Patient Safety and Quality

An automated phone response system can help track adverse drug events in primary care patients

Gathering information on adverse drug events (ADEs) or side effects from patients seen at primary care clinics could be assisted by use of an interactive voice response system (IVRS), according to a feasability study. The researchers confirmed that the IVRS can be used to contact patients to find out if they have suffered any ADEs or side effects from any of a targeted group of drugs, primarily used to treat chronic diseases, which were selected because of safety concerns or because they had been approved by the U.S. Food and Drug Administration within the past 7 years.

Some patients were more likely to participate in the IVRS study than others. The 902 patients with new prescriptions of 31 target drugs who participated in the study represented 43.3 percent of those who were contacted and 25.7 percent of potentially eligible patients with a working phone. Adjusting for demographic information and drug class, potentially eligible patients older than 66 years were 47 percent more likely to participate than those aged 56-65. Ethnicity and income level also influenced the likelihood of participation, with Hispanics 44 percent less likely to participate than non-Hispanic whites, and patients from low-income communities (median household income under $50,000/year) 31 percent less likely to participate than those from high-income communities (median more than $50,000/year).

Compared with patients prescribed drugs for insomnia, those successfully contacted who received drugs for erectile dysfunction or smoking cessation were 30-37 percent less likely to participate, while patients prescribed anti-seizure drugs were 65 percent more likely to participate. To conduct their study, the researchers sought the involvement of patients from 11 primary care clinics in and around Boston that used the same Web-based electronic health record. Patients were eligible if between 18 and 84 years old, had a visit with a primary care physician at one of the clinics, and received a prescription for one of 31 target medications. The study was funded in part by the Agency for Healthcare Research and Quality (HS16970).

More details are in "Participation in an ambulatory e-pharmacovigiliance system," Jennifer S. Haas, M.D., M.S.P.H., Aarthi Iyer, M.P.H., E. John Orav, Ph.D., and others in Pharmacoepidemiology and Drug Safety 19(9), pp. 961-969, 2010.

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