect, drug involved, chronological compatibility) and non-critical (posology, dosage) information, whereas the plausibility of the cases were assessed in weekly multispecialty staffs. Each patient's notification was matched with the immediate pre- and post-notifications declared by health care providers.
Results: Spontaneous notifications from 61 patients were compared with 122 notifications from health care providers. Neither the critical information necessary for declaring the case in the national database (7/61 versus 16/122, P=0.75), nor the uncritical elements allowing to assess the case (30/61 versus 51/122, P=0.22), its plausibility or the causality of the drug (P=0.10) differed significantly between the two groups. 107 cases out of 122 (88%) notified by health care providers were classified as serious, as compared with 19 out of 61 (15%) of patient's ones (P<0.001).
Conclusion: Despite concerns from pharmacovigilance specialists in France, the medical relevance of spontaneous reported drug-associated adverse events does not differ from that of health care providers.
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http://dx.doi.org/10.1016/j.therap.2017.04.004 | DOI Listing |
J Law Med
November 2024
Consultant Respiratory Physician, East Melbourne.
Cough syncope is an uncommon but well-recognised medical condition diagnosed primarily on the history provided by the sufferer. In situations where the sufferer is in control of a motor vehicle, syncope can lead to accidents involving death and injury. In the medico-legal setting, cough syncope can be a contested cause of such accidents.
View Article and Find Full Text PDFJ Law Med
November 2024
School of Nursing and Midwifery, Western Sydney University.
This article examines whether the current termination laws of Australia and Aotearoa New Zealand align with the midwifery scope of practice. It begins with an introduction to termination of pregnancy from a health care perspective. An overview of previous and current legal frameworks in Australia and Aotearoa New Zealand that impact upon the provision of termination of pregnancy health services is provided.
View Article and Find Full Text PDFJ Law Med
November 2024
Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
The framing of patients making decisions about their medical treatment and care as traditional legal decisions, thresholds and formalities is a means to avoid legal liabilities through a rationalisation of decision-making, autonomy and choice. A credible account for the actual place of patients posits the sovereign power (founded in the works of Carl Schmitt and Giorgio Agamben) of the health care professional deciding the state of exception - a discrete legal space where the authority of health care professionals is both lawful and beyond the law. This reveals that dealing with broadly conceived consent issues with more law, more process and procedure but without addressing the inherent legality assumptions that empower health care professionals will always be flawed.
View Article and Find Full Text PDFMed J Aust
January 2025
Juno Healthcare, Melbourne, VIC.
Perspect Sex Reprod Health
January 2025
Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, California, USA.
Objective: We explored awareness of and attitudes about the safety of various methods people use to attempt to end a pregnancy without medical assistance, which we refer to in this study collectively as self-managed abortion (SMA).
Methods: In 2020, we invited individuals living in eight United States (US) states considered "hostile" to abortion rights or with a history of criminalizing abortions performed outside the formal healthcare system to participate in semi-structured telephone interviews regarding their attitudes toward these practices. We analyzed coded transcripts for content and themes.
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