title: Spontaneous adverse drug reaction reporting by patients in Canada: a multi-method study-study protocol.
abstract: BACKGROUND
  Monitoring adverse drug reactions (ADRs) through pharmacovigilance are vital to patient safety. Spontaneous ADR reporting is one method of pharmacovigilance, and in Canada all reporter types admitted to report an ADR to the Canadian Vigilance Program at Health Canada. Reports are submitted to Health Canada by post, telephone, or via the internet. The Canada Vigilance Program electronically records submitted information to detect medication safety alerts. Although previous studies have shown differences between patients and healthcare professionals (HCPs) on the types of drugs and reactions reported, relatively little is known about the importance of patient reports to pharmacovigilance activities. This article proposed a multi-method approach to evaluate the importance of patient ADR reporting on pharmacovigilance activities, by systematically review the available literature, comparing patient-versus HCPs-generated ADR reports that were submitted to the Canada Vigilance Program, and exploring patient views and experiences regarding the Canadian ADR reporting system.
  
  
  METHODS
  Guided by a risk-perception theoretical lens, the proposed multi-methods research study will involve three phases. Phase I is a systematic review of all studies that analyse the factors influence ADR reporting by patients to the pharmacovigilance schemes. Phase II is a descriptive statistical analysis of all ADR reports received by the Canada Vigilance Program database between 1 January 2000 and 31 December 2014 from patients and HCPs to compare ADRs reported by patients with those reported by HCP reports in terms of ADR seriousness, ADR classification by system organ class, and the medication involved based on the anatomical therapeutic class system. In phase III, an interpretative descriptive approach will be used to explore patient's views and experiences on ADR reporting and usability of the Canadian Vigilance ADR report. Participants will be purposefully selected to ensure diverse backgrounds and experiences. Interviews will be digitally-recorded, transcribed verbatim, and inductively analysed to identify themes. Patients will be interviewed until theoretical saturation is achieved.
  
  
  CONCLUSIONS
  Findings from this research will highlight the role of the patients in directly reporting ADRs, and provide information that may guide streamline and optimizing patient ADR reporting. Policy makers, public health officials, and regulatory agencies will require this critical information in order to improve medication safety in Canada and worldwide.
authors.affiliation: Population Health Program, Faculty of Health Science, University of Ottawa, Ottawa, ON Canada.
authors.forename: Rania Al
authors.initials: RA
authors.lastname: Dweik
authors.affiliation: School of International Development and Global Studies, Faculty of Social Science, University of Ottawa, Ottawa, ON Canada.
authors.forename: Sanni
authors.initials: S
authors.lastname: Yaya
authors.affiliation: Ottawa Hospital Research Institute, School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON Canada.
authors.forename: Dawn
authors.initials: D
authors.lastname: Stacey
authors.affiliation: School of Epidemiology, Public Health, and Preventive Medicine, University of Ottawa, Ottawa, ON Canada.
authors.forename: Dafna
authors.initials: D
authors.lastname: Kohen
keywords: Adverse drug reactions (ADRS); Canada; Patient reporting; Pharmacovigilance