Can adverse drug reactions be detected earlier? A comparison of reports by patients and professionals

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Abstract
A telephone medicines information service was started in 1990 by the Dutch Ministry of Health and the Royal Dutch Association for the Advancement of Pharmacy to promote the correct use of drugs and identify problems related to drug use. Anonymously and free of charge, patients can consult a pharmacist. The pharmacist summarises each call on a standard form. All reports produced by the service in 1992-4 were searched for those indicating an adverse reaction associated with the antidepressant paroxetine. This drug was introduced just before the study (September 1991) and has been prescribed in considerable volume. The time lag between marketing of paroxetine and the date of the phone calls was calculated and compared with the time lag between marketing of paroxetine and the date of suspected reactions reported by health professionals to the Netherlands Pharmacovigilance Foundation. This is a typical spontaneous adverse drug reaction reporting system, which in 1994 covered a population of about two million people in seven regions of the Netherlands. We analysed separately the time lag in both systems for those drug reactions that were not mentioned in the patient information leaflet at the time of the study.