Learning Pharmacovigilance

LEARNING PHARMACOVIGILANCE

A principal educational challenge for contemporary pharmacovigilance is that of translating results of findings in a timely manner into the customary practice of clinically based health professionals. Additional to this challenge (but beyond the scope of this chapter) is the challenge of effective communication with the public.

Conventional methods of communication of phar-macovigilance knowledge have generally been restricted to letter writing, label wording and pack-age insert warnings. Unfortunately, there is now considerable evidence that these processes have very limited success in achieving the goal of an informed prescriber ready to apply pharmacovigi-lance intelligence in their everyday practice (Belton et al., 1995; Smalley et al., 2000). Similarly with the general public, largely ineffective communication has been observed using these conventional tools (Berry et al., 2002).

In many respects, these difficulties in communica-tion are paralleled by the well-recognized difficulty of translating evidence-based medicine into widespread clinical practice.

In this regard, a recent summary of 26 systematic reviews of the effects of continuing medical education on improving physician clinical care and patient health (Bloom, 2005) has concluded that Interactive tech-niques (audit-feedback, academic detailing/outreach, and reminders) are the most effective at simultane-ously changing physician care and patient outcomes. Clinical practice guidelines and opinion leaders are less effective. Didactic presentations and distributing printed information only have little or no beneficial effect in changing physician practice.

Interactive techniques and judicious use of reminders therefore need to constitute a new foundation for communication of the fruit of ongoing pharmacovigi-lance alongside more traditional methodologies. There are an increasing number of opportunities for achiev-ing more rapid and effective dissemination of practice-changing pharmacovigilance messages.