title: Strategies to improve adverse drug reaction reporting: a critical and systematic review.
abstract: BACKGROUND
  Underreporting is the major limitation of a voluntary adverse drug reaction (ADR) reporting system. Many studies have assessed the effectiveness of different interventions designed to reduce underreporting.
  
  
  OBJECTIVE
  We aimed to conduct a critical review of papers that assessed the effectiveness of different strategies to increase ADR reporting, regardless of the health professionals or patients included.
  
  
  METHODS
  Scientific papers were selected after a search of the MEDLINE-PubMed and EMBASE scientific databases up to 7 December 2010.
  
  
  METHODS
  We included papers in English, French or Spanish that analysed an intervention aimed at increasing the number of reported ADRs, and quantify the results of the intervention in terms of number of reports.
  
  
  METHODS
  The abstracts retrieved in both computerized searches were reviewed independently by two of the authors. Initially selected papers were thoroughly read to evaluate if they met inclusion and exclusion criteria. Data in finally selected papers were independently extracted by both authors and set in pre-designed tables. A third author took the final decision in case of disagreement. For each study, we analysed study design, type of intervention, assessment period, and results of the intervention.
  
  
  RESULTS
  Of the 4,221 papers located that fulfilled the search criteria, 43 met the selection criteria. With the exception of one study, the interventions assessed were deemed to be effective. The vast majority of papers displayed methodological and formal limitations that lowered the grade of evidence. Multiple interventions seem to have had more impact than did single interventions. There were very few cases in which interventions were designed on the basis of inappropriate attitudes and mistaken beliefs about ADRs.
  
  
  CONCLUSIONS
  In general, there is a need for studies of better methodological quality in this topic, so that more evidence of the effectiveness of the respective strategies can be collected for the purpose of improving ADR reporting by health professionals. It is probable that multiple interventions cause greater increases in the ADR reporting rates than single.
authors: Dto. de Medicina Preventiva y Salud Pública, Facultad de Medicina, University of Santiago de Compostela, c/ San Francisco s/n, 15786 Santiago de Compostela-A Coruña, Spain.
authors: Cristian
authors: C
authors: Gonzalez-Gonzalez
authors: Elena
authors: E
authors: Lopez-Gonzalez
authors: Maria T
authors: MT
authors: Herdeiro
authors: Adolfo
authors: A
authors: Figueiras
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems / Q000592:standards* / Q000639:trends; D001291:Attitude of Health Personnel; D003627:Data Interpretation, Statistical; D006801:Humans
references: Clin Epidemiol. 2009 Aug 09;1:75-92
references: 20865089
references: Eur J Clin Pharmacol. 2010 Sep;66(9):937-45
references: 20552176
references: Eur J Clin Pharmacol. 2007 May;63(5):505-8
references: 17347804
references: Drug Saf. 2009;32(1):19-31
references: 19132802
references: JAMA. 2006 Sep 6;296(9):1086-93
references: 16954488
references: Cochrane Database Syst Rev. 2009 Apr 15;(2):CD003030
references: 19370580
references: JAMA. 2001 Apr 18;285(15):1987-91
references: 11308435
references: Eur J Clin Pharmacol. 2009 May;65(5):511-4
references: 19127360
references: Jt Comm J Qual Improv. 1996 Apr;22(4):259-63
references: 8743062
references: Hosp Formul. 1995 Apr;30(4):226-8, 231-2
references: 10141866
references: Am J Hosp Pharm. 1994 Feb 1;51(3):358-63
references: 8160688
references: Hosp Pharm. 1995 May;30(5):384-5, 389-91, 394-6
references: 10142377
references: Ther Umsch. 2000 Sep;57(9):584-90
references: 11036440
references: Ann Pharmacother. 2002 Feb;36(2):231-5
references: 11847939
references: BMJ. 1990 Jan 6;300(6716):22-3
references: 2105117
references: J Eval Clin Pract. 2001 May;7(2):223-41
references: 11489046
references: Ann Pharmacother. 2008 Oct;42(10):1491-6
references: 18780808
references: BMC Res Notes. 2011 Jun 22;4:212
references: 21696585
references: Hosp Formul. 1986 Nov;21(11):1140-3, 1146
references: 10279322
references: Br J Clin Pharmacol. 2005 Aug;60(2):221-3
references: 16042677
references: Conn Med. 2004 May;68(5):281-4
references: 15171264
references: Med Interface. 1996 May;9(5):85-7
references: 10157690
references: Am J Health Syst Pharm. 2004 Jun 15;61(12):1230, 1232-3
references: 15259751
references: Drug Saf. 2010 May 1;33(5):409-16
references: 20397740
references: Pharmacoepidemiol Drug Saf. 2007 Apr;16(4):429-34
references: 16953518
references: Lancet. 1984 Nov 10;2(8411):1098
references: 6150168
references: Cent Afr J Med. 1998 Aug;44(8):190-5
references: 10101417
references: Qual Saf Health Care. 2003 Jun;12(3):215-20
references: 12792013
references: QRB Qual Rev Bull. 1990 Apr;16(4):149-55
references: 2113667
references: Pharm World Sci. 1999 Jun;21(3):110-5
references: 10427579
references: Drug Saf. 2006;29(5):385-96
references: 16689555
references: Am J Hosp Pharm. 1983 Mar;40(3):444-5
references: 6846353
references: JAMA. 1990 Apr 4;263(13):1785-8
references: 2313850
references: Am J Hosp Pharm. 1986 Sep;43(9):2202-5
references: 3766573
references: Drug Saf. 2009;32(12):1135-40
references: 19916580
references: Am J Health Syst Pharm. 2002 May 1;59(9):841-5
references: 12004462
references: Clin Pharmacol Ther. 1970 Nov-Dec;11(6):802-7
references: 5481567
references: Formulary. 1995 Aug;30(8):471-3
references: 10151735
references: Am J Hosp Pharm. 1989 Nov;46(11):2300-3
references: 2589347
references: Malar J. 2010 Jul 14;9:205
references: 20630066
references: Pharmacoepidemiol Drug Saf. 2003 Mar;12(2):97-101
references: 12642973
references: Hosp Pharm. 1994 Mar;29(3):244-6, 249-50
references: 10171808
references: Lancet. 2002 Nov 9;360(9344):1435
references: 12433504
references: Drug Saf. 2003;26(14):1049-55
references: 14583065
references: BMC Clin Pharmacol. 2007 Jul 28;7:8
references: 17662147
references: Arch Dis Child. 2001 Apr;84(4):337-9
references: 11259235
references: Pharmacoepidemiol Drug Saf. 2004 Jul;13(7):457-64
references: 15269929
references: Drug Saf. 2009;32(1):77-83
references: 19132807
references: Hosp Formul. 1988 Aug;23(8):658-61
references: 10288394
references: Drug Saf. 2008;31(4):335-44
references: 18366244
references: Hosp Formul. 1986 Sep;21(9):949-52
references: 10289704
references: Am J Hosp Pharm. 1990 Jun;47(6):1327-33
references: 2368726
references: Am J Hosp Pharm. 1990 Jun;47(6):1334-9
references: 2368727
references: Pharmacoepidemiol Drug Saf. 2002 Dec;11(8):647-50
references: 12512239
references: BMC Public Health. 2009 Jul 31;9:274
references: 19643033
references: JAMA. 1998 Apr 15;279(15):1200-5
references: 9555760
references: Br J Clin Pharmacol. 1989 Jul;28(1):113-6
references: 2775609
references: J Nurses Staff Dev. 2010 Sep-Oct;26(5):215-9
references: 20885144
references: Am J Health Syst Pharm. 2008 Jun 15;65(12):1177-9
references: 18541689
references: J Gen Intern Med. 1996 Aug;11(8):454-60
references: 8872782
references: Am J Hosp Pharm. 1990 Jan;47(1):155-7
references: 2301425
references: Br J Clin Pharmacol. 1997 Jul;44(1):98-100
references: 9241104
references: Eur J Clin Pharmacol. 2006 May;62(5):381-5
references: 16572320
references: Pharmacoepidemiol Drug Saf. 2003 Mar;12(2):89-91
references: 12642971
references: Epidemiol Health. 2011;33:e2011005
references: 21716598
references: Am J Hosp Pharm. 1988 May;45(5):1086-9
references: 3400650
references: Formulary. 1995 Aug;30(8):454-61
references: 10151733
references: Cochrane Database Syst Rev. 2010 Mar 17;(3):CD005470
references: 20238340
references: Drug Saf. 2008;31(10):867-76
references: 18759510