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. 2022 Jan;18(1):50-58.
doi: 10.1007/s12519-021-00478-1. Epub 2021 Nov 13.

Physicians' perspectives on adverse drug reactions in pediatric routine care: a survey

Martina P Neininger  1 , Sarah Jeschke  2 , Lisa M Kiesel  3 , Thilo Bertsche  3 , Astrid Bertsche  2
Affiliations

Physicians' perspectives on adverse drug reactions in pediatric routine care: a survey

Martina P Neininger et al. World J Pediatr. 2022 Jan.

Abstract

Background: Children and adolescents are at particular risk for adverse drug reactions (ADRs). We investigated physicians' perceptions on ADRs in pediatric routine care.

Methods: In this exploratory study from April to November 2020, we invited physicians treating pediatric patients across Germany to complete an online questionnaire consisting mainly of closed questions.

Results: Completion rate was 98% (127/129). Of all participants, 23% (29/127) stated they were not able to estimate how many of their pediatric patients experienced ADRs during drug therapy. The remaining physicians estimated that 7.5% (median; Q25/Q75 3%/20%) of their pediatric patients were affected by ADRs. Regarding counseling on ADRs, 61% (77/127) stated they do not ask regularly the extent to which parents want to be informed. In total, 26% (33/127) stated they avoid counseling on ADRs concerning commonly used approved therapies, whereas only 4% (5/127) did so concerning off-label use (P < 0.001). Altogether, 16% (20/127) stated they rather prescribe new medicines as they hope for better effectiveness; 72% (91/127) said they are cautious about doing so owing to yet unknown ADRs. Of all respondents, 46% (58/127) stated they do not report ADRs to the authorities. Concerning the black triangle symbol, a European pharmacovigilance measure, 11% (14/127) stated they knew it and 6% (7/127) stated they reported any suspected ADR for drugs with that symbol.

Conclusions: Physicians' perspectives on ADRs were ambivalent: ADRs influenced their parent counseling and drug prescribing; yet, they struggled to estimate the impact of ADRs on their patients and were not aware of specific pharmacovigilance measures.

Keywords: Adverse drug reactions; Pediatrics; Physicians; Routine care; Spontaneous reporting.

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Conflict of interest statement

A Bertsche reports grants from UCB Pharma GmbH and honoraria for speaking engagements from Biogen GmbH, Desitin Arzneimittel GmbH, Eisai GmbH, GW Pharma GmbH, Neuraxpharm GmbH, Shire/Takeda GmbH, UCB Pharma GmbH, and ViroPharma GmbH. The other authors declare they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Physicians’ most frequent measures when adverse drug reactions occur in pediatric patients (multiple answers possible). The score (S) was calculated from the physicians’ prioritization of the answers and frequency of each answer: S = 3n1 + 2n2 + n3; in this context, n1/2/3 indicates the number of nominations of the respective answer at position 1/2/3
Fig. 2
Fig. 2
Physicians’ level of agreement with given statements on drug prescription and parent counseling. ADR adverse drug reaction
See this image and copyright information in PMC

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