title: Active pharmacovigilance and healthcare utilization.
abstract: While active surveillance for adverse drug events using electronic medical records (EMRs) and claims data is expanding, these data do not fully capture patient experiences with medication-related symptoms. Our objective was to describe adherence and outcomes associated with an automated pharmacovigilance call.
  
  
  
  Prospective cohort of patients receiving a prescription for a target medication at a participating primary care clinic were eligible for an automated phone pharmacovigilance call. Outcomes, compared for participants who completed (n = 1184) versus did not complete the call (n = 407), included EMR documentation during the 6 months following the call that the patient had: stopped the medication, used acute care services or died, or received a specialty or primary care visit.
  
  
  
  Compared with those who agreed to participate but did not complete the pharmacovigilance call, subjects who completed the call had greater rates of EMR-documented medication cessation (3.9% vs 1.0%, adjusted P value = .007), and use of primary or specialty care (32.8% vs 18.7%, P value <.0001), but similar use of acute care services or death (12.2% vs 9.8%, P = .38). Of participants, 50.2% reported >1 symptom; of these, 22.0% thought the symptom was medication-related. In contrast to the low rates of EMR-documented medication cessation, 21.2% of participants said that they were no longer taking the medication; 69% said that their doctor did not know that they had stopped.
  
  
  
  Automated phone pharmacovigilance provides important information about adherence, and was associated with greater EMR-documented medication cessation and planned service use.
authors.affiliation: Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA 02120, USA. jhaas@partners.org
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Haas
authors.forename: Elissa
authors.initials: E
authors.lastname: Klinger
authors.forename: Lucas Xavier
authors.initials: LX
authors.lastname: Marinacci
authors.forename: Phyllis
authors.initials: P
authors.lastname: Brawarsky
authors.forename: E John
authors.initials: EJ
authors.lastname: Orav
authors.forename: Gordon D
authors.initials: GD
authors.lastname: Schiff
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
mesh_terms: D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D060735:Pharmacovigilance; D011446:Prospective Studies; D013689:Telephone