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Prospective identification and causality evaluation of suspected adverse drug reactions in neonates
Author(s) -
Roberts Eve K.,
Hawcutt Daniel B.,
Turner Mark A.
Publication year - 2021
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.14485
Subject(s) - medicine , observational study , causality (physics) , drug reaction , pharmacovigilance , prospective cohort study , pediatrics , drug , population , intensive care medicine , adverse effect , emergency medicine , pharmacology , environmental health , physics , quantum mechanics
Neonates experience adverse drug reactions (ADRs), but under‐reporting of suspected ADRs to national spontaneous reporting schemes in this population is particularly high. A prospective observational study collected suspected neonatal ADRs at a tertiary neonatal unit. Cases were analysed for causality by six assessors using three existing methods. Sixty‐three suspected ADR cases were identified in 35/193 neonates (18.1%). The proportion of suspected ADRs where the drug was prescribed “off‐label” was 30/68 (44.1%). When 34 cases were assessed for causality using three methods, global kappa scores of less than 0.3 for each tool suggested only “fair” inter‐rater reliability. Neonatal ADRs can be captured and occur from a variety of drugs affecting many organ systems. The current tools for assessing causality need to be adapted before they can reliably assess neonatal ADRs.