A clinician network for sharing patients experiences in pharmacovigilance: the PHARMACOWIKILANCE project

Introduction: ‘‘Medical wiki’’, including platforms or similar online resources, allows clinicians to add and edit medical information collectively [1]. After thalidomide tragedy, ‘‘experience sharing’’ become one the fundamental elements of Pharmacovigilance philosophy. In line with this, the application of a ‘‘wiki’’ model to Pharmacovigilance activities seems an appealing strategy to implement drug safety awareness among healthcare professionals. Aim: To develop and run a networking platform (Pharmacowikilance) for the monitoring of adverse drug reactions. Methods: The Pharmacowikilance platform has been developed to be a patient management tool that can be used in any Hospital ward or primary care. The platform was organized in the following sections: patient demographics, patient medical history, hospital or emergency department or primary care admissions depending on study settings, therapies, adverse drug events, drug–drug interactions and laboratory investigations. The platform use hierarchical-based strategy for online accessing to the information that preserve patient privacy and provide the possibility of sharing clinical experience among healthcare professionals participating to the network. Active monitoring of a drug, a group of drugs or a specific type of patients can be proposed by the coordinating centre or even the peripheral centres. Then a network of centres interested in this monitoring is created and the follow up starts. Patients data can be entered from already existing medical records (manually or automatically) or prospectively after the signature of an informed consent. The coordinating centre supports the identification and the reporting to the national health authority of any adverse drug reaction (ADR). Results: The Pharmacowikilance platform was released in 2015 and its use is ongoing. A total of 4 safety observational studies are carried out, 6 centres were included (1 Pisa, 1 Pistoia, 3 Firenze, 1 Siena) and 4.582 patients are recorded in the database on April 30st, 2017. These studies were performed in the following settings: oncology wards, geriatric wards, emergency departments and primary care. Over the study period, 468 suspected ADRs have been captured by the network. Discussion: Pharmacowikilance platform is a quick and easy tool for clinicians to manage patient care and to collect data for drug safety in observational studies. Conclusion: Pharmacowikilance platform allows quality data check and update in real time, it has improved the completeness of patients records. This platform has created a network of healthcare professionals that can easily share their experience upon request.