Undesirable Effects Related to Oral Antineoplastic Drugs: Comparison Between Patients’ Internet Narratives and a National Pharmacovigilance Database

BackgroundThe Internet is changing the way people learn about health and illness. Over the previous decade, the oral antineoplastic (OAN) agents have changed patient management allowing more ambulatory care. In this regard, websites could be an interesting source of data about OAN-induced adverse events (AEs).ObjectiveThe aim of the study was to describe the characteristics of AEs, as reported on websites by patients exposed to OAN agents, and to compare these to those recorded in the French pharmacovigilance database (FPVD).MethodsWe performed a retrospective study to collect AEs reported by patients in five of the best-known website forums in France over 1 year (2011). For each report, we recorded demographic data, cancer type, drug involved and AEs. The same analysis was done in the FPVD for OAN-induced adverse drug reactions (ADRs).ResultsA total of 202 AEs were identified in website posts and 1,448 ADRs were found in the FPVD. The most cited drugs in websites were protein kinase inhibitors (n = 88, 43.5 %) and hormone antagonists (n = 61, 30.2 %). More musculoskeletal disorder reports were found in the patient websites compared with the FPVD (16.34 vs. 4.70 %, p < 0.001). As for skin disorders, we collected fewer reports in the patient website forums than in the FPVD (13.37 vs. 22.17 %, p = 0.004). AEs reported in the patient websites were less serious (n = 10, 4.95 %) than ADRs recorded in the FPVD (n = 999, 68.99 %) (p < 0.001).ConclusionsAEs reported in the website forums are considered by patients to be relevant enough to be shared. Data from patient websites could be used as a source of data to detect AEs alongside conventional pharmacovigilance.

[1]  J. Moncrieff,et al.  ACTA PSYCHIATRICA , 2006 .

[2]  L Pochard,et al.  Analysis of patients' narratives posted on social media websites on benfluorex's (Mediator®) withdrawal in France , 2014, Journal of clinical pharmacy and therapeutics.

[3]  J. Powell,et al.  Patient perspectives on health advice posted on Internet discussion boards: a qualitative study , 2009, Health expectations : an international journal of public participation in health care and health policy.

[4]  H. Putter,et al.  High non-compliance in the use of letrozole after 2.5 years of extended adjuvant endocrine therapy. Results from the IDEAL randomized trial. , 2012, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.

[5]  E. Brown,et al.  The Medical Dictionary for Regulatory Activities (MedDRA) , 1999, Drug safety.

[6]  Lyle H. Ungar,et al.  Identifying potential adverse effects using the web: A new approach to medical hypothesis generation , 2011, J. Biomed. Informatics.

[7]  N. Moore,et al.  [French pharmacovigilance database system: examples of utilisation]. , 1995, Therapie.

[8]  F. Romano,et al.  Active home-based cancer treatment , 2012, Journal of multidisciplinary healthcare.

[9]  S. Buetow,et al.  Distinguishing objective from subjective assessments of the severity of medication‐related safety events among people with Parkinson’s disease: a qualitative study , 2012, Journal of clinical pharmacy and therapeutics.

[10]  S. Schröder,et al.  Drug related problems with Antiparkinsonian agents: consumer Internet reports versus published data , 2007, Pharmacoepidemiology and drug safety.

[11]  Nehama Lewis,et al.  Internet use leads cancer patients to be active health care consumers. , 2010, Patient education and counseling.

[12]  Françoise Haramburu,et al.  Incidence of hospital admissions due to adverse drug reactions in France: the EMIR study , 2015, Fundamental & clinical pharmacology.

[13]  J. Krska,et al.  Patient reporting of potential adverse drug reactions: a methodological study. , 2002, British journal of clinical pharmacology.

[14]  I. Edwards,et al.  Adverse drug reactions: definitions, diagnosis, and management , 2000, The Lancet.

[15]  J. Frost,et al.  Sharing Health Data for Better Outcomes on PatientsLikeMe , 2010, Journal of medical Internet research.

[16]  L. Hazell,et al.  How Do Patients Contribute to Signal Detection? , 2013, Drug Safety.

[17]  M. Lapeyre-Mestre,et al.  Notifications d'effets indésirables par le personnel infirmier et comparaison avec celles des médecins , 1995 .

[18]  J. Montastruc,et al.  Spontaneous reporting of serious cutaneous reactions with protein kinase inhibitors , 2013, European Journal of Clinical Pharmacology.

[19]  Katrina Armstrong,et al.  Differences in information seeking among breast, prostate, and colorectal cancer patients: results from a population-based survey. , 2010, Patient education and counseling.

[20]  Adrian Benton,et al.  Online discussion of drug side effects and discontinuation among breast cancer survivors , 2013, Pharmacoepidemiology and drug safety.

[21]  P. Schultz,et al.  Internet message board use by patients with cancer and their families. , 2003, Clinical journal of oncology nursing.

[22]  A. Sommet,et al.  “Medicamentation” of society, non-diseases and non-medications: a point of view from social pharmacology , 2005, European Journal of Clinical Pharmacology.

[23]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[24]  M. Petrovic,et al.  Reporting adverse drug reactions on a geriatric ward: a pilot project , 2003, European Journal of Clinical Pharmacology.

[25]  M. Lacouture,et al.  Adverse cutaneous reactions secondary to tyrosine kinase inhibitors including imatinib mesylate, nilotinib, and dasatinib , 2011, Dermatologic therapy.

[26]  E. Winer,et al.  Aromatase inhibitors and arthralgias: a new frontier in symptom management for breast cancer survivors. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[27]  Richard B. Berlin,et al.  Predicting adverse drug events from personal health messages. , 2011, AMIA ... Annual Symposium proceedings. AMIA Symposium.

[28]  A. Blenkinsopp,et al.  Patient reporting of suspected adverse drug reactions: a review of published literature and international experience. , 2007, British journal of clinical pharmacology.

[29]  Shannon Hughes,et al.  Can Online Consumers Contribute to Drug Knowledge? A Mixed-Methods Comparison of Consumer-Generated and Professionally Controlled Psychotropic Medication Information on the Internet , 2011, Journal of medical Internet research.

[30]  N. Coulson,et al.  An investigation into the empowerment effects of using online support groups and how this affects health professional/patient communication. , 2011, Patient education and counseling.

[31]  J Jouglard,et al.  [Imputation of the unexpected or toxic effects of drugs. Actualization of the method used in France]. , 1985, Therapie.