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Open Access Research article

Using clinical trial data and linked administrative health data to reduce the risk of adverse events associated with the uptake of newly released drugs by older Australians: a model process

Margaret T Whitstock1*, Christopher M Pearce2, Stephen C Ridout3 and Elizabeth J Eckermann1

Author Affiliations

1 Department of Sociology, School of History, Heritage and Society, Deakin University, Pigdons Road, Geelong, Vic 3217, Australia

2 Faculty of Medicine, Nursing and Health Sciences, Monash University, Wellington Road, Clayton, Vic 3800, Australia; Melbourne East General Practice Network, 250 Mont Albert Road, Surrey Hills, Vic 3127, Australia

3 School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA 6009 Australia

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BMC Public Health 2011, 11:361  doi:10.1186/1471-2458-11-361

Published: 21 May 2011

Abstract

Background

The study was undertaken to evaluate the contribution of a process which uses clinical trial data plus linked de-identified administrative health data to forecast potential risk of adverse events associated with the use of newly released drugs by older Australian patients.

Methods

The study uses publicly available data from the clinical trials of a newly released drug to ascertain which patient age groups, gender, comorbidities and co-medications were excluded in the trials. It then uses linked de-identified hospital morbidity and medications dispensing data to investigate the comorbidities and co-medications of patients who suffer from the target morbidity of the new drug and who are the likely target population for the drug. The clinical trial information and the linked morbidity and medication data are compared to assess which patient groups could potentially be at risk of an adverse event associated with use of the new drug.

Results

Applying the model in a retrospective real-world scenario identified that the majority of the sample group of Australian patients aged 65 years and over with the target morbidity of the newly released COX-2-selective NSAID rofecoxib also suffered from a major morbidity excluded in the trials of that drug, indicating a substantial potential risk of adverse events amongst those patients. This risk was borne out in post-release morbidity and mortality associated with use of that drug.

Conclusions

Clinical trial data and linked administrative health data can together support a prospective assessment of patient groups who could be at risk of an adverse event if they are prescribed a newly released drug in the context of their age, gender, comorbidities and/or co-medications. Communication of this independent risk information to prescribers has the potential to reduce adverse events in the period after the release of the new drug, which is when the risk is greatest.

Note: The terms 'adverse drug reaction' and 'adverse drug event' have come to be used interchangeably in the current literature. For consistency, the authors have chosen to use the wider term 'adverse drug event' (ADE).