Introduction
National competent authorities (NCAs) use Direct Healthcare Professional Communications (DHPCs) to communicate new drug safety issues to healthcare professionals (HCPs). More knowledge ...is needed about the effectiveness of DHPCs and the extent to which they raise awareness of new safety issues among HCPs.
Objective
The objective was to assess and compare general practitioners’ (GPs’), cardiologists’, and pharmacists’ familiarity with DHPCs as communication tools, their awareness of specific drug safety issues, and the sources through which they had become aware of the specific issues.
Methods
GPs, cardiologists, and pharmacists from nine European countries (Croatia, Denmark, Ireland, Italy, the Netherlands, Norway, Spain, Sweden, and the UK) completed a web-based survey. The survey was conducted in the context of the Strengthening Collaboration for Operating Pharmacovigilance in Europe (SCOPE) Joint Action. Respondents were asked about their familiarity with DHPCs in general and their awareness of safety issues that had recently been communicated and involved the following drugs: combined hormonal contraceptives, diclofenac, valproate, and ivabradine. Those HCPs who were aware of the specific safety issues were subsequently asked to indicate the source through which they had become aware of them. Differences between professions in familiarity with DHPCs and awareness were tested using a Pearson
χ
2
test per country and post hoc Pearson
χ
2
tests in the case of statistically significant differences.
Results
Of the 3288 included respondents, 54% were GPs, 40% were pharmacists, and 7% were cardiologists. The number of respondents ranged from 67 in Denmark to 916 in Spain. Most respondents (92%) were familiar with DHPCs, with one significant difference between the professions: pharmacists were more familiar than GPs in Italy (99 vs 90%,
P
= 0.004). GPs’ awareness ranged from 96% for the diclofenac issue to 70% for the ivabradine issue. A similar pattern was shown for pharmacists (91% aware of the diclofenac issue to 66% of the ivabradine issue). Cardiologists’ awareness ranged from 91% for the ivabradine issue to 34% for the valproate issue. Overall, DHPCs were a common source through which GPs (range: 45% of those aware of the contraceptives issue to 60% of those aware of the valproate issue), cardiologists (range: 33% for the contraceptives issue to 61% for the valproate issue), and pharmacists (range: 41% for the contraceptives issue to 51% for the ivabradine issue) had become aware of the specific safety issues, followed by information on websites or in newsletters.
Conclusions
GPs, cardiologists, and pharmacists were to a similar extent (highly) familiar with DHPCs, but they differed in awareness levels of specific safety issues. Cardiologists were less aware of safety issues associated with non-cardiology drugs even if these had cardiovascular safety concerns. This implies that additional strategies may be needed to reach specialists when communicating safety issues regarding drugs outside their therapeutic area but with risks related to their field of specialisation. DHPCs were an important source for the different professions to become aware of specific safety issues, but other sources were also often used. NCAs should consider the use of a range of sources when communicating important safety issues to HCPs.
Escitalopram, the active enantiomer of the selective serotonin reuptake inhibitor (SSRI) citalopram, has effects in animal models for the detection of antidepressant and anxiolytic effect and in ...patients with major depressive and anxiety disorders. In the present study, the effects of escitalopram in the dorsal periaqueductal grey (dPAG) stimulation model of panic anxiety were investigated and compared to a number of clinically used anti-panic agents. The SSRIs, citalopram (ED
50 6.6
mg/kg), fluoxetine (ED
50 13.6
mg/kg), paroxetine (ED
50 2.9
mg/kg) and the benzodiazepine ligand, alprazolam (ED
50 0.3
mg/kg) all reduced the flight-like escape behaviour produced by electrical stimulation of the dPAG in the rat, this is presumed to indicate a reduction in fear and/or physical sensation and is interpreted as an anti-panic effect of the drugs. Escitalopram (ED
50 3.1
mg/kg) also significantly reduced flight behaviour indicating the anti-panic potential of the compound; it is suggested that escitalopram will be twice as potent as citalopram in this context.
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