Development of methodological approaches to the formation of a risk-based model to minimize the prevalence of adverse reactions in drug application in medical organizations of Moscow

Objective: development of approaches to predict the likelihood of adverse reactions (ARs) when using drugs based on a comprehensive assessment of risk factors.Material and methods. We used a database containing 1,450 drug-related ARs reports from January through December 2021. A list of antibacteria...

Full description

Saved in:
Bibliographic Details
Main Authors: E. V. Kuznetsova, M. V. Zhuravleva, I. A. Mikhailov, T. I. Kurnosova
Format: Article
Language:Russian
Published: IRBIS LLC 2023-07-01
Series:Фармакоэкономика
Subjects:
Online Access:https://www.pharmacoeconomics.ru/jour/article/view/829
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1839584333528039424
author E. V. Kuznetsova
M. V. Zhuravleva
I. A. Mikhailov
T. I. Kurnosova
author_facet E. V. Kuznetsova
M. V. Zhuravleva
I. A. Mikhailov
T. I. Kurnosova
author_sort E. V. Kuznetsova
collection DOAJ
description Objective: development of approaches to predict the likelihood of adverse reactions (ARs) when using drugs based on a comprehensive assessment of risk factors.Material and methods. We used a database containing 1,450 drug-related ARs reports from January through December 2021. A list of antibacterial drugs by international nonproprietary name (INN) with 4 or more ARs reports was selected as a reference group to perform various types of statistical analysis. A cumulative multivariate regression analysis was carried out on a database of 187 ARs notifications for 13 INN of antibacterial drugs. The study was performed in two stages. In the first stage, a statistical method was used (classical multiple regression, linear discriminant analysis, factor analysis, principal component regression, partial least squares regression, estimation of variance accuracy); at the second stage a modeling method was used. As part of the modeling stage, the integral score of the risk of ARs was presented as a sum of values for individual risk factors. Two groups of risks were proposed to be assessed: 1) intrinsic risk value for each factor (attribute), which was equal to the sum of risks of all factors (conditions) in which the drug had been used; 2) intrinsic risk value for antibacterial drugs by each INN. The total risk value was defined as the sum of the risk of the drug and all factors (conditions) in which this drug had been used.Results. The results were visualized in the form of a two-level risk-based model matrix, with a “heat map” of the risk level overlaid on it. The maximum total risk of ARs was obtained for ceftriaxone – 404.96 points, depending on patient’s gender. The minimum total risk was calculated for azithromycin and cefotaxime depending on the International Classification of Diseases (10th revision) code – 88.46 points. The proposed methodological approach also allows combining all possible combinations of drugs and conditions of their use. For example, for the use of vancomycin in hospital conditions by intravenous administration: intrinsic risk of use – 42.93 points; risk of use in hospital conditions – 183.68 points; risk when administered intravenously – 209.95 points; the total risk value in the designated situation – 436.56 points.Conclusion. The proposed approach can allow medical organizations to reduce significantly the number of ARs when using drugs by categorizing and preventing risks before they occur. It also has significant prospects of application at the federal level, given its modification on a large volume of data.
format Article
id doaj-art-91004ac63b1a4d41a34dca4b8f41a3f6
institution Matheson Library
issn 2070-4909
2070-4933
language Russian
publishDate 2023-07-01
publisher IRBIS LLC
record_format Article
series Фармакоэкономика
spelling doaj-art-91004ac63b1a4d41a34dca4b8f41a3f62025-08-03T19:49:36ZrusIRBIS LLCФармакоэкономика2070-49092070-49332023-07-0116224825710.17749/2070-4909/farmakoekonomika.2023.184436Development of methodological approaches to the formation of a risk-based model to minimize the prevalence of adverse reactions in drug application in medical organizations of MoscowE. V. Kuznetsova0M. V. Zhuravleva1I. A. Mikhailov2T. I. Kurnosova3Research Institute for Healthcare Organization and Medical ManagementSechenov University; Scientific Center for Expert Evaluation of Medicinal ProductsCenter for Healthcare Quality Assessment and Control; Russian Medical Academy of Continuing Professional Education; Semashko National Research Institute of Public HealthCenter for Healthcare Quality Assessment and ControlObjective: development of approaches to predict the likelihood of adverse reactions (ARs) when using drugs based on a comprehensive assessment of risk factors.Material and methods. We used a database containing 1,450 drug-related ARs reports from January through December 2021. A list of antibacterial drugs by international nonproprietary name (INN) with 4 or more ARs reports was selected as a reference group to perform various types of statistical analysis. A cumulative multivariate regression analysis was carried out on a database of 187 ARs notifications for 13 INN of antibacterial drugs. The study was performed in two stages. In the first stage, a statistical method was used (classical multiple regression, linear discriminant analysis, factor analysis, principal component regression, partial least squares regression, estimation of variance accuracy); at the second stage a modeling method was used. As part of the modeling stage, the integral score of the risk of ARs was presented as a sum of values for individual risk factors. Two groups of risks were proposed to be assessed: 1) intrinsic risk value for each factor (attribute), which was equal to the sum of risks of all factors (conditions) in which the drug had been used; 2) intrinsic risk value for antibacterial drugs by each INN. The total risk value was defined as the sum of the risk of the drug and all factors (conditions) in which this drug had been used.Results. The results were visualized in the form of a two-level risk-based model matrix, with a “heat map” of the risk level overlaid on it. The maximum total risk of ARs was obtained for ceftriaxone – 404.96 points, depending on patient’s gender. The minimum total risk was calculated for azithromycin and cefotaxime depending on the International Classification of Diseases (10th revision) code – 88.46 points. The proposed methodological approach also allows combining all possible combinations of drugs and conditions of their use. For example, for the use of vancomycin in hospital conditions by intravenous administration: intrinsic risk of use – 42.93 points; risk of use in hospital conditions – 183.68 points; risk when administered intravenously – 209.95 points; the total risk value in the designated situation – 436.56 points.Conclusion. The proposed approach can allow medical organizations to reduce significantly the number of ARs when using drugs by categorizing and preventing risks before they occur. It also has significant prospects of application at the federal level, given its modification on a large volume of data.https://www.pharmacoeconomics.ru/jour/article/view/829adverse reactionsdrug usepharmacovigilancerisk-based approachmultifactorial models
spellingShingle E. V. Kuznetsova
M. V. Zhuravleva
I. A. Mikhailov
T. I. Kurnosova
Development of methodological approaches to the formation of a risk-based model to minimize the prevalence of adverse reactions in drug application in medical organizations of Moscow
Фармакоэкономика
adverse reactions
drug use
pharmacovigilance
risk-based approach
multifactorial models
title Development of methodological approaches to the formation of a risk-based model to minimize the prevalence of adverse reactions in drug application in medical organizations of Moscow
title_full Development of methodological approaches to the formation of a risk-based model to minimize the prevalence of adverse reactions in drug application in medical organizations of Moscow
title_fullStr Development of methodological approaches to the formation of a risk-based model to minimize the prevalence of adverse reactions in drug application in medical organizations of Moscow
title_full_unstemmed Development of methodological approaches to the formation of a risk-based model to minimize the prevalence of adverse reactions in drug application in medical organizations of Moscow
title_short Development of methodological approaches to the formation of a risk-based model to minimize the prevalence of adverse reactions in drug application in medical organizations of Moscow
title_sort development of methodological approaches to the formation of a risk based model to minimize the prevalence of adverse reactions in drug application in medical organizations of moscow
topic adverse reactions
drug use
pharmacovigilance
risk-based approach
multifactorial models
url https://www.pharmacoeconomics.ru/jour/article/view/829
work_keys_str_mv AT evkuznetsova developmentofmethodologicalapproachestotheformationofariskbasedmodeltominimizetheprevalenceofadversereactionsindrugapplicationinmedicalorganizationsofmoscow
AT mvzhuravleva developmentofmethodologicalapproachestotheformationofariskbasedmodeltominimizetheprevalenceofadversereactionsindrugapplicationinmedicalorganizationsofmoscow
AT iamikhailov developmentofmethodologicalapproachestotheformationofariskbasedmodeltominimizetheprevalenceofadversereactionsindrugapplicationinmedicalorganizationsofmoscow
AT tikurnosova developmentofmethodologicalapproachestotheformationofariskbasedmodeltominimizetheprevalenceofadversereactionsindrugapplicationinmedicalorganizationsofmoscow